Bipolar Disorder, also known as manic-depressive illness, is a mental illness characterized by extreme mood swings that include mania, or extremely 'high' and 'low' moods, as well as major depression.

These moods influence all aspects of behavior and thinking. Sleep and appetite may be affected. Likewise, attitudes about oneself and one's confidence about the future may be altered to the point where they no longer reflect reality.

Extreme moods occur in discrete episodes. Between the episodes, a person with Bipolar Disorder may be free of symptoms.

The frequency of episodes will vary throughout the course of the disorder, generally because of variations in the duration of the symptom-free periods. The duration of the symptom-free periods usually decreases with each occurrence of symptoms.

Some people develop what is termed rapid cycling, which is defined as four or more episodes a year. Rapid cycling occurs most often later in the course of the illness. Sometimes, symptoms of depression and mania occur together, a situation known as a "mixed state."

Specialists recognize several types of Bipolar Disorder, based on the intensity of manic episodes. The general diagnostic features for all forms of the disorder, however, are the same.

Features of 'mania' and 'major depression'

About one in 100 people suffers from the most severe form of Bipolar Disorder (Bipolar I); another one in 100 suffers from milder forms. Those figures make Bipolar Disorder quite common in comparison to the disorders the public often hears about in connection with genetics.

Cystic fibrosis, for example, occurs in about one in 2,000 Caucasians and is even less common among African-Americans and Asians. Sickle cell disease affects about one in 500 African-Americans, and Huntington's disease, which has received much media attention, affects about one in 20,000 people.

As the frequency of Bipolar Disorder might lead you to suspect, its financial toll is significant annually in medical costs and lost productivity. Of course, the human toll on affected individuals and those close to them has no price tag. But it is equally devastating because this illness so often results in family disruption, alcohol and drug abuse, and a successful suicide rate of about 10 percent to15 percent of those who are ill.

Bipolar Disorder may occur at any time, but the average age at onset is about 30 years. The nature of Bipolar Disorder in young children is now an active area of investigation. Unlike major depression (a similar disorder, but without mania), which is more than twice as common in women, the incidence of Bipolar Disorder is equal in men and women.

Treatment varies, but generally involves a combination of counseling and medications. The numerous medications now in use are effective for many people. Other people, however, show only limited improvement in symptoms. Individual genetic variations probably influence the effectiveness of medications from one person to the next.

While there is no cure, treatment programs can often be very effective.

Mania

Mania Defined: A manic episode is accompanied by at least three of the following seven symptoms:

Feelings of grandeur or inflated self-esteem

Diminished need for sleep

Being extremely talkative

Sensing that thoughts and ideas are racing

Being easily distracted

Increased productivity and/or activity at work, at school or in social situations

Excessive involvement in high-risk activities that are likely to have painful consequence (such as extramarital affairs or unsound business deals).

Depression

Major Depression Defined: A person is suffering a major depressive episode if they exhibit either the first or second of the following nine symptoms, along with four others, for more than a two week period:

Depressed mood with overwhelming feelings of sadness and grief

Loss of interest and pleasure in activities formerly enjoyed

Insomnia, early morning waking, or oversleeping nearly every day

Noticeable changes in appetite and weight (significant loss or gain)

Inability to concentrate or think; indecisiveness

Physical symptoms of restlessness or being slowed down

Feelings of guilt, worthlessness, and helplessness

Recurrent thoughts of death and suicide; suicide attempts.