Bipolar disorder

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Normally, how happy or sad we feel is connected to events in our lives - achievements and rejections, love found and loved ones lost. But in people with mood disorders, these emotions take on a life of their own often unrelated to circumstance. Mood has been described as our emotional temperature. With mood disorders, we lose the ability to regulate that temperature.

Bipolar disorder, once known as manic-depressive illness, is a mood disorder. People with the condition cycle through changes in mood that are - just as the name suggests - at opposite ends of a spectrum. The "up" part of the cycle is called mania. Untreated, mania can last months, even years. In its milder form, it can be pleasant. People feel wonderful - exuberant, energetic, optimistic. They're charming, outgoing, and talkative. They believe their thinking is sharper and more creative - and sometimes it is.

But manic episodes tend to crescendo. Self-confidence changes into grandiosity as people imagine they have special talents and can achieve unrealistic fame and fortune. The nimble thinking accelerates into racing, jumbled thoughts. Some people lose touch with reality and hallucinate or have delusions.

Mania is sometimes depicted as a happy state of mind, but full-fledged episodes can be miserable. People often become tense, irritable, and angry as mania takes hold.

Mania also unleashes reckless behavior; a shopping spree is the classic example. In An Unquiet Mind, psychologist Kay Redfield Jamison's memoir of her struggles with bipolar disorder, Jamison writes about purchasing 12 snakebite kits in a mania-fueled moment of safety-consciousness.

Such sprees may seem harmlessly odd, but they can land people disastrously in debt if they spin out of control. Mania can also lead to sexual indiscretions and hasty, ill-advised marriages as well as the breakup of established ones.

Depressive side of the coin

Because mania is the hallmark of bipolar disorder, the depressive episodes sometimes get overlooked. But in reality, people with bipolar disorder spend much more time depressed than manic. Years of depression may go by between manic episodes.

The depression experienced by people with bipolar disorder is similar in many ways to any other significant depression. People struggle with poor self-esteem, concentration, and making decisions. But some research suggests that the depression of bipolar disorder is distinctive. Bipolar depression may lead to excessive sleep and overeating, whereas in regular depression, insomnia tends to be the problem. Bipolar depression may come on more abruptly than normal depression, and a study published in 2006 found that fears were more common.

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