Bipolar Disorder affects both men and women, young and old, from all races and backgrounds. Bipolar Disorder is in the same family of illnesses (called "affective disorders") as clinical depression. However, unlike clinical depression which appears more frequently in women than in men, Bipolar Disorder appears to affect both men and women in equal numbers.

The origins of Bipolar Affective Disorder are biological, yet the person with Bipolar Disorder will experience it to be psychological in nature. Bipolar Disorder is very contradictory in that it gives its victim advantage and pleasure, yet it follows up with near overwhelming suffering and discord. There is currently no known cure for Bipolar Disorder. Most patients do show signs of improvement with the proper medication, coupled with therapy and education. Most people with Bipolar Disorder are able to lead close to normal, relatively productive lives as long as they continue to treat their illness.

The textbook definition of Bipolar Disorder is: "One or more Manic or Hypomanic Episodes, accompanied by one or more Major Depressive Episodes. These episodes typically happen in cycles."

In simpler terms, Bipolars have mood swings ranging from grand elation and euphoria, to devastating lows and dispair. Most people with Bipolar Disorder experience periods between that can be described as normal or balanced. Now you may argue that everyone feels these ups and downs, does that mean that everyone has Bipolar Disorder? No! For most people the emotional ups and downs are the direct effects of happy or sad moments in their lives. For the person with Bipolar Disorder those ups and downs do not always coincide with happy or sad moments. Oftentimes the ups occur during very troubled times and the downs occur during times of great happiness. These ups and downs can rapidly cycle throughout the day, or they can last for days and weeks.

Bipolar Disorder is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. It is distinguished from Schizoaffective Disorder by the absence of psychotic symptoms (such as delusions, halucinations) during periods of stable mood.

Bipolar Disorder is really a spectrum of disorders. Bipolar I disorder is characterized by a history of at least one manic episode, and (usually) depressive episodes. Bipolar II disorder is characterized by hypomanic episodes alternating with depressive episodes. Cyclothymia is characterized by highs which fulfil some but not all criteria for hypomania and lows which fulfil some but not all criteria for depression.

Some psychiatric disorders are very difficult to diagnose accurately. One of the most confusing conditions is schizoaffective disorder. This relatively rare disorder is defined as "the presence of psychotic symptoms in the absence of mood changes for at least two weeks in a patient who has a mood disorder." The diagnosis is used when an individual does not fit diagnostic standards for either schizophrenia or "affective" (mood) disorders such as depression and bipolar disorder (manic depression).

Some people may have symptoms of both a depressive disorder and schizophrenia at the same time, or they may have symptoms of schizophrenia without mood symptoms.

Many individuals with schizoaffective disorder are originally diagnosed with manic depression. If the person experiences delusions or hallucinations that go away in less than two weeks when the mood is "normal," bipolar disorder may be the proper diagnosis. Someone who experiences psychosis for three or four weeks while in a manic phase does not have schizoaffective disorder. However, if delusions or hallucinations continue after the mood has stabilized and are accompanied by other symptoms of schizophrenia such as catatonia, paranoia, bizarre behavior, or thought disorders, a diagnosis of schizoaffective disorder may be appropriate. Accurate diagnosis is easier once the acute psychotic episode is under control.

Distinguishing between bipolar disorder and schizophrenia can be particularly difficult in an adolescent, since at that age psychotic features are especially common during manic periods.

Because Schizo-Affective disorder is so complicated, mis-diagnosis is common. Some people may be misdiagnosed as having schizophrenia. Others may be misdiagnosed as having bipolar disorder. And those diagnosed as having schizoaffective disorder may actually have schizophrenia with prominent mood symptoms. Or they may have a mood disorder with symptoms similar to those of schizophrenia.

What is the treatment for this disorder?

Psychiatrists often treat this disorder with an anti-psychotic medication and lithium, or with Carbamazepine (an anticonvulsant medication) and lithium. As a practical matter, differentiating between schizophrenia, bipolar disorder, and Schizo-Affective disorder is not absolutely critical, since antipsychotic medication is recommended for all three. If a mood problem is suspected, lithium or an antidepressant should be added.

What is the prognosis for those with this disorder?

The prognosis for individuals diagnosed with Schizo-Affective disorder is generally better than for those diagnosed with schizophrenia, but not quite as good for those diagnosed with a mood disorder. (Schizophrenia is a chronic brain disorder interfering with a persons' ability to think clearly, manage emotions, make decisions, and relate to others. Persons with schizophrenia may experience hallucinations and delusions. Mood disorders, including depression and bipolar disorder, are chronic illnesses in which the person's mood may return to "normal" between depressive or manic episodes.) Those with schizoaffective disorder generally respond to lithium better than those with schizophrenia, but not as well as those with mood disorders. More research is needed to fully understand this illness and why it resists conventional treatment. New medications may be developed to treat this disorder more effectively.

For further information please contact:

National Alliance for the Mentally Ill

200 N Glebe Road, Suite 1015

(800) 950-NAMI

National Mental Health Association

1021 Prince Street

Alexandria, VA 22314-2917

(800) 969-NMHA

National Depressive and Manic Depressive Association

730 North Franklin Street, Suite 501

Chicago, IL 60610

(800) 826-3632

This page was last updated on Oct-23-2008