Bipolar Disorder

Bipolar cycles are often seasonal.

The synonymous terms “bipolar” and “manic depressive” have entered the popular lexicon, and in truth they are thrown around too casually by laypeople. Just because someone is feeling down one day and excitable the next does not make them bipolar; in fact, the up/down mood states usually cycle gradually from one extreme to the other over several months, with periods of wellness in between. The condition is marked by devastatingly depressive lows and maniacal highs.

An increasing number of children are being diagnosed as bipolar.

A study published in September 2007 held a shocking statistic: In the nine years between 1994 and 2004, the number of people under the age of 20 diagnosed with bipolar disorder leapt from 20,000 to 800,000—a 40-fold increase.

The numbers prompt both alarm and controversy. Are instances really increasing that rapidly, or are psychiatrists being overly aggressive with the diagnosis? Do we even know if symptoms seen in children indicate the same mental illness those symptoms represent in adults?

The criteria defining bipolar disorder in children are still evolving.

Dr. Carolyn Robinowitz, president of the American Psychiatric Association in Washington, D.C., acknowledges that the diagnostic criteria continue to evolve as we study the young people affected. She notes that the subject, and the controversy mentioned above, elicits a “subtle stigma” about psychiatric diagnoses.

“When we see more youngsters having diabetes, we don’t question whether there are misdiagnoses or if the right levels of blood sugars are being used… but the blood-sugar level for pre-diabetes has changed as we learn more about who goes on to be diabetic,” Robinowitz says. “I think we’re in that stage in the diagnosis of bipolar disorder—the more we can treat mental illnesses as we treat other illnesses, the greater will be our understanding.” Robinowitz hopes more information will also yield better funding for long-term research of appropriate medications for kids.

Patients may have delusions and hallucinations at each extreme.

For example, when depressed someone with bipolar depression may believe he/she has committed a heinous crime, and when manic that he/she has supernatural powers. In a “mixed bipolar state,” the person can feel agitated and even suicidal while at the same time feeling tremendously energized.

Hallucinations have been known to affect all five senses. Patients have reported seeing auras around other people, hearing music in a silent room, experiencing unpleasant tastes and smells that come from nowhere, having the sensation of being touched, and even receiving messages from God. Sometimes medications prescribed for the disorder are responsible for milder visual and auditory hallucinations.

Electric shock therapy is an aggressive but effective treatment.

Known clinically as electroconvulsive treatment, or ECT, this therapy is believed to work by causing a momentary seizure via electric shock. The goal is to alter brain chemistry so that neurotransmitters can better deliver their messages from one brain cell to the next.

ECT suffers an image problem—the mere term “electric shock” brings to mind a doctor infinitely more psychotic than the patient attaching electric cables to someone’s head. Dr. Jefferson Prince, a child psychiatrist at Massachusetts General Hospital at Harvard Medical School, offers a sober and less cinematic view.

“There’s a lot of bias against ECT, but it is among the best treatments we have for affective illnesses,” says Prince. “In the pediatric group we don’t use it much, but in adults we’ve used it and it’s done in a very humane way now. Unfortunately, people often associate it with inhumane treatments used previously, like insulin shock therapy and lobotomy… but if you have a really sick family member with a terribly psychotic depression or mania, ECT is sometimes the best treatment.”

Confused by health myths and misinformation? Each week, Rich Maloof talks to leading health experts to bring you the straight facts on a broad range of health topics.

Take a Closer Look at Health Myths and Misconceptions :

Rich Maloof is a regular contributor to MSN Health & Fitness. He specializes in health as well as technology and music. Rich has also written for CNN, Yahoo!, Women's Health, Billboard and the “For Dummies” book series.