BIPOLAR DISORDER TEST Bipolar disorder is a mental illness marked by extreme mood swings from high (mania) to low (depression) and low to high. The mood swings may even become mixed, so you might feel elated and depressed at the same time. Bipolar is not a rare diagnosis. More than 5 million people in the United States are living with some form of bipolar disorder. Symptoms tend to appear in a person’s late teens or early adult years, but they can occur in children as well. Women are more likely to receive bipolar diagnoses than men, though the reason for this remains unclear. Bipolar disorder can be hard to diagnose, but there are warning signs you can look for. What are the warning signs of bipolar disorder? Bipolar disorder may include the following warning signs. 7 signs of mania
feeling overly happy or “high” for long periods of time having a decreased need for sleep talking very fast, often with racing thoughts feeling extremely restless or impulsive becoming easily distracted having overconfidence in your abilities engaging in risky behavior, such as having impulsive sex, gambling with life savings, or going on big spending sprees
7 signs of depression
feeling sad or hopeless for long periods of time withdrawing from friends and family or losing interest in activities that you once enjoyed having a significant change in appetite feeling severe fatigue or lack of energy speaking slowly having problems with memory, concentration, and decision-making thinking about or attempting suicide, or having a preoccupation with death Suicide prevention If you think someone is at immediate risk of self-harm or hurting another person: Call 911 or your local emergency number. Stay with the person until help arrives. Remove any guns, knives, medications, or other things that may cause harm. Listen, but don’t judge, argue, threaten, or yell.
Types of bipolar disorder
Although there are four common types of bipolar disorder, there are two types that are most often diagnosed. Bipolar I This classic form of bipolar disorder used to be called “manic depression.” In bipolar I, manic phases are clear. The person’s behavior and moods are extreme, and their behavior quickly escalates until they’re out of control. The person may end up in the emergency room if left untreated. To have bipolar I, a person must have manic episodes. In order for an event to be considered a manic episod, it must:
include moods or behaviors that are unlike the person’s usual behavior be present most of the day, nearly every day during the episode last at least one week, or be so extreme that the person needs immediate hospital care.
Bipolar II Bipolar II is four times more common than bipolar I. It includes symptoms that are much less severe. These symptoms are called hypomanic symptoms. Bipolar II is harder for people to see in themselves, and it’s often up to friends or loved ones to encourage someone with this type to get help. Hypomania often becomes worse without treatment, and the person can become severely manic or depressed. Rarer types of bipolar There are two other types of the disorder that are less common than bipolar I and II. Cyclothymic disorder involves mood swings and shifts similar to bipolar I and II, but the shifts are often less dramatic in nature. A person with cyclothymic disorder can often function normally without medication, though it may be hard. Over time, a person’s mood swings may develop into a diagnosis of bipolar I or II. Bipolar disorder not otherwise specified is a general category for a person who only has some bipolar symptoms. These symptoms are not enough to make a diagnosis of one of the other three types. What bipolar disorder feels like Hear from real people who live with bipolar disorder. How is bipolar diagnosed? Bipolar disorder can be difficult to diagnose. Unless you have severe mania, the symptoms can be hard to spot. People who have hypomania may feel more energized than usual, more confident and full of ideas, and able to get by on less sleep. These are things that hardly anyone complains about. You’re more likely to seek help if you’re depressed, but your doctor may not observe the manic side then.
When doctors do suspect bipolar disorder, they may use a few different approaches to make the diagnosis:
a physical exam to rule out any other medical conditions that could cause your symptoms, such as thyroid disease a mental health evaluation, which may include a questionnaire and interviews with family members a mood-charting diary to keep track of your sleep patterns and daily moods
the Diagnostic and Statistical Manual of Mental Disorders, which can be used to compare your symptoms with the official description If you’re worried that you might have bipolar disorder, the best thing to do is educate yourself about mood disorders and their symptoms. Then share your list of symptoms with your doctor. It can be harder to address if you’re concerned about a friend or loved one having bipolar disorder. Ask for help from other friends or family members. People with bipolar disorder often deny any problems, especially during manic episodes. Think of bipolar disorder as you would any other serious disease, and get professional help right away. Bipolar and other illnesses People with bipolar disorder may have other psychological diagnoses,including obsessive-compulsive disorder, eating disorders, and substance abuse. The desire to medicate their bipolar with drugs or alcohol can put them at risk for substance abuse. Men are more likely to deal with substance abuse alongside their bipolar. Women most often experience thyroid disease, obesity, and migraines with bipolar. Approximately 1 in 5 people with a bipolar diagnosis also have borderline personality disorder. There are some similarities between the two disorders, but there are also many differences in the symptoms and causes. More research is needed to understand the relationship between them. How is bipolar treated? Once you have a diagnosis, your doctor will decide on a treatment program that works best for you. Bipolar treatment may include:
medication behavioral therapy substance abuse treatment electroconvulsive therapy
A licensed psychiatrist usually manages your treatment. You may also have a social worker, psychologist, or psychiatric nurse practitioner involved in your care.
Common prescriptions for people with bipolar include mood-stabilizing drugs. Mood stabilizers, such as those containing lithium and valproic acid (Depakene), will help with manic episodes. If mood stabilizers are not enough to improve a person’s quality of life, a doctor may next prescribe antidepressantantipsychotic drug combinations such as fluoxetine-olanzapine (Symbyax). Treatment for bipolar must be ongoing. When people stop taking medication or meeting with their doctor, they will likely have manic and depressive episodes again. However, with the proper treatment, bipolar disorder can be controlled and a person can lead a healthy and productive life. Overview Bipolar disorder can be one of the most distinct and dramatic of mental illnesses. It is characterized by intense episodes of elation or irritability and despair, with any combination of mood experiences in between, including periods of normal moods. Mood changes are accompanied by changes in behavior, such as altered patterns of sleep and activity. Traditionally, one percent of the population has been affected by bipolar disorder, but as the condition has expanded to include a spectrum of proposed bipolar conditions, this number has risen to an estimated 2.6 to 6.5 percent. According to the World Health Organization, bipolar disorder is the sixth leading cause of disability among people aged 15 to 44. It is less common than major depression, also called “unipolar” depression, or simply, “depression.” The classic form of bipolar disorder, which involves recurrent episodes of mania and depression, is called bipolar I disorder. Some people, however, never develop severe mania but instead experience milder episodes, called hypomania, that alternate with depression; this form of the illness is called bipolar II disorder. In addition, there are two other forms of bipolar disorder: bipolar disorder not otherwise specified (BP-NOS) and cyclothymic disorder, or cyclothymia. BP-NOS is reserved for cases where people have symptoms of bipolar disorder that do not meet all the diagnostic criteria for bipolar I or II. Cyclothymia is a mild form of bipolar disorder where people have episodes of hypomania that shift back and forth with mild depression for at least two years. The symptoms of cyclothymia also do not fit into the diagnostic criteria for bipolar I or II. Studies show that men and women are equally likely to develop bipolar disorder; however, there is some evidence that women may have more depressive and fewer manic episodes than men with the illness. Women seem to have “mixed states” (mania or hypomania occurring at the same time as depression) more often than men. Also, women are more likely to have the rapid cycling form of the disease, which is characterized by four or more episodes of depression, mania or hypomania a year, and may be more resistant to standard treatments. Women are also more likely to have bipolar II disorder.Bipolar Disorder The symptoms of bipolar disorder can be severe and debilitating. Bipolar disease is not curable. However, medication can help many people achieve remission of symptoms. Treatment and maintenance of this disorder is necessary throughout a person’s life once bipolar disorder is diagnosed.
Like some other illnesses that require lifelong treatment, bipolar disorder poses unique medical challenges for women with the disorder who are pregnant or considering pregnancy. The notion that pregnancy itself is protective for women with bipolar disorder is not true. The risk of recurrence of either depression or mania during pregnancy and postpartum is high. A recurrence during the postpartum period often develops as postpartum psychosis. These risks are high for women who stop their moodstabilizing medications and even higher for women who stop these medications abruptly. So a woman with bipolar disorder who wants to become pregnant should discuss her treatment options with her health care team before conception, if possible, or as early in her pregnancy as possible. Concerns exist about the potential harmful effects mood-stabilizing medications used to treat bipolar disorder may have on the developing fetus and the nursing infant. However, these concerns need to be weighed against the potential serious risks that an episode of mania or depression may pose to the developing fetus, infant or mother. Diagnosis Bipolar disorder, also known as manic depression, generally strikes in late adolescence or early adulthood, most often between the ages of 15 and 30, and usually continues throughout a person’s life. However, some people develop their first symptoms in childhood and others don’t develop them until later in life. Researchers theorize that there are a number of contributing factors for why and how someone develops bipolar disorder, including a genetic predisposition, environmental influences and brain chemistry. According to the National Institute of Mental Health (NIMH), close relatives of people suffering from bipolar illness are four to six times more likely to develop bipolar disorder than the general population. It is important to note, however, that not everybody with a family history develops the illness. No one gene has been identified for the disorder, but it appears likely that many genes act together and in combination with other factors in the person or the person’s environment to cause bipolar disorder. Studies of identical twins who share the same genes show that a person who has an identical twin with bipolar disorder is more likely to develop the disorder than someone who has a sibling with the illness, indicating that genes are definitely involved. However, an individual who has a twin with bipolar disorder will not always develop the illness, indicating that genes and other factors both play a role. Studies suggest that stress, difficulty at work or interpersonal relationships may trigger episodes in those with bipolar disorder, particularly if the stress causes loss of sleep. The theory is that stress and/or loss of sleep precipitates changes in brain chemistry in susceptible people. Behaviors and moods common to bipolar disorder may initially be attributed to other medical problems, or other mental illnesses, which can delay an accurate diagnosis and appropriate treatment. For example, many people with bipolar disorder are misdiagnosed with major depression. In addition, alcohol and drug abuse and/or difficulties with work and school performance may be identified, but their
underlying cause—bipolar disorder—may not be diagnosed. However, the disorder is not difficult to diagnose by a well-trained clinician. Bipolar disorder is diagnosed based on an evaluation of symptoms, the course of the illness and family history. To be diagnosed with bipolar disorder, a person must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), published by the American Psychological Association. In addition to a psychiatric evaluation, a complete medical exam should be completed. A physical exam and blood tests can rule out medical conditions that can mimic or worsen bipolar disorder. Physical tests, such as a blood test or brain scan, cannot conclusively identify the illness, although progress is being made in these areas. For example, brain-imaging studies using magnetic resonance imaging (MRI), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) procedures allow researchers to take pictures of the brain to examine its structure and activity. These noninvasive techniques are beginning to help scientists learn what goes wrong in the brain to produce bipolar disorder as well as other mental illnesses. Symptoms The symptoms of bipolar disorder fall into several categories: depression, mania and mixed state type of episodes (in mixed episodes, symptoms of both depression and mania are present at the same time). In addition, people experiencing any of these types of mood episodes may experience psychosis, which is a serious inability to think and perceive clearly, or losing touch with reality. If you or a family member experiences any of these symptoms, you should discuss them with a health care professional and request a thorough evaluation, which should include a physical checkup and a family health history. The symptoms of depression include:
constant or persistent sadness loss of pleasure and interest in activities that were once fun, including sex significant change in appetite or weight (either increase or decrease) restlessness or agitation irritability or excessive crying change in sleep patterns, either oversleeping or insomnia lack of energy, feeling slowed down mentally and physically feelings of guilt, worthlessness, helplessness, hopelessness persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain difficulty thinking or concentrating recurring thoughts of death or suicide
The symptoms of mania include:
persistent and abnormally elevated mood (euphoria) irritability overly inflated self-esteem or feelings of importance
a decreased need for sleep increased talkativeness racing thoughts increased activity, including sexual activity distractibility increased energy and/or physical agitation excessive involvement in risky behaviors, such as spending money irresponsibly poor judgment inappropriate social behavior
Significant disruption in your sleep-wake cycle is an early warning sign of an impending episode. Controlling your sleep-wake cycle and maintaining a regular pattern is critical to avoid making the illness worse. Decreased and disrupted sleep occurs frequently for new mothers. It is important for women with bipolar disorder who are pregnant or considering pregnancy to talk with their health care providers about ways to reduce their sleep disruptions after giving birth. Other symptoms of manic depression include psychosis, which involves hallucinations and delusions (falsely believing in something with conviction, despite proof or evidence to the contrary). Mixed state episodes include symptoms of both depression and mania, often including agitation, trouble sleeping, change in appetite, psychosis and thoughts of suicide. Symptoms of mania, depression or mixed state are episodic and typically recur. Episodes may become more frequent with age if the condition isn’t properly treated. These episodes, especially early in the course of the illness, are separated by periods of wellness, when someone suffers few or no symptoms. Women with bipolar syndrome are more likely to experience psychosis and manic episodes during pregnancy and after giving birth. This risk is higher for women who stop their mood-stabilizing medications and even higher for women who stop these medications abruptly. The combinations and severity of symptoms vary from person to person. Some people have severe manic episodes in which they feel out of control, have tremendous difficulty functioning and severe psychosis. Other people have milder “hypomanic” episodes that include increased energy, euphoria and irritability. Some suffer completely incapacitating periods of depression and are unable to function within their normal daily routine. Hospitalization is necessary to treat severe episodes of mania or depression. If you have bipolar disorder, you may have difficulty acknowledging your mood swings even if family and friends tell you about these behaviors. During a manic episode, you might abuse alcohol, schedule too many events or meetings for one day, drive recklessly, go on a spending spree, make unwise or risky business decisions or be unusually promiscuous sexually. Untreated, the manic phase can last from days to months. As it fades, a period of normal mood and behavior may occur. Sometimes the depressive phase of the illness then sets in, but another manic episode could also follow.
When you’re experiencing a depressed episode, you might lose complete interest in everything you used to enjoy, not be able to stop crying, feel completely hopeless and contemplate suicide. In some people, depression occurs immediately after a manic episode or within the next few months. But with others, there is a long interval before the next manic or depressive episode. The depressive phase has the same symptoms as major depression (also called “unipolar” depression). People with bipolar disorder may have abnormal thyroid gland function. Because too much or too little thyroid hormone alone can lead to mood and energy changes, it is important that your health care professional closely monitor your thyroid levels. Additionally, if you’re treated with lithium, that may cause low thyroid levels. Treatment If you have bipolar disorder, you will need lifelong treatment. Regular monitoring and consultation with a health care professional is necessary to establish which medication or combination of drugs works best. Medications called “mood stabilizers” are most often prescribed to help control bipolar disorder, and several types of mood stabilizers are available. In general, people with bipolar disorder continue treatment with mood stabilizers for an extended time to manage their illness, usually for years. Other medications are sometimes combined with mood stabilizers when necessary to treat powerful episodes of mania or depression that may break through despite the mood stabilizer. These additional medications may include: an antipsychotic for psychosis or mania; an antidepressant for depression; and/or a benzodiazepine for agitation. For nearly 40 years, the mood stabilizer lithium has been one of the main treatments for people with bipolar disorder. Lithium evens out moods so you don’t feel as high or as low, but it’s unclear exactly how the medication works in the brain. Lithium is not used just for manic attacks, but rather as an ongoing treatment to prevent all types of episodes. It can take up to three weeks to start reducing severe manic symptoms. It might take a few months of medication before the illness is under control. When taken regularly, lithium can effectively control depression and mania and reduce the chances of recurrence. However, while it is effective treatment for many people, it doesn’t work for everybody. Regular blood tests are a must if you’re taking lithium. The level of lithium in your blood can be measured with a blood test. This level is used by your doctor, along with your symptoms, to determine the appropriate dose of lithium for you. Too small a dose might not be effective and too large might produce unwanted side effects, including weight gain, tremors, excessive thirst and urination, drowsiness, weakness, nausea, vomiting and fatigue. Salt intake also affects the amount of lithium in your body. A dramatic reduction in salt intake, excessive exercise and sweating, fever, vomiting or diarrhea may cause lithium to build up in your body to toxic levels. An overdose of lithium can cause confusion, delirium, seizures, coma and may result, although rarely, in death.
In addition to lithium, other mood stabilizers used in the treatment of bipolar disorder include anticonvulsants. They may be combined with lithium or with each other for maximum effect. Specific ones used for bipolar syndrome include:
Anticonvulsants. Antiseizure medications (also called anticonvulsants) such as valproic acid (Depakene) and divalproex (Depakote) can have a mood-stabilizing effect in people with bipolar disorder. There is some evidence that valproic acid may result in hormonal changes in teenage girls and polycystic ovarian syndrome (PCOS) in women who began taking the medication before age 20. Young women should discuss this risk with their health care professionals, and those taking valproic acid should be monitored carefully for possible hormonal problems.The anticonvulsants carbamazepine (Tegretol) and oxcarbazepine (Trileptal) also have some effects as mood stabilizers, although they are not yet approved for bipolar disorder by the U.S. Food and Drug Administration (FDA). At this point, there is more evidence on the effectiveness of Tegretol than Trileptal.And the anticonvulsant lamotrigine (Lamictal) is FDA-approved for the long-term treatment of adults with bipolar disorder. It is specifically used to treat the depressive episodes involved with bipolar disorder.Some anticonvulsants can decrease the effectiveness of hormonal contraceptives, such as birth control pills. It is important to discuss your method of contraception with your health care provider to determine if there is an interaction.
Severely ill patients may require a combination treatment with mood stabilizers and other drugs, including:
Antidepressant medications. Several classes of antidepressant medications are sometimes used to treat the depressive symptoms of bipolar disorder, including fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and bupropion (Wellbutrin). However, the use of antidepressants in people with bipolar disorder is controversial, since antidepressants may not be any more effective than mood stabilizers at treating depressive episodes in people with bipolar disorder and can trigger manic episodes. Make sure you tell your health care professional about any prior symptoms of hypomania or mania (episodes that include increased energy, euphoria and irritability) before beginning antidepressants.Side effects and effectiveness differ for each class of antidepressant, as well as for the individual brands. Antipsychotics. If you’re experiencing psychotic or manic symptoms during an episode of bipolar disorder, health care practitioners will sometimes prescribe antipsychotic medicine alone or in combination with a traditional mood stabilizer to control symptoms.Olanzapine can also be used alone for the treatment of bipolar disorder.Examples of antipsychotics used include: olanzapine (Zyprexa), ziprasidone (Geodon), quetiapine (Seroquel), aripiprazole (Abilify) and risperidone (Risperdal), all FDA-approved for the treatment of bipolar disorder.In addition, antianxiety medications such as benzodiazepines may be used in some people with bipolar disorder with acute mania to help with sleep. There is a potential for abuse of or physical dependence on benzodiazepines. Therefore, these medications are often prescribed only for a limited time, such as during an acute episode.
Be patient. It may take up to three weeks of regular use of a new drug before your symptoms improve or subside. Stay in close communication with your health care professional and let him or her know if you don’t feel like you are responding to treatment. In some cases, treatment plans need to be changed to effectively control symptoms. Electroconvulsive therapy (ECT) is another treatment option for bipolar disorder and other types of major depression. It is usually only used to treat bipolar disorder when medication, psychosocial treatment or the combination of these treatments are ineffective or work too slowly to relieve severe symptoms such as psychosis or thoughts of suicide. ECT may also be considered when certain medical conditions, such as pregnancy, make the use of medication too risky. Just prior to ECT treatment, you’re given a muscle relaxant and sometimes general anesthesia. Electrodes are then attached to your scalp. An electric current causes a brief convulsion. Treatments usually last for 30 to 90 seconds. You won’t remember the treatments and will probably awake slightly confused. You will most likely recover in five to 15 minutes and be able to go home the same day. Acute treatments usually occur three times per week for about a month. Maintenance treatments may be given after that at a reduced frequency. ECT has been used for more than 70 years and has been refined since its early introduction as a treatment for depression. According to Mental Health America , ECT is administered to an estimated 100,000 people a year, primarily in general hospital psychiatric units and in psychiatric hospitals. Researchers don’t understand exactly how it works to improve symptoms of depression and/or mania in some individuals, but the evidence is clear that it does work. Although myths and negative perceptions continue to be perpetuated about ECT, it is a very effective treatment for many people with severe depressive, manic or mixed episodes who don’t respond to or have bad effects from other treatments or can’t take other treatments for some reason. Research has shown that patients who receive ECT followed by maintenance lithium therapy have better outcomes than patients who receive lithium alone. As with all other treatments, you should undergo a complete physical evaluation before beginning ECT therapy. Side effects can include permanent memory loss and confusion. These side effects were more of a concern in the past, and modern ECT techniques have reduced them significantly. However, the benefits and risks of ECT should still be carefully weighed before an individual or his or her family and friends decide to go with the treatment. Psychotherapy. As with all mental illnesses and other serious conditions, bipolar disorder can devastate a person’s selfesteem and relationships, especially with spouses and family. Without treatment, people with the illness may jeopardize their finances, their careers, their families and their lives. Thus, in addition to treatment
with medications, psychotherapy (“talk therapy”) is also recommended for individuals with the disorder, as well as for their family members. Bipolar Disorder and Pregnancy Women with bipolar disorder who want to become pregnant need to consider several issues. Careful planning for pregnancy can help women with bipolar disease best manage their illness while avoiding risks to their babies. The goal is to maintain a stable mood during pregnancy and postpartum. It is extremely important to consider both the risks of the medications to the unborn baby, as well as the risks of untreated bipolar disorder to both the mother and unborn baby. These should be weighed carefully in a thorough discussion with your health care provider. After discussing risks and benefits with your health care professional, if you prefer not to use medication during pregnancy, a trial off medications (following a gradual taper) prior to pregnancy, possibly only stopping medications after conception, might be an option. Most health care professionals suggest avoiding sudden changes in medication during pregnancy, which can increase the risk of relapse. Overall, studies show that taking only one mood stabilizer during pregnancy poses less of a risk to the developing fetus than does taking multiple medications. Some anticonvulsants have been shown to be harmful to fetuses, possibly leading to birth defects. However, rates of problems vary widely based on the medication. Discuss possible medications and their risks with your health care professional and always weigh this against the risk of untreated bipolar disorder. Some of these medications can be used while breastfeeding but all options should be discussed with your health care professional. Overall, if you are pregnant or planning to become pregnant and you have bipolar disorder, be sure to discuss safety of various treatment options during and after pregnancy with your health care professional. ECT has also been used for decades (with appropriate adjustments) in pregnancy to treat severe mania or depression. Prevention Patients and their families need to understand that bipolar disorder will not go away, and there is no way to prevent the disorder from developing. The only way to keep the disorder under control is through continued compliance with treatment. Facts to Know
Bipolar disorder involves episodes of mania and depression. Traditionally, one percent of the population has been affected by bipolar disorder, but as the condition has expanded to include a spectrum of proposed bipolar conditions, this number has risen to an estimated 2.6 to 6.5 percent. According to the World Health Organization, bipolar disorder is the sixth leading cause of disability among people aged 15 to 44.
Most people with bipolar disorder can expect that even their most severe mood swings will be relieved with treatment. Like other serious illnesses, bipolar disorder is not only difficult for the person who has it but also hard on family members, friends and employers. Family members of people with bipolar disorder often have to cope with serious behavioral problems (such as wild spending sprees) and the lasting consequences of these behaviors. Bipolar disorder generally strikes between the ages of 15 and 30. Bipolar disorder tends to run in families, and many researchers believe it is genetic. Researchers, however, have not associated a specific genetic defect with the disease. Not everybody with a family history of manic depression develops the illness. Studies suggest that stress, difficulty at work or with interpersonal relationships may trigger episodes in people with bipolar disorder, particularly if the stress causes loss of sleep. Lithium has been the treatment of choice for people with bipolar disorder but doesn’t work for everyone with the disorder. Other effective treatment options are available. Bipolar disorder can get worse during and after pregnancy. Because of potential risk to the developing fetus due to both untreated illness as well as some medications, the disease must be carefully treated by a health care professional during this time.
Key Q&A 1. What is bipolar disorder?Also called manic depressive illness or manic depression, this mental illness is characterized by episodic mood swings that range from overly “high” and/or irritable to sadness and hopelessness, and then back again, with periods of normal mood in between. 2. Who usually is affected by bipolar disorder?Men and women are equally likely to develop the condition, usually between the ages of 15 and 30. However, research has shown that women are more likely than men to develop the rapid cycling form of the condition—with episodes occurring four or more times within a 12-month period. Most often, symptoms begin between age 15 and 30. Research has shown that there is a genetic component to the disorder and that people with a close relative with bipolar disorder are four to six times more likely to develop it than people with no family history. 3. Can the disorder be effectively treated?Yes. For nearly 40 years, lithium has been the treatment of choice for people with bipolar disorder. It levels out mood swings so that patients don’t feel as high or as low and is used as an ongoing treatment. Symptoms may diminish after one to three weeks of treatment, but it might take a few months of medication to control the illness. Newer drugs developed for the disorder, used alone or in combination with lithium, are also prescribed. 4. Can bipolar disorder be cured?No. Treatment for the illness in considered lifelong. Ongoing maintenance and periodic consultation with a knowledgeable health care professional is typical. 5. What if I can’t tolerate lithium?There are a number of other effective treatments. Your health care professional might prescribe several medications including both antidepressants and anticonvulsant medications. However, it may take several months to determine the proper medication, dosage and frequency. For more information visit us our website: http://www.healthinfi.com