Bipolar 1 disorder, also known as manic depressive disorder, is the most serious type of bipolar disorder. People with this disorder go through cycles of manic and depressive episodes, but in between cycles, their behavior appears to be normal. A typical cycle can last from a few weeks to a few months, but some people have been known to cycle several times in one day. When someone is experiencing a manic episode, their mood is elevated to a level that is beyond normal. During a depressive episode, their behavior resembles that of someone who is clinically depressed. The signs and symptoms of this type of bipolar disorder usually appear during adolescence or in the early twenties, but they have been known to appear in early childhood. Those who are diagnosed with this disorder are almost always diagnosed before the age of fifty. Although the cause of this disorder remains unknown, experts have found the people who are closely related to someone with this disorder are at a much greater risk of developing it themselves.
The symptoms of bipolar 1 disorder will vary depending on the cycle that the person is in at the time. During a manic episode, their mood and self image will be abnormally elevated. Many people going through this cycle describe it as having a feeling of euphoria, like nothing can possibly go wrong. They may engage in dangerous behaviors that they normally would not, including large spending sprees, binge drinking, drug abuse, and sexual promiscuity. Often times, people in this cycle require medical attention in order to get their behavior under control, though they rarely seek treatment on their own.
During a depressive episode, people with this disorder take on the characteristics of someone with clinical depression. They experience feelings of worthlessness, guilt, and sadness and have a low energy level. They generally do not enjoy life and may even become suicidal. This cycle can last for several weeks, months, or even years. It is during this cycle that the individual normally seeks treatment.
Diagnosis and Treatment
To date, there are no laboratory tests that can diagnose this disorder. If it is suspected, the patient will be referred to a psychiatrist who has experience in diagnosing it. Lab tests may be done to rule out any possible medical reason for the behaviors exhibited. Once everything else has been ruled out, a trained psychiatrist will perform diagnostic tests in order to properly diagnose the disorder.
Once a diagnosis has been made, there are several treatment options available. Lithium is commonly used as a first line of treatment because it is an effective mood stablizer. While antidepressants are also effective, they can initially make the symptoms of mania worse, so they are usually not given until the patient is more stable. Depakote, a medication often used in the treatment of epilepsy, is also a common drug used in people with this disorder because it can quickly treat sudden episodes of mania and can also help in preventing such episodes. Antipsychotic drugs like Ablify, Saphris, and Zyprexa are also options that work well in treating and preventing episodes of mania, while also treating the depression associated with the disorder. In rare cases, medications may not be effective methods of treatment and more drastic measures are needed. In these cases, electroconvulsive therapy may be necessary in order to properly treat the disorder.
WebMD: Bipolar 1 Disorder
National Institude of Mental Health: Bipolar Disorder