Bipolar I Disorder is one of the most severe forms of mental illness and is characterized by recurrent episodes of mania and (more often) depression (5% of cases only experience the 'high').
The condition has a high rate of recurrence and if untreated, it has an approximately 15% risk of death by suicide. It is the 3rd leading cause of death among people aged 15-24 years, and is the 6th leading cause of disability (lost years of healthy life) for people aged 15-44 years in the developed world. Bipolar I Disorder affects both sexes equally in all age groups and its worldwide prevalence is approximately 3-5%. There are no significant differences among racial groups in the prevalence of this disorder. It can present in preschoolers, but the average age at onset is 21. More than 90% of individuals who have a single Manic Episode go on to have future episodes. Untreated patients with Bipolar I Disorder typically have 8 to 10 episodes of mania and depression in their lifetime. Often 5 years or more may elapse between the first and second episode, but thereafter the episodes become more frequent and more severe. There is significant symptom reduction between episodes, but 25% of patients continue to display mood instability or mild depression. As many as 60% of patients experience chronic interpersonal or occupational difficulties between acute episodes.
Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance. Family, twin and adoption studies suggest genetic factors. The concordance rate for monozygotic (identical) twins is 43%; whereas it is only 6% for dizygotic (nonidentical) twins. About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder (about half of these will have Bipolar I or II Disorder, while the other half will have Major Depressive Disorder). If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder. First-degree biological relatives of individuals with Bipolar I Disorder have elevated rates of Bipolar I Disorder (4%-24%), Bipolar II Disorder (1%-5%), and Major Depressive Disorder (4%-24%).
According to The Depression & Mood Disorders Association of NSW (DMDA)...
"When we're up...
we feel good, ready to save the world, creative, zappy, sexy, bossy, we spend money extravagantly, are over generous and overtalkative. We can become self-absorbed, irritable and agressive. Sometimes our relationships suffer. We stay up all night, stop eating, and race around until the whole thing gets spinning too fast and we might end up in hospital...crazy.
When we're down...
we feel tired and getting up in the morning is a tremendous effort. We have no self confidence, are not interested in sex and even simple tasks seem too difficult. We find it hard to concentrate and make decisions. Our attention slips. We feel a tremendous heavy sadness that never lifts: our face and body muscles may sag and we may look blank. Or we may be agitated, worried and anxious, unable to keep still. We need other people but feel that we are a nuisance and that we have nothing to offer them anyway. We may feel anxious about the future and filled with despair - suicidal and hospitalised...
and when we're neither up nor down we're just like anyone else!"
Learn about mania and hypomania
Learn about bipolar depression
Take a bipolar disorder self-test
An overview of the biochemical and genetic basis for mood disorders
Comprehensive overviews of bipolar disorder from the National Institute of Mental Health (US) or the American Academy of Family Physicians
An easy-to-read story about bipolar disorder
Children of Parents with a Mental Illness (COPMI)
Association of Relatives and Friends of the Mentally Ill (ARAFMI) is an organisation dedicated to carers of people with a mental illness, and provides support for carers and a 24 hour telephone information line: (02) 9805 1883 or Toll Free 1800 655 198 (NSW only) .
The Depression and Mood Disorders Association of NSW (DMDA)