Bipolar Disorder (BD) is a treatable mood disorder that affects approximately 4 percent of the U.S. population with equal prevalence among women and men (including all subtypes: BD I, BD II and BD not otherwise specified). BD is characterized by extreme shifts in energy, behavior and mood cycling between the “highs” of mania or hypomania to the “lows” of depression. BD episodes may also present as a mix of high energy and low mood states (i.e., mixed mania) in which some will experience agitation, anger or rage as well as depressive symptoms.
Manic and depressive episodes consist of multiple symptoms that co-occur and are present majority of the time for a distinct period. Manic episodes typically include three or four (including irritability) symptoms that co-occur for one week and are often associated with impaired function. Hypomanic mood states may last for fewer days and are not likely to cause impairment.
- History of a first-degree relative with BD or another mental illness
- Trauma or stressful life events
- History of postpartum psychosis
- Brain structure
Treatment of BD
Pharmacotherapy is the mainstay of treatment for BD in combination with psychotherapy. Interpersonal Social Rhythms Therapy (IPSRT), mid-day chronotherapy or light therapy and support groups are useful adjuncts to treatment. Optimal treatment differs between individuals and must be determined through discussions with the patient and psychiatrist/psychologist.
Bipolar Disorder & Women
BD typically onsets at 18 years of age, which means that women experience this illness throughout their childbearing years. Women are more likely to have a diagnosis of BD II disorder, which is characterized by hypomanic “highs” and predominantly depressive episodes. They are also more likely to experience rapid cycling, seasonal changes in mood and mixed episodes of BD. Women also experience longer delays in diagnosis compared to men.
Treatment of Bipolar Disorder in Pregnancy, Postpartum & Lactation
Treatment of BD during pregnancy and lactation is ideally addressed prior to conception. Pharmacotherapy is the recommended treatment during pregnancy, postpartum and lactation in addition to psychotherapy, chronotherapy and/or IPSRT. Choice of drug therapy requires a risk-benefit assessment with a specialized psychiatrist to identify an option with optimal effect and minimal adverse outcomes. Perinatal management of pharmacotherapy must account for the impact of physiological changes in pregnancy on drug concentration, which may require dose adjustment to maintain drug effectiveness.
Members of the Asher Center for the Study and Treatment of Depressive Disorders provide clinical care through Feinberg-affiliate care sites. Visit our Patient Care page for more information.
With research participants' help, we are able to able to better understand, diagnose and develop treatment for depressive disorders. Browse our clinical trials to participate and help test new treatments.