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An introduction to this devestating form of depression and how it can be treated.

Bipolar disorder (manic-depressive illness) is a mood disorder, which means that the symptoms are disturbances or abnormalities of mood. Major depression is a more common illness, the symptoms of which are mainly those of 'low' mood. Bipolar disorder involves episodes of both serious mania and depression. The person's mood swings from excessively 'high' and irritable, to sad and hopeless, and then back again, with periods of normal mood in between. Different from normal mood states of happiness and sadness, symptoms of manic-depressive illness can be severe and life threatening. However, because many artists, musicians and writers have suffered from bipolar illness, the effect of the illness has sometimes been trivialised, and regarded in some way as beneficial for artistic creativity. In fact, for those afflicted with the illness, it is extremely distressing and disruptive.

Bipolar disorder is the third most common mood disorder after major depression and dysthymic disorder. It affects about 1% of adults during their lifetime. Symptoms typically begin during adolescence or early adulthood, and continue to recur throughout life. Men and women are equally likely to develop this disabling illness. The consequences of the illness can be devastating, and may include marital break-ups, unemployment, alcohol and drug abuse. Bipolar illness is often complicated by co-occurring alcohol or substance abuse. Without effective treatment, bipolar illness leads to suicide in nearly 20% of cases.

Effective treatments are available that greatly reduce the suffering caused by bipolar disorder, and can usually prevent its devastating complications. However, bipolar disorder is often not recognised by the patient, relatives, friends, or even physicians. People with bipolar disorder may suffer needlessly without proper treatment, for years or even decades. Also, many patients do not respond to at least one drug, and many show no response to several. This means that combination treatment is often the rule because a combination of different drugs with different methods of action can be more effective wiithout increasing the risk of side effects. Lithium is still the most used drug overall in mania, but mood stabilising anticonvulsants are also widely used.

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