Q:
Why do some people call bipolar disorder manic depression?
A:
That is an older term. Part of the reason it changed was that not everyone with bipolar disorder has full manias. Some have depression and mania simultaneously (known as mixed episodes), or hypomanias. We now think about bipolar disorder as a spectrum of disorders, although where to draw the boundaries between bipolar disorder and severe moodiness is not always clear.
Q:
The stereotypical bipolar patient is unpredictable and unreliable. Is this accurate?
A:
If the person is not being treated and his or her mood is rapidly varying between depression and mania, then yes, he or she can be unpredictable and unreliable. If the person is getting treatment there is no reason he or she can’t live a stable productive life. Those stereotypes can be very unfair to people doing their best to lead healthy lives despite the illness.
Q:
How can someone help a bipolar loved one or friend?
A:
First thing is to learn to identify when the person is escalating into mania. There is a brief window when you should get on the phone with the physician. Signs of an oncoming manic episode can include sleeping less and less, making plans that don’t make sense, or getting increasingly irritable and agitated. When the person is already manic and denying any need for help, it may be too late.
Q:
Do bipolar patients do better if they follow a special diet or lifestyle regimen?
A:
Sleep regularity is essential. A bipolar person should generally err on the side of taking jobs that give them regular sleep-wake cycles. If you are bipolar and working as a happy-hour waitress one day and working the breakfast shift the next, you will not do well. Generally we also think exercise is a good treatment for depression. And it is important to stay away from alcohol and drugs. We suspect that certain kinds of high sugar foods can make people higher when they are already getting manic.
Q:
Is the risk for suicide higher in bipolar patients than in the general population?
A:
Risk for suicide in bipolar disorder is 30 times higher than the general population. As many as one out of seven dies by suicide. Suicide usually happens in the depression phase or mixed phase. Lithium treatment, other mood stabilizers, and psychotherapy can reduce the risk of suicide considerably.
Q:
What percentage of bipolar patients can live normal, productive lives?
A:
I think it is very painful to live with a psychiatric diagnosis, because there is a lot of prejudice. But there are many people who do quite well. It's hard to quantify this in terms of percentages, because many people lead productive lives and then get ill again, and have to start over. But with good treatment your chances of leading a healthy life go up considerably.
Journey:
Bipolar Disorder
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Dr. David Miklowitz Answers Critical Questions About Bipolar Disorder
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