Bipolar Disorder​—Consistently Inconsistent

Clinical depression is indeed challenging. But when mania is added to the equation, the result is called bipolar disorder.c “The only consistent thing about bipolar disorder is that it is inconsistent,” says a sufferer named Lucia. During mania, notes The Harvard Mental Health Letter, bipolar patients “can be unbearably intrusive and domineering, and their reckless and restless euphoria may suddenly change into irritability or rage.”

Lenore recalls her experience with the exhilaration of mania. “I was absolutely brimming over with energy,” she says. “Many called me a superwoman. People would say, ‘I wish I could be more like you.’ I often felt a great sense of power, as though I could accomplish anything. I exercised furiously. I functioned on very little sleep​—two or three hours a night. Yet, I woke up with that same high energy level.”

In time, however, a dark cloud began to hover over Lenore. “At the height of my euphoria,” she says, “I would feel an agitation from somewhere deep inside, a motor running that could not be shut off. In a flash, my agreeable mood would become aggressive and destructive. I would verbally pounce on a family member for no apparent reason. I was furious, hateful, and completely out of control. After this frightening display, I would suddenly become exhausted, tearful, and extremely depressed. I felt worthless and wicked. On the other hand, I might switch back to my amazingly cheerful self, as if nothing had ever happened.”

The erratic behavior of bipolar disorder is a source of confusion to family members. Mary, whose husband suffers from bipolar disorder, states: “It can be confusing to see my husband happy and talkative and then suddenly become despondent and withdrawn. It’s a real struggle for us to accept the fact that he has little control over this.”

Ironically, bipolar disorder is often just as distressful​—if not more so—​to the sufferer. “I envy people who have balance and stability in their lives,” says a bipolar patient named Gloria. “Stability is a place that bipolar people visit. None of us actually live there.”

What causes bipolar disorder? There is a genetic component​—one that is stronger than that of depression. “According to some scientific studies,” says the American Medical Association, “immediate family members​—parents, siblings, or children—​of people with bipolar depression are 8 to 18 times more likely than the close relatives of healthy people to develop the illness. In addition, having a close family member with bipolar depression may make you more vulnerable to major depression.”

In contrast with depression, bipolar disorder seems to afflict men and women equally. Most often, it begins in young adulthood, but cases of bipolar disorder have been diagnosed in teenagers and even children. Nevertheless, analyzing the symptoms and arriving at the proper conclusion can be highly challenging even for a medical expert. “Bipolar disorder is the chameleon of psychiatric disorders, changing its symptom presentation from one patient to the next, and from one episode to the next even in the same patient,” writes Dr. Francis Mark Mondimore of the Johns Hopkins University School of Medicine. “It is a phantom that can sneak up on its victim cloaked in the darkness of melancholy but then disappear for years at a time​—only to return in the resplendent but fiery robes of mania.”