Manic-depressive illness, known in medical terms as bipolar disorder, is characterized by severe swings in high and low mood states that generally last weeks or months. Available evidence suggests that not only is this a fairly common affliction, occurring in one to three percent of the general population, but that it runs in families and is inheritable. Close relatives of people suffering from bipolar illness are 10 to 20 times more likely to develop either depression or manic-depressive illness than the general population. Unlike major depression, which can occur at any age, manic-depressive illness generally strikes before the age of 35. Manic episodes are characterized by euphoria, constant talkativeness or movement, grandiose thoughts, need for less sleep, distractibility, and reckless behavior. When severe mania sets in, the dividing line between reality and fantasy is crossed. Delusional ideation, paranoia, hallucinations, and disorganized behavior may be seen in full-blown mania, with patients requiring hospitalization to protect both themselves and those around them.

Untreated, the manic phase can last as long as three months. As it abates, the patient may have a period of normal mood and behavior. Eventually, however, the depressive phase of the illness will set in. In some, depression occurs immediately or within the next few months. But with other patients there is a long interval before the next manic or depressive episode. The depressive phase has the same symptoms as major or unipolar depression. Depressive episodes consist of feelings of worthlessness and hopelessness, inability to concentrate, thoughts of death or suicide, change in appetite or weight, and fatigue or loss of energy.

Anyone who suspects they or a loved one suffers from manic-depressive illness should receive a complete medical evaluation to rule out any other mental or physical disorders. Once diagnosed, bipolar disorder is a highly treatable condition. Management is primarily medical and consists of drugs such as lithium. In addition to medical management, many affected patients will benefit from psychotherapy or counseling.

Description adapted from the Let’s Talk Facts About Manic–Depressive Bipolar Disorder Handout produced by the APA Joint Commission on Public Affairs and the Division of Public Affairs, Copyright 1992 American Psychiatric Association (Revised 1997).

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	This 30 minute video (click tape at left) from the National Depressive and Manic-Depressive Association, hosted by Tony Dow of Leave it to Beaver, provides information about this disorder. The free RealOne software needed to play this video is available from Real Networks.
	The Saturday Evening Post has taken a particular interest in helping readers understand bipolar disorder. The link at left is an article about manic-depressive illness and an interview with Dr. Kay Redfield Jamison. Use your back button to return here when you are done reading the article.
	Dr. John I. Nurnberger, Jr., M.D., Ph.D. is a principal investigator in the Bipolar Genetics Collaboration and a leading expert on genetic research in psychiatry. This article is an interview with him on the genetics of manic-depression.