Complex Bipolar Disorder Calls for a Combination of Prescription Medications

Bipolar disorder, also known as manic-depressive disorder, is characterized by extreme, uncontrollable shifts in mood. Bipolar patients ride an emotional roller coaster between depression and euphoria. Generally, each stage lasts weeks to months, but the severity and frequency of episodes vary from person to person and even in each individual. Patients experience normal moods in between episodes of mood swings.

Symptoms of the depression stage include sadness, guilt, hopelessness, anxiety, sleep disturbances, fatigue, irritability, and loss of interest in normal activities. During the manic stage, the person may feel elated, all powerful, excited and energetic, or appear agitated and irritable. Their thoughts and speech race; they need less sleep, and they exhibit poor judgment. They may engage in reckless and uncharacteristic behavior like hypersexuality, substance abuse, reckless driving, and spending sprees. In extreme cases, sufferers experience psychotic episodes where they experience hallucinations and delusions of grandeur.  They may believe they are on a mission or that they are the "chosen one".

Most sufferers are depressed more often than they are manic. Women tend to experience more depression than men, and to cycle more quickly between episodes. Manic episodes are also associated with creativeness and accomplishment in some individuals.  Vincent van Gogh is one of many successful people believed to have been bipolar.

Bipolar disorder is classified into two categories – bipolar I and bipolar II.  Bipolar I is characterized by sustained manic episodes interspersed with depression.  Bipolar II is less severe, and is characterized by major depressive episodes interspersed with less severe manic episodes known as hypomania. Hypomania involves increased energy, elevated mood, grandiosity, racing thoughts and less need to sleep. There's also a mild form of bipolar disorder known as cyclothymia.

There's also a variation of bipolar disorder known as mixed bipolar.  In mixed bipolar, patients experience the depression and mania at the same time. Mixed bipolar patents' wild mood swings results in erratic and unpredictable behavior. It is most common in young bipolar patients, but many, if not most, bipolar patients experience mixed bipolar episodes.

The exact cause of bipolar disorder remains a mystery, but it is believed to be caused by abnormal fluctuations in brain chemicals. It occurs equally in males and females, and usually strikes in late adolescence or early adulthood.  Genetics play a role, as do environmental factors like stress or drug use. Bipolar disorder is often associated with a high risk of anxiety disorders and substance abuse, and a 10 to 20 percent higher risk of suicide than the general population.

Bipolar disorder is a chronic condition that requires lifelong treatment. Prescription medications are the cornerstone of bipolar treatment, and most bipolar patients will require more than one medication. Mood stabilizers like lithium carbonate are prescribed to treat mood swings. Seizure medications such as Depakote are used to control mania. Antipsychotic medications help deal with the psychotic episodes, and depression medication addresses the depression. Patients typically stay on maintenance medication between episodes of mania and depression to avoid relapses. Psychotherapies such as cognitive behavior therapy and interpersonal therapy are also recommended.  Electroconvulsive therapy may be required in extreme cases.