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Bipolar Disorder: Managing the Balancing Act

Bipolar disorder symptoms include dramatic shifts in mood and the ability to function. Successful bipolar disorder treatment requires a careful course of medication, psychotherapy, and discipline to stay on track--and avoid an emotional crash
WebMD Magazine - Feature
Reviewed by Louise Chang, MD

Most teens spend their time discussing their latest crush with friends, studying for college admission tests, and taking driver's education. Not Robin Molliner. When the 26-year-old California native was 16, she was busy trying to talk car dealers into selling her a new ride -- even though she didn't have a dime to her name -- and staging a two-week walkout from her high school chemistry class because she wasn't "happy with the level of the teaching."

But what seemed like normally high levels of energy and ambition were just the beginning of the full-blown mania that quickly followed.

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"I wanted to have sex with anything, I didn't care who or what," she recalls. "I felt like my mom was trying to hurt me, and I had feelings of being a prophet."

At the time, "I would go from moments of being totally happy, bubbly, and having fun to moments when pain from every point in life would come exploding out and I would lose control," she says.

The Lowdown

As a result of these symptoms and the depression that followed, Molliner was diagnosed with bipolar disorder. Affecting more than 2 million American adults, this illness brings dramatic shifts in mood, energy, and ability to function.

Just about everyone has ups and downs from time to time, but for people like Molliner, these changes can be severe. Moods range from ecstatic or irritable to sad and hopeless -- often with extended periods of normalcy in between. Manic episodes may mean increased energy, euphoria, and an unrealistic belief in one's abilities. People with bipolar disorder may go on lavish spending sprees. They may also have hallucinations (such as hearing voices) and delusional thoughts, as Molliner did about her mother.

Onset typically occurs in late adolescence, as it did with Molliner, or early adulthood. But some people develop symptoms later in life and still others start showing them during childhood. The illness affects children and teens differently from the way it affects adults, according to results from the Course and Outcome of Bipolar Illness in Youth (COBY) research program. The very young develop symptoms that last longer and swing more swiftly from hyperactivity and recklessness to lethargy and depression, the study showed.

While the exact cause of bipolar disorder is not known, most researchers say that it is the result of a chemical imbalance in certain parts of the brain. And some evidence suggests that individuals may have a genetic predisposition to the illness. More than two-thirds of people with bipolar disorder have at least one close relative with the disorder or with unipolar major depression. True to form, Molliner has two uncles and a grandfather with the disorder.

Medicating Mania

Bipolar disorder can't be cured but is typically treated with medication, psychotherapy, and lifestyle changes. Doctors often treat the mania symptoms with one set of drugs, and use other drugs to treat the depression. Maintenance treatment with a mood stabilizer such as lithium or an anticonvulsant drug can substantially reduce the number and severity of episodes for most people, but this can be a tough pill to swallow.

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