Bipolar disorder may raise the risk of suicide. Mania and depression, the hallmarks of bipolar disorder, can be dangerous. During a manic phase, a person with bipolar disorder may be reckless. In about half of cases, people with mania can become psychotic -- hearing or sometimes seeing things that aren't real. During a depressive state, things may seem so hopeless that life doesn't seem worth living. . Manic or depressive episodes that involve mixed features (aspects of mania during depression, or depression during mania) are particularly dangerous. A person might feel depressed but keyed-up and agitated or energized at the same time.
Suicide is a very real risk for people with bipolar disorder, particularly when they're in a depressive episode -- 10% to 15% of people with bipolar disorder kill themselves. Many more attempt suicide. It's an alarming statistic, but you have to remember that treatment greatly lowers the risk.
People with bipolar disorder often have cycles of elevated and depressed mood that fit the description of "manic depression." When a person's illness follows this classic pattern, diagnosing bipolar disorder is relatively easy.
But bipolar disorder can be sneaky. Symptoms can defy the expected manic-depressive sequence. Infrequent episodes of mild mania or hypomania can go undetected. Depression can overshadow other aspects of the illness. And substance abuse can cloud the picture.
Any person with bipolar disorder needs to know what to do in an emergency.
Your condition -- by its very nature -- may prevent you from seeing things clearly. So when you're feeling well, make a plan with your friends and family for what to do in case you become unsafe. You should agree to:
Call your health care provider, therapist, or a suicide hotline right away if you feel suicidal.
Ask for help from friends or family members.
Stay safe until you can get help.
Remember that mood episodes are temporary. Suicidal thoughts are a symptom of your bipolar disorder. You will feel better with time.
SOURCES: Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision, American Psychiatric Association, 2000.
The Nations Voice on Mental Illness.
Depression and Bipolar Support Alliance (DBSA).
American Psychiatric Association.
National Institute of Mental Health.
Practice Guideline for the Treatment of Patients with Bipolar DisordernSecond Edition.
WebMD Medical Reference: Bipolar Disorder.
Muller-Oerlinghausen, B. The Lancet, Jan. 19, 2002.
Kaufman, K. Annals of Clinical Psychiatry. June, 2003.
Compton, M. Depression and Bipolar Disorder, ACP Medicine.