by Lamron Modles

Created on: June 26, 2008   Last Updated: September 22, 2008

Bipolar disorder can be understood best in terms of a complex continuum of mood illnesses. And for this reason, psychiatrists are tending to avoid as much as possible the simplistic and trendy "bipolar" designation.

Much like an onion, the layers of this debilitating and tricky illness have been peeled back rapidly in just the last decade. New effective drug treatments, such as atypical antipsychotics such as Risperdol and anticonvulsants such Klonopin, have sprung from this wave of research. However, as each layer is peeled away, new diagnostic challenges present themselves.

Here is the quick, well-established overview of bipolar, or mood disorder:

Bipolar Disorder I: Classic bipolar disorder is characterized by episodes of mania and episodes of depression. In a manic state, a person may have extreme euphoria or optimism, to the point of impairing judgment. They may be hyperactive and stay up all night, talk and move extremely fast, have increased sexual drive and decreased inhibition. Manic episodes almost always include delusions of some sort (most often delusions of grandeur), one of the reasons why it is sometimes confused with schizophrenia. Untreated manic episodes can last for weeks or even months. Conversely, during a depressive, the same person can feel hopeless and personally worthless. They may lose interest in their normal activities (including sex), have very little energy or motivation, be unable to concentrate, and have disturbances in sleep and eating habits.

Bipolar Disorder II: While some would mistakenly think of this as "Bipolar Lite," to do so would be uninformed and dangerous. Mania holds the key to bipolar diagnosis, but when mania symptoms are less-intense, called hypomania, many patients learn to live with them, often using them to advantage. Hypomanics will speak of "missing their mania" after being on lithium or another effective treatment. When the untreated hypomanic patients eventually fall into depression, their tales of mania are more difficult for a clinician to judge as "textbook" mania. They are likely to be judged as suffering from depression while merely recalling a time when they felt "not depressed." Antidepressants alone will often not be effective in bipolar patients. So those not properly diagnosed often fall through the clinical cracks with a high incidence of suicide.

Mixed Episode: This mood state is characterized by symptoms of both mania and depression occurring together during the same day for at least one week. A

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