Let's talk a little bit about bipolar disorder and the statistics.
For bipolar 1.
It is usually diagnosed equally men and women
both equally for bipolar disorder with a prevalence of 0.4% to 1.6%.
The onset, the age of onset that we normally see is about 18 years old.
This differs from bipolar 2,
where we normally see women having more bipolar 2 than men.
And that's in a prevalence of .5%.
And we're seeing a little bit later in life in the mid 20's.
Cyclothymic disorder, again, is equal between the genders
and we're seeing it between 0.4% and 1.0%.
And that we normally see an adolescence in early childhood.
So when we're thinking about the differences
between bipolar 1 and bipolar 2,
we think about bipolar 1, which is depression and mania,
that there's at least one manic episode and at least one depressive episode,
major depressive episode that we can identify.
We also want to be able to understand that the depressive episode
has to have been either occurring right before or right after the manic episode.
This gives us a much better understanding that this person
think about bipolar is experiencing both depression and mania.
Also, that manic episode may have required hospital care.
And that's important to understand, it is also may require
because not everyone requires hospital care
when they are having a manic experience.
So let's think again, when we're thinking about bipolar 1 and bipolar 2.
The bipolar 1 is depression and mania
and bipolar 2 is depression and hypomania.
Now, manic episodes are usually characterized by
exceptional energy, they are restless,
the person has a really hard time concentrating on one thing,
they are jumping from one thing to the next.
They have euphoria all the time.
And they don't need any sleep.
They have some risky behaviors,
there's increased sexuality, increased risk taking.
Oftentimes, if they are too up, they might be using drugs to try to self medicate.
And they also do not sleep.
They can stay awake for days on end.
Now, if we're thinking about bipolar 2 with hypomania, not with mania,
now we have again, a sustained mood that's elevated, which is our hypomania.
And also we end up seeing that there is that grandiosity,
that expansive belief that they can do anything,
they also are able to differentiate.
Because when they're up, it's not just like happiness.
It's not like a normal being up.
When they are up, it is very up.
And it really is exactly when they are not depressed.
There is no period of time in between the two that we're noticing
where they're up, and now they have what we call Euthymia,
which means a normal mood.
They're either very up or very sad.
So in mania, that mood is extremely abnormal, right?
And it is usually so much activity and energy,
which is also so abnormal.
But with hypomania,
we don't normally see any of the psychosis that we will see with mania.
Mania, they will become paranoid, after so much not sleeping, not eating.
There are some real psychotic symptoms that come along with prolonged mania
that we don't see with hypomania.
Now, when you're thinking about bipolar disorder,
you want to make sure that as these people are going really up and really down
that we are watching and trying to help them.
It is such a disruptive feeling to be that high and that low
that they cannot continue with their normal life as it is.
They also usually have to have this diagnosis with bipolar disorder
that they've had this manic episode and a depressive episode.
And otherwise, it is not considered bipolar 1.
Now, with bipolar 2, we can see that depressive episode.
And again, that depressive episode has to be at least 2 weeks long.
And then they have also the hypomanic episode.
Bipolar disease is more common that we know of
with some of the people who are extremely famous,
Winston Churchill suffered from bipolar disease,
Mel Gibson,
and Kurt Vonnegut, the writer,
Ernest Hemingway, another great writer,
Frank Sinatra, and Demi Moore, all have had bipolar disease and all have come out
and been able to help other people with bipolar disease
understand that it can be treated.
So this mania, this manic piece,
it has to be greater than a week to be considered manic.
And they have high distractibility.
Again, this insomnia, they can't sleep, this grandiose opinion of themselves,
taking amazing risks and not being able to stop talking.
Once they start talking with you, it's amazing.
If you are taking a history on a person who is manic,
it's really hard to get them to answer your questions easily.
They will give you a full history.