How to Balance Bipolar Disorder

Female Speaker: He went -- and it was scary, it was just a very scary situation because we hadn't really been through that. Host: Life has normal ups and downs, but for nearly six million Americans who suffer from bipolar disorder, those emotional highs and lows are dramatic and life altering. It takes a multi-layered approach to balance bipolar illness. In exhilarating high, a plummeting fall, this is life with bipolar disorder. Robert Chokan: My thoughts were erratic and I was manic depressive at the time. Life was not worth living. I could not see any end to it. Host: Robert Chokan is among the 5.7 million American adults with bipolar disorder, also known as manic depression. It typically develops in late adolescence or early adulthood. Dr. Joseph Calabrese: Bipolar disorder is a mood disorder, in which people have periods of depression, then alternate with episodes of being manic. Host: The patient is experiencing a manic episode may be euphoric and energetic. David: I was out, staying up late, even going out after work. So, I was drinking, carousing and I felt like I was on top of the world. Dr. Segundo Imbert: It's like if you get your brain and push the accelerator, and everything that was in your brain gets lighten up and they start to lose adequate judgment. Dr. Ellen Frank: Individuals who are manic become hypersexual so they can behave in ways that are really inconsistent with their normal values. Robert Chokan: My spending was probably the most extreme thing. Host: There is a less exaggerated manic state called hypomania; a time when a person can be very positive, creative, and productive. Dr. Ellen Frank: What we also know about hypomania is that it often leads to a crash and to depression. David: I was not just going to face anybody. I was just so upset with what the depression was doing to me. Host: And that's when bipolar can become fatal. Robert Chokan: I tried to commit suicide five times. Host: So diagnosis and treatment is critical but recognizing bipolar isn't a slam dunk. Dr. Ellen Frank: Most individuals go ten years from their first symptoms to a correct diagnosis. Host: That is what happened to David Bruce (ph). David: They talked about being hypomanic, which is at slightly elevated and it was probably that until I was 30 and had their first depression. Host: Doctors and loved ones often have to act like detective digging through this cycle of illness and family history. Dr. Ellen Frank: There is clearly a large genetic component. Dr. Joseph Calabrese: Bipolar disorder we now know is a disorder of brain chemistry. Host: For people with bipolar disorder, neurotransmitters may be out of balance. Dr. Segundo Imbert: When you have a decrease in serotonin, you tend to have a depressed mood. When you have an increase in dopamine and epinephrine, you have sort of euphoric or aggressive mood. Host: Drugs can help restore balance. Dr. Ellen Frank: The backbone of treatment for bipolar disorder was for decades lithium carbonate. Host: But not everyone could take lithium, so doctors began to look on anti-convulsive medications like the ones used for epilepsy, again with good results for some but not all patients. Now, there is a third category. Dr. Ellen Frank: Most recently, with the development of what we call the atypical antipsychotic drugs, all of them affect brain chemistry and neurotransmission, the signals that get sent from one nerve ending to another. Host: The drugs block or alter the action of those two key messengers; serotonin and dopamine, thus balancing brain chemistry, but drug therapy requires vigilance. David: You get to the point where the single medications aren't working, now you are using a combination of medications. I am now on four different ones. Host: For David, medication has clearly helped. David: I can't even describe what it was like the first day that I realized that wasn't as sad. Host: But drugs alone are not enough. David: My therapy is very important. What also helps me get through all that, is working with a support group, which my wife and I are very active in. Host: David urges others like him to come out from the shadows of bipolar disorder. David: Talk it with your family doctor, talk it with whoever you need to talk to, but to raise help and that's out there.