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Bipolar Disorder

According to the National Institute of Mental Health (NIMH), approximately 5.7 million Americans aged 18 or older suffer from bipolar disorder.[1] If you or someone you care about suffers from this disorder, you are not alone, although it may often feel very much that way.

Though it can emerge at any point in a person’s life, from childhood to later years, this disorder usually begins in a person’s late teens or early adulthood. Perhaps the most tragic aspect of this disorder is that it is often not recognized as a treatable, biological illness. Too often, as symptoms develop, the person assumes that he or she is at fault and should be able to be different or get back to normal just by personal effort.

Although it may feel like something one ought to be able to control, bipolar disorder needs medical treatment and management just as any other condition which cannot be changed through willpower alone. Like diabetes, a heart condition or blindness, this disorder requires lifelong lifestyle management. The good news is that with proper medical help, people with bipolar can live rewarding and fulfilling lives.


Many factors combine to cause this disorder. Although there is a genetic component, research makes clear that it is not caused by one single gene, but by many genes in combination as well as other aspects of a person’s life and environment.


Though there may be times of normal mood, an indication of bipolar disorder is pronounced swings in mood, energy, and behaviors between what are referred to as manic or depressive episodes. Each of these has its own distinct symptoms, only some of which are listed here. A physician diagnoses this disorder based not only upon the presence of symptoms, but also upon their combination and length of time they are present. As with any medical disorder, it is essential to get medical assessment and rely upon a professional’s diagnosis.

Symptoms of Manic Episodes:

Lots of energy, restlessness, and little need for sleep

Inability to concentrate and racing thoughts

Euphoric mood and unrealistic assessments of one’s abilities

Poor judgment, spending sprees

Increased sexual drive

Abuse of drugs

Denial that anything is wrong

Symptoms of Depressive Episodes:

Feeling guilty, worthless, helpless, or hopeless

Feeling sad, anxious, empty

Lack of interest in activities which once seemed to be worthwhile and fun

Decreased sexual drive

Changes in weight or sleeping patterns

Difficulty in making decisions or focusing attention

Thoughts of death or suicide

While swings between the highs and lows listed above are typical for bipolar disorder, some people experience a mixture of the two, for example, feeling low and sad in mood while at the same time experiencing more rather than less energy.

In addition, substance abuse is a commonly co-occurring problem which may actually be a symptom of the underlying bipolar disorder and an effort to self-medicate. Other commonly co-occurring problems include post-traumatic stress, anxiety, and obsessive-compulsive disorders.

Bipolar disorder also often occurs with thyroid abnormalities, which require focused medical treatment. For these and many other reasons, diagnosing bipolar disorder is a complicated matter requiring medical expertise. It cannot be done by the most well meaning friends or family or well read individual who wonders if he or she has this condition.


The National Institute of Mental Health says “a strategy that combines medication and psychosocial treatment is optimal for managing the disorder over time.”[2] It is important to understand that once this disorder emerges, it is a condition which must be managed for life. Dropping in and out of treatment can be terribly dangerous for all concerned, since suicide is a real risk for those who do not receive appropriate care and individualized treatment.

It is important for a psychiatrist to be involved in prescribing the most appropriate medication for a person with bipolar disorder. Usually, the medication will be one of several available “mood stabilizers” and it will be needed over a long period of time. Sometimes additional medication may be needed when a problem breaks through, despite the help of the stabilizing drug. Careful monitoring of medication is also necessary since side effects may occur. Once prescribed, no medication dosage should ever be changed or discontinued without medical supervision.

While each person’s situation is unique, studies indicate that the best results for managing care of bipolar disorder include Psychosocial treatments in addition to medication. Among other possibilities, these approaches may include education about the disorder for the individual and his or her family and friends, and cognitive (sometimes called “talk”) therapy which can help the person recognize and change negative patterns of thinking and damaging behaviors.

According to the NIMH, an emerging new approach which shows good promise is called interpersonal and social rhythm therapy. In this treatment, a person with bipolar disorder is helped to structure and maintain daily routines and sleep patterns, which may help to prevent some episodes.


It is important to remember that according to the best medical knowledge, “bipolar disorder is a long-term illness that currently has no cure.”[3] While it is discouraging to recognize that there is no cure, the good news is that carefully maintained and appropriate treatment can enable people with bipolar disorder to manage this condition and improve the quality of their lives tremendously. When treated, bipolar disorder need not end in tragedy.

Social Security defines “work” as an eight hour a day, five-day week endeavor. As in most Social Security Disability claims, the judge’s decision really boils down to whether or not he or she believes that you can perform the basic functions of work (concentrating, interacting appropriately with people encountered in the workplace, etc.). The fact that a claimant can only perform these basic functions sporadically, but not consistently, is the basis for the large majority of successful Social Security Disability claims.

We have represented many people with this disorder; what we have found is that clients who are truly unable to work and who participate in their care by following their doctors’ orders, and who are truly trying to get better but just cannot, are usually successful in their claim for Social Security disability benefits.

We hope this article has helped you in more ways than one. Although it’s a lot of information to process, and we certainly understand your concerns, we aim to only assist you in these hard times you are likely facing. You are more than welcome to call our office if you have any other inquiries, or concerns you’d like to discuss. Again, we want you to know that while having serious medical conditions may certainly be tough, we believe our clients are tougher. When we take a case it’s because we believe in you, and we will fight for you.


  • An Unquiet Mind: A Memoir of Moods and Madness, by Kay Redfield Jamison. An inspiring account of a personal life story.
  • Mental Health Crisis Intervention
    Crisis counseling, emergency care, and referrals by professional mental health and addictions counselors. 24 Hours 1 (888) 424-2287
  • Suicide & Crisis Hotline
    Immediate emotional support by trained telephone volunteers
    24 Hours 1 (412) 820-HELP
  • United Way Helpline
    Trained social workers provide crisis intervention for any type of problem
    24 Hours 1 (412) 255-1155
  • Website for Mental Health America, Allegheny County. Has links to emergency hotline numbers, support groups and information about mental health issues and programs for support.
  • Not a professional site. Online community and helpful links to informative articles and testimonies
  • U.S. Department of Health and Human Services website offers many helpful and informative links for further information
  • (a component of the above) National Mental Health Information Center also has many helpful links and online articles


[1] Accessed January 16, 2009. Much of the information in this article is taken from this source.