Starry Night painted by Vincent van Gogh in 1889 in the hospital for mentally disturbed people in St. Rémy de Provence. Van Gogh is considered to have been affected by bipolar disorder and this picture has high contrasts analagous to extreme bipolar highs and lows as well as capturing the vibrancy associated with mania.
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Bipolar disorder

Bipolar disorder, still often referred to colloquially as manic-depression, is a mood disorder marked by episodes of clinically significant impairment due to mania or depression. more...

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Emil Kraepelin, who first described the illness and coined the term "manic depression", noted in his original delineation of the disease that intervals of acute illness, manic or depressive, were generally punctuated by relatively symptom-free intervals in which a patient was able to function normally.

Diagnostic criteria

The DSM-IV-TR details two general profiles of bipolar disorder, Bipolar I and Bipolar II. Bipolar I is characterized by alternating episodes of full-blown mania and depression, while Bipolar II, the less severe and more common type of the disorder, is characterized by episodes of hypomania and depression.

Criteria for a MANIC EPISODE (DSM-IV-TR):

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary).

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

(1) inflated self-esteem or grandiosity (2) decreased need for sleep (e.g., feels rested after only 3 hours of sleep) (3) more talkative than usual or pressure to keep talking (4) flight of ideas or subjective experience that thoughts are racing (5) distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) (6) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (7) excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The symptoms do not meet criteria for a Mixed Episode.

D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).


A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) or (2).

(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others) (3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. (4) Insomnia or Hypersomnia nearly every day (5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) (6) fatigue or loss of energy nearly every day (7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) (8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) (9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide


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Unraveling the genetics of bipolar disorder: by participating in ongoing studies of families at risk, Post readers are helping researchers identify suspect
From Saturday Evening Post, 3/1/05

Researchers exploring the role of genetics in bipolar disorder are launching an exciting new study and asking for your help. Over the years, hundreds of Post readers and their families have generously participated in bipolar disorder surveys and, in the process, made significant contributions to scientific understanding of the genes at work in the disorder.

The Institute of Psychiatric Research at Indiana University School of Medicine is now enrolling participants in an investigation that further explores the role of genetic and environmental factors in bipolar disorder.

Under the guidance of one of the country's leading experts on the subject, Dr. John I. Nurnberger, the new study seeks participants with bipolar I disorder--that is, those persons who have experienced both manic and major depressive episodes.

In earlier surveys, Dr. Nurnberger and colleagues looked for families with multiple cases of bipolar illness to gain better insight into the genetic link to the disorder. The research provided clues as to which chromosomes--the threadlike structures that carry genetic information in the form of genes--may play a role in bipolar disorder. Scientific teams are now focusing attention on identifying specific genes at work in the disorder.

"Before, we looked for families with multiple cases of bipolar illness to do what is called genetic linkage analysis, which shows us which and what part of chromosomes are important," Dr. Nurnberger explained to the Post. "The next step is to go into the portions of chromosomes to pick out the individual genes that are operating. To do that, we need a different type of sample. For this form of investigation, scientists use what is referred to as a large case-control sample, where DNA is obtained from as many unrelated people with bipolar illness as possible. Our goal is 5,000 people."

"We will conduct a confidential diagnostic interview on everyone who participates," Dr. Nurnberger explains. "Participation involves an interview that will take approximately four hours, as well as a donation of a blood sample."

Biological parents may be given the opportunity to donate a blood sample if they wish to participate as well. For participants who live far away from Indiana University School of Medicine, the interview can be done by telephone and the blood sample drawn by a local physician, who will then forward the sample to the laboratory.

By participating, you or family members will aid investigators in identifying and isolating specific genes involved, which will help pave the way toward better therapies.

"We think this research study is terribly important for people with bipolar illness," stresses Dr. Nurnberger. "It represents a way to the future with a better understanding of where the condition comes from, what may be causing it in different groups of people, and new avenues to treatment."

Indiana University is the coordinating site for the study, which is a national collaboration funded by the National Institutes of Mental Health. If you are interesting in learning more about the study or becoming a participant, you can find more information about the study on the Web site at http://www. or by calling 888-750-2201.

Symptoms of Severe Mania

* Constant talkativeness and movement

* Inability to concentrate

* Illogical speech

* Delusions of grandeur

* Loss of judgment

* Spending money beyond financial capability

* Extreme hostility

* Arrogance

* Demanding behavior

* Making abusive or obscene statements

* Shouting and throwing things

* Paranoid thoughts

* Seductive sexual behavior

Symptoms of Depression

* Sadness

* Guilt

* Hostility

* Remorse

* Anger

* Crying

* Mood swings

* Poor self-image

* Indecisiveness

* Eating disorders

* Weight loss or gain

* Sleeping problems

* Loss of sexual interest

* Feelings of hopelessness, helplessness, and worthlessness

* Withdrawal from life

* Agitated or slowed movements

* Fatigue or weakness

COPYRIGHT 2005 Saturday Evening Post Society
COPYRIGHT 2005 Gale Group

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