Bipolar Disorder

Bipolar disorder is one of the most distinct and dramatic of mental illnesses. It is characterized by intense episodes of elation or irritability and despair, with any combination of mood experiences in between, including periods of normal moods. Mood changes are accompanied by changes in behavior, such as altered patterns of sleep and activity. According to the National Institute of Mental Health, about 5.7 million Americans, or 2.6 percent of the population, have bipolar disorder in a given year. It is less common than other forms of depression, such as major depression, also called 'unipolar' disorder, or simply, "depression."

The classic form of bipolar disorder, which involves recurrent episodes of mania and depression, is called bipolar I disorder. Some people, however, never develop severe mania but instead experience milder episodes, called hypomania, that alternate with depression; this form of the illness is called bipolar II disorder.

Studies show that men and women are equally likely to develop bipolar disorder; however, there is some evidence that women may have more depressive and fewer manic episodes than men with the illness. Women seem to have "mixed states" (mania or hypomania occurring at the same time as depression) more often than men. Also, women are more likely to have the rapid cycling form of the disease, which is characterized by four or more episodes of depression, mania or hypomania a year, and may be more resistant to standard treatments. Women are also more likely to have bipolar II disorder.

The symptoms of bipolar disorder can be severe and life threatening. Bipolar disease is not curable. However, medication can help many people achieve remission of symptoms. Treatment and maintenance of this disorder is necessary throughout a person's life once bipolar disorder is diagnosed.

Like some other illnesses that require life-long treatment, bipolar disorder poses unique medical challenges for women with the disorder who are considering pregnancy. According to the National Alliance on Mental Illness, pregnant women and new mothers with bipolar disorder have seven times the risk of hospitalization and two times the risk of a recurrent episode compared to women who are not pregnant or who have not recently delivered.

So a woman with bipolar disorder who wants to become pregnant should discuss her treatment options with her health care team prior to conception, if possible, or as early in her pregnancy as possible. Concerns exist about the potential, harmful effects mood-stabilizing medications used to treat bipolar disorder may have on the developing fetus and the nursing infant.