Tell Me About Rapid-cycling.

The DSM’s idea of rapid is at least four episodes over one year. Rapid-cyclers, however, tend to change from one mood to the other and back again at far shorter intervals, sometimes several times a day and even several times an hour and in rare cases in the space of minutes. Because those with rapid-cycle represent a moving target, and because of the instability of their condition, this group of people are notoriously difficult to treat, with high rates of failure. Women are more likely than men to be rapid-cyclers.

So Bipolar Is Just A Mood Disorder. Simple As That, Right?

Wrong. The conventional wisdom has been that bipolar is an episodic illness affecting mood, with often long periods of remission between moods while an illness such as schizophrenia is a chronic illness affecting cognition that progressively worsens. Now psychiatry is revisiting that distinction. What the experts are finding is that even between episodes, many people with bipolar experience subtle cognitive deficits that can get worse over time.

That’s The Last Thing I Need To Hear.

Don’t panic. The brain also has infinite ways of repairing itself. But brain imaging studies and studies of post-mortem brains do show smaller volumes in certain parts of the brain and larger volumes in others for bipolar patients, which may affect learning and memory and function. The good news — some medications for bipolar may protect against further deterioration and even reverse the damage. Studies on rats have found that two bipolar meds, lithium and Depakote, cause new brain cells to grow, and a study on humans found lithium also produced the same result.

Anything Else I Should Know About The Nature Of Bipolar?

Yes. People with bipolar tend to suffer from at least one other mental illness, as well, including anxiety, panic, alcohol, and substance dependence. According to one major study, 61 percent of people with bipolar have a lifetime substance dependence disorder (note, the percentage at any one time would be a lot smaller).

What If I Have Bipolar And A Substance Dependence Problem?

The Substance Abuse and Mental Health Services Administration recommends treating both illnesses simultaneously, ideally in an integrated setting in the same facility, at the very least with the different treatment providers working together.

I Heard Marijuana Can Really Help.

Only if you believe that being stoned out of your mind is the price you’re willing to pay for temporary relief from your symptoms. One’s complete inability to think straight and function would never be tolerated in a drug by any other name.

However, if you trust your ability to limit your consumption, a reader who uses the drug reports that very small doses - as little as one-tenth of what it would take to get stoned — can restore mental clarity and improve function for some people. Nevertheless, until the drug is studied for treatment of mania and is made legal, with evenness of quality, marijuana use should be regarded as problematical.

Does Bipolar Affect Other Areas Of The Body?

Yes, unfortunately. People with bipolar die seven years younger than those in the general population, independent of suicide. Most of the research on the mind-body connection relates to depression, but we can apply much of those findings to bipolar.

Such As?

The risk of heart disease is doubled in people with depression, and a previous depression is often the greatest risk factor for heart disease and other ills, over smoking, drinking, high blood sugar, and previous heart attacks. Depression has also been connected to diabetes, bone loss, stroke, irritable bowel syndrome, and possibly cancer.