Bipolar illness is a very common but poorly understood set of conditions, a group of conditions that, like its cousin ADD, is routinely misdiagnosed and mistreated. When people are stuck, when they seem to be mysteriously unable to function at a level commensurate with their intellect, bipolar illness is often the lurking culprit.

A few important points about bipolar illness:

1. Most bipolar illness is not “manic” in the classic sense (racing speech, hyper-sexuality, senseless spending, no sleep, literally “crazy”); Depression is much more common.

2. The most important distinguishing feature is “racing thoughts”, racing thoughts that can be about almost anything (anger, fear, fatigue, depression, suicidal thoughts, food, sex, gambling) and that can come and go abruptly, or can be virtually constant.

3. The racing thoughts are mostly unwanted, and seen intrusive and pointless.

4. There is often a lifelong sense of fatigue and negativity that can seem unrelated to life events

5. Erratic, over-stimulated rapidly unpleasant responses to antidepressants are a sign of bipolar illness.

6. These are probably in some sense electrical conditions. I see them as specific small short circuits akin to epilepsy in some way; they respond to mood stabilizers (Lamictal, Depakote, Neurontin, Trileptal, Topamax; and of course the original Lithium) almost all of which were developed as anti-epileptic drugs

7. They also seem to respond to the newer anti-psychotic medications; (Risperdal, Abilify, Geodon Seroquel and Zyprexa)

8. Different mood stabilizers seem to control different sets of neurons and different sorts of experiences; Depakote for anger; Neurontin for anxiety; Lamictal for fatigue and depression; Topamax for depression

9. Many many eating disorders are in fact racing bipolar thoughts about food; and I have seem almost miraculous responses to lamictal alone, and in combination with litlium and topamax

10. The difficult distinction is between the racing thoughts of bipolar illnesses and the obsessive compulsive disorders and obsessive depressions caused by serotonin abnormalities; this is all the more important because the treatments for ocd and serotonin depressions can worsen bipolar conditions.

11. Bipolar conditions must also be distinguished from ADD, both can be experienced as distraction and erratic follow-through.

Future entries here will look in more detail how we can tell the difference among these sometimes similar problems.

Bipolar illnesses, with their disconcerting effects on both mood and thinking, are a prime example of a condition that requires a concerted educational medical and psychotherapeutic effort. Please feel free to explore our sites for the ways in which we can help you find the integrated care which these conditions require.

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