What is bipolar disorder? - Helen M. Farrell

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The word bipolar means ‘two extremes.’ For the many millions experiencing bipolar disorder around the world, life is split between two different realities: elation and depression. So what causes this disorder? And can it be treated? Helen M. Farrell describes the root causes and treatments for bipolar disorder.

Lesson by Helen M Farrell, animation by Uncle Ginger.

What is bipolar disorder?

The word bipolar means two extremes.

For the many millions experiencing
bipolar disorder around the world,

life is split between
two different realities -

elation and depression.

Although there are many variations
of bipolar disorder,

let's consider a couple.

Type 1 has extreme highs
alongside the lows,

while Type 2 involves briefer,
less extreme periods of elation

interspersed with long periods
of depression.

For someone seesawing between
emotional states,

it can feel impossible to find the balance
necessary to lead a healthy life.

Type 1's extreme highs are known
as manic episodes,

and they can make a person range from
feeling irritable to invincible.

But these euphoric episodes exceed
ordinary feelings of joy,

causing troubling symptoms
like racing thoughts,

sleeplessness,

rapid speech,

impuslive actions,

and risky behaviors.

Without treatment, these episodes
become more frequent,

intense,

and take longer to subside.

The depressed phase of bipolar disorder
manifests in many ways -

a low mood,

dwindling interest in hobbies,

changes in appetite,

feeling worthless or excessively guilty,

sleeping either too much or too little,

restlessness or slowness,

or persistent thoughts of suicide.

Worldwide, about one
to three percent of adults

experience the broad range of symptoms
that indicate bipolar disorder.

Most of those people are functional,
contributing members of society,

and their lives, choices,
and relationships

aren't defined by the disorder,

but still, for many, the consequences
are serious.

The illness can undermine educational
and professional performance,

relationships,

financial security,

and personal safety.

So what causes bipolar disorder?

Researchers think a key player is
the brain's intricate wiring.

Healthy brains maintain strong connections
between neurons

thanks to the brain's continuous efforts
to prune itself

and remove unused or faulty
neural connections.

This process is important because our
neural pathways serve as a map

for everything we do.

Using functional magnetic
resonance imaging,

scientists have discovered that the brain's
pruning ability is disrupted

in people with bipolar disorder.

That means their neurons go haywire

and create a network
that's impossible to navigate.

With only confusing signals as a guide,

people with bipolar disorder develop
abnormal thoughts and behaviors.

Also, psychotic symptoms,

like disorganized speech and behavior,

delusional thoughts,

paranoia,

and hallucinations

can emerge during extreme phases
of bipolar disorder.

This is attributed to the overabundance
of a neurotransmitter called dopamine.

But despite these insights, we can't pin
bipolar disorder down to a single cause.

In reality, it's a complex problem.

For example, the brain's amygdala
is involved in thinking,

long-term memory,

and emotional processing.

In this brain region, factors as varied
as genetics and social trauma

may create abnormalities and trigger
the symptoms of bipolar disorder.

The condition tends to run in families,

so we do know that genetics have
a lot to do with it.

But that doesn't mean there's
a single bipolar gene.

In fact, the likelihood of developing
bipolar disorder

is driven by the interactions between
many genes

in a complicated recipe we're still
trying to understand.

The causes are complex,

and consequently, diagnosing and living
with bipolar disorder is a challenge.

Despite this, the disorder
is controllable.

Certain medications like lithium can help
manage risky thoughts and behaviors

by stabilizing moods.

These mood stabilizing medications work by
decreasing abnormal activity in the brain,

thereby strengthening the viable
neural connections.

Other frequently used medications
include antipsychotics,

which alter the effects of dopamine,

and electroconvulsive therapy,

which works like a carefully controlled
seizure in the brain,

is sometimes used as
an emergency treatment.

Some bipolar patients reject treatment

because they're afraid it will
dim their emotions

and destroy their creativity.

But modern psychiatry is actively
trying to avoid that.

Today, doctors work with patients
on a case-by-case basis

to administer a combination of treatments
and therapies

that allows them to live
to their fullest possible potential.

And beyond treatment, people with
bipolar disorder can benefit

from even simpler changes.

Those include regular exercise,

good sleep habits,

and sobriety from drugs and alcohol,

not to mention the acceptance
and empathy of family and friends.

Remember, bipolar disorder
is a medical condition,

not a person's fault,

or their whole identity,

and it's something that can be controlled

through a combination of medical
treatments doing their work internally,

friends and family fostering acceptance
and understanding on the outside,

and people with bipolar disorder
empowering themselves

to find balance in their lives.