Manic-Depressive disorder is commonly called bipolar. It involves the extreme of moods that ranges from mania to episodes of depression. Currently, the prevalence rate of bipolar in America is 1.2% and affects 2.3 million people in America. It is known to exist in every 83 American people or affects 3.3 million people in USA.

Manic-depressive disorder ranked second to major depression in causing worldwide disability. The ultimate risk in patients with bipolar disorder is their tendency to commit suicide. Young men, especially those who are recently discharged out of the hospital and have history of suicide attempts and alcohol abuse, are at high risk of committing complete suicide. This disorder is known to have a genetic origin. It is equally common to occur in both sexes. Highly educated people, those with family history of depression and college students who are deprived of sleep are known to have a higher risk of having bipolar tendencies.

Behaviors of patients with manic depressive disorder revolve around two categories. First is the manic behavior and second is the depressive behavior. Manic behavior involves the following: heightened, agitated or grandiose mood; exaggerated self-esteem; pressured speech; sleeplessness; flight of ideas; easily distractible; and poor judgement. Depressive behavior is comparable to major depression and involves the following: depressed mood, lack of enjoyment (anhedonia), change in sleep pattern, agitation, tiredness, worthlessness, difficulty in making decisions and hopelessness.

Treatment involves psychopharmacology and psychotherapy. Psychopharmacology involves lifetime intake of medication and involves anti-manic agent such as lithium and mood stabilizers such as anticonvulsants (carbamazepine).  Antipsychotic medications can be given in addition to bipolar medications for patients who exhibit psychotic tendencies (hallucination, illusion and delusion). Psychotherapy works best for patients who are mildly depressed or within the normal phase of the disorder. This therapy helps the client to accept the condition and helps reduce the risk of committing suicide.

Family members who care for a bipolar patient should know what the disorder is all about, the treatment involved, the adverse effects of the medications (lithium has a narrow margin of safety), the dietary precautions ( normal salt intake), signs of relapse, risk taking behaviors and how to avoid it, and the follow ups of the patient to the physician. Monthly blood exam is usually involved in the treatment of bipolar to check lithium levels. With these, it can be said that the family members should not just be physically and emotionally prepared but also financially.

The burden of manic-depressive disorder is usually reflected back on the family members thus it is best for the family members to find time to unwind and distress. Family members can talk to a counsellor or a psychologist in order to know how to handle the burden of the disease. Remember, family members should be psychologically healthy in order to help the patient. If not, then definitely there would be no healing that would occur.

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