One in four people in the world will be affected by mental or neurological disorders at some point in their lives. The median age of onset for bipolar disorder is 25 years old Bipolar disorder affects approx. 5,7 million adult Americans, or 2.6% of the U.S. population age 18 and older every year.

Almost 50% of adults will develop at least one form of mental illness during their lifetime.

In all, about 80-90% of people diagnosed with bipolar disorder have a family history of either bipolar or major depression. However, this does not necessarily mean that someone with such a family history will inherit the genetic predisposition of the disease, or if they do, that their predisposition will eventually develop into symptoms.

fMRI has found that patients with bipolar disorder have very few oligodendrocytes in the left hippocampus of the brain, a significant finding, because this area controls emotion and memory processing. Remember, stress affects the hippocampus-but why bipolar patients have asymmetrical hippocampuses is unknown.

Several studies have demonstrated that depressive symptoms dominate the longitudinal course of bipolar illness.1-3 According to one study,1 people with bipolar disorder spent ~53% of their time asymptomatic, 32% depressed, 9% manic, and 6% in cycling/mixed states (Slide 2). For bipolar I patients, the depressive symptoms, which are often subsyndrom

Patients experiencing a manic or “up” cycle, present with symptoms such as poor judgment, racing speech, inflated self esteem, feelings of euphoria and extreme optimism, to name a few. Patients depression or “down” phase may present with symptoms such as sadness, anxiety, guilt, chronic pain, hopelessness, fatigue.

More than 4 percent of Americans have ever met diagnostic criteria for bipolar disorder, as compared with a worldwide average of about 2 percent, according to a study that conducted face-to-face interviews with 61,392 randomly selected people in 11 countries, published in the March Archives of General Psychiatry (Vol. 28, No. 3). Because the data were not based on medical-provider reports, the differences can’t be attributed to higher rates of assessment or diagnosis, the researchers note.

Current classification schemes are based on the predominant pattern of mood (i.e., depression, mania, hypomania, or mixed states), the intensity of mood, and the rate of cycling from one mood to another (Fig. 1). Disturbed mood in BPD is typically accompanied by reckless and impulsive behavior, psychotic symptoms (e.g., delusions, hallucinations, and disorganized thinking), and cognitive disturbances.