Criteria

Criteria for Diagnosis of Bipolar Affective Disorder

DEPRESSION

At least 5 of the following symptoms - one of
which must be depressed mood or loss of
interest or pleasure - that persist every day for at
least 2 weeks and represent a change in the way
a person felt or functioned in the past.

1. Depressed mood (feeling sad or empty or
seeming sad or tearful)

2. Greatly diminished interest in all or almost all
activities.

3. Significant weight gain or loss without dieting
(more than 5 percent of body weight) or
increased or decreased appetite.

4. Sleeping much less or much more than usual.

5. Slowing down or speeding up of activity that
is observable by others.

6. Fatigue, or loss of energy.

7. Feelings of worthlessness, or excessive and
innappropriate guilt, not merely self--reproach
about being sick.

8. Diminished ability to think or concentrate, or
indecisiveness.

9. Recurrent thoughts of death (not just fear of
dying), recurrent thoughts of suicide without a
specific plan, or a suicide attempt or specific
plan for attempting suicide..

**Great distress or impairment in social,
occupational, or other important areas of
functioning.

**The episode is not due to the direct effect of a
medication, an illicit drug, or a medical condition.

MANIA

A distinct period of an abnormally and
persistently elevated, expansive or irritable mood
that lasts at least one week or requires
hospitalization.
Also at least 3 of the following symptoms (4 if
the only change in mood is increased irritability)
have occurred to a significant degree.

1. Inflated self esteem or grandiosity.

2. Decreased need for sleep (eg.feeling rested
after 3 hours sleep)

3. More talkative than usual or pressure to keep
talking

4. Flight of ideas or feeling that one's thoughts
are racing

5. Distractibility

6. Increase in goal-directed activity (socially,
sexually, at work or school) or physical and
mental restlessness and agitation.

7. Excessive involvement in pleasurable activites
that are likely to lead to painful consequences,
such as shopping sprees or sexual indiscretions.

**Marked impairment in the individual's ability
to work or engage in usual social activites or
relationships, or a need for hospitalization to
prevent harm to self or others

**The episode is not due to the direct effects of
a medication, an illicit drug, or a medical
condition.

From DSM 1V

CAUSE OF BIPOLAR AFFECIVE DISORDER

The cause of Bipolar Affective Disorder is not known. Most mental health professionals believe that
it is caused by abnormal brain functioning. Genetic, chemical, hormonal, psychological, social and
developmental factors may also play a role.

Close relatives of individuals who have bipolar disorder are definitely at risk so heredity plays a role.
If you have a parent, sibling or child with the disorder there is a 7-10 percent chance that you may
develop the same disorder, and an 8-10 percent chance you may develop depression.

Stress may trigger an episode but is not usually accepted as a cause of the illness.

Another theory is that bipolar disorder stems from a defect in the brains internal clock, which
controls daily and seasonal rhythms.

Another is that an episode of depression, hypomania or mania may alter brain chemistry in ways that
create a predisposition to future episodes.

Research continues seeking a definitive cause. Until the cause is found there will be no cure. But
there is hope!

CYCLES

Changes in mood, thinking, behavior and physical condition for a distinct period of time, either to
depression or mania, characterize bipolar disorder. These changes occur in cycles. An episode of
mania may be followed closely by an episode of depression or vice versa. Or there may be a shorter
or longer period of euthymic (normal) mood between episodes. Each individual is different but to
experience 4 or more major episodes in a ten year span is not unusual. As a bipolar person ages his
episodes may come closer together and last longer.

Rapid Cycling

Some bipolars (approx 5-15%) experience "rapid cycling" - four or more manic or depressive
episodes in a year, each lasting at least 24 hours, and ending with a switch to the opposite state or
stability.

Seasonal

Bipolar illness can follow a seasonal pattern with individuals sinking into depression at certain times
of the year and swinging into hypomania or mania a few months later. For me this is a definite
pattern...with episodes occurring exclusively in either Spring or Fall.

BIPOLAR ILLNESS and CEATIVITY

Kay Redfield Jamison PhD of Johns Hopkins University, in her book "Touched by Fire: Manic
Depressive Illness and the Artistic Temperament" estimates that the rate of bipolar illness is ten to
forty times higher among artists than in the general public.

Certainly history shows that many famous creative people suffered from this disorder. Artist Vincent
van Gogh, composers Robert Schumann and George Frederick Handl, poets Sylvia Plath and
Robert Lowell and writers Virginia Woolf and Ernest Hemingway all suffered from Bipolar Affective
Disorder. Virginia Woolf, in a letter to a friend wrote "as an experience, madness is terrific, I can
assure you, and not to be sniffed at".

Creative bipolars sometimes do their best work when in a state of hypomania. While depressed they
are at a standstill and while manic they are too frenetic to accomplish a great deal. They worry about
the effect that treatment will have on their creativity.

Generally treatment will channel their creativity and allow them to be more creative over the long
haul. Certainly it does not take away from their creativity and allows them to work at their art more
consistently.