Bipolar Facts

Definition:
Bipolar disorder (commonly referred to as manic-depression) is a major affective disorder in which an individual alternates between states of deep depression and extreme euphoria (mania).

These "mood swings" or episodes may last for a few hours, days, weeks or even months. The full spectrum of bipolar disorders includes all the different types of the disorder, diagnosed according to type and frequency/severity of episodes.

Bipolar disorder is a paradox - biological in nature, yet psychological in expression. Physicians and patients often either fail to recognize it or are reluctant to acknowledge it. It is estimated that only one in three patients receive treatment, the lowest rate among major psychiatric disorders. Worse yet, this disorder is often misdiagnosed and inappropriate medications are prescribed - medications that may do more harm than good.

For the patient, bipolar disorder magnifies common human experiences to larger-than-life proportions. Among its symptoms are exaggerations of normal sadness and fatigue, joy and exuberance, sensuality and sexuality, irritability and rage, energy and creativity. In its diverse forms, bipolar disorder afflicts a large number of people - the exact number depending on how the illness is defined and how accurately it is ascertained. If one considers the full bipolar spectrum, that is, Bipolar I, Bipolar II, and episodes arising from cyclothymic or hyperthymic traits, as well as pseudo-unipolar depression, review of the literature supports an incidence rate of 5% (Akiskal, HS. 2001. Clinical Validation of The Bipolar Spectrum: Focus on Hypomania, Cychlothymia and Hyperthymia. 154th Annual Meeting of the American Psychiatric Association. May 5).

To those afflicted, it can be so painful that suicide seems the only means of escape; one of every four or five untreated bipolar individuals actually does commit suicide. (Goodwin FK and Jamison KR. 1990. Manic-Depressive Illness. New York: NY. Oxford University Press).

If we also take into consideration the suicides that occur during major depressive episodes, the rates rise to 20% to 35% of all deaths by suicide. (Angst et al. 1999. Suicide risk in patients with major depressive disorder. Journal of Clinical Psychiatry, 60(Suppl.2):57-62).

The significant need for education, research and physician/consumer interaction is clear:

Of the ten leading causes of disability worldwide in 1990, measured in years lived with a disability, five were psychiatric, including bipolar disorder. Globally, it is estimated that 14.1 million people (3%) are affected. (Global Burden of Disease and Injury Series in the Global Burden of Disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. 1996. Murray, Christopher JL and Lopez AD, Harvard School of Public Health on behalf of the World Health Organization and the World Bank).

The projections show that psychiatric and neurological conditions could increase their share of the total global burden by almost half, from 10.5% of the total burden to almost 15% in 2020. This is a bigger proportionate increase than that for cardiovascular diseases.

Financial Burden:
In the United States, the value of the lifetime cost of persons with onset of bipolar disorder in 1998 was estimated at $24 billion dollars. Average cost per case ranged from $11,270 for persons with a single manic episode to $624,785 for persons with nonresponsive episodes (Begley et al. 2001. Pharmacoeconomics. 19:5(1):483-495).

The annual cost to UK society attributable to bipolar disorder is estimated to be £2 billion at 1999/2000 prices (estimated 297,000 people with the disorder). Ten percent of this cost is attributable to National Health Service resource use; 4% to non-healthcare resource use and 86% to indirect costs (Gupta RD & Julian F. Guest. 2002. Annual cost of bipolar disorder to UK Society. The British Journal of Psychiatry. 180:227-233).