Bipolar Depression I

The Diagnostic and Statistical Manual of the American Psychological Association (DSM-IV) places Bipolar Depression I within the sphere of affective disorders that are primarily disturbances of mood (1994). More commonly known as a mood disorders, a distinction is made between Bipolar Depression I and Bipolar Depression II. Individuals with mood disorders have disturbances in their emotional states or moods. Two major mood disturbances are known as dysphoria and euphoria. In dysphoria, associated with depression, the individual "feels overwhelming sadness", while in euphoria, the opposite pole, individuals "feel overwhelming elation", (Halgin and Whitbourne 2003, 266). To understand bipolar disorder fully, one must understand the term episode. An episode is a "time-limited period during which specific, intense symptoms of a disorder are evident", (Halgin et al. 2003, 266). Bipolar disorder I is characterized by one or more manic or mixed episodes, often accompanied by major depressive episodes.

Individuals with bipolar disorder I often experiences periods of extreme elation, sleeping and eating less than normal, followed by a crash period that may involve depression. A manic episode is defined as a "full-blown expression of extreme symptoms involving abnormally heightened levels of thinking, behavior, and emotionality that cause impairment in social or occupational functioning" (Halgin et al. 2003, 270). Bipolar disorder I a

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e that it is more effective than lithium for treating both mania and depression. When lithium and/or valproate prove ineffective, the other anticonvulsant drugs are typically prescribed. One of the more commonly used of these other drugs is lamotrigine, a phenyltriazine derivative. According to Goldsmith, Wagstaff, Ibbotson and Perr (2004), "the mechanism of action of the drug in patients with bipolar disorder may be related to the inhibition of sodium and calcium channels in presynaptic neurons and subsequent stabilization of the neuronal membrane", (63). Other drugs are also used in tandem with lithium or the anticonvulsants discussed above. Such drugs include the benzodiazepines like lorazepam (Ativan) and clonazepam (Lonopin), anti-anxiety and sedative drugs that help calm patients in an acute state of mania. Other drugs are less commonly used but are also prescribed for manic or depressed patients like risperidone (Risperdal). Recently the Medical Letter on the CDC & FDA reported that the FDA has "approved Risperdal as monotherapy for the treatment of acute manic or mixed episodes associated with bipolar disorder I", (FDA 2004, 14). Such drugs are novel in use but are more effective in providing a calming effect and un

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