sleep, increased energy, and disorganized behavior that interferes with
relationships, he says.
"I don't think people look forward to manic episodes," Smith says.
"When you are not manic, you can look back and see how disruptive your life
Smith advises bipolar disorder patients to know their early signs of a manic
or depressive episode so they can get additional treatment promptly.
Bipolar Myth No. 5: There is a bipolar test.
Not true. In early 2008, an at-home bipolar test, sold over the Internet,
made headlines. But the test only tells users whether their genetic makeup puts
them at higher risk of having or getting bipolar disorder.
The bipolar test evaluates saliva samples for two mutations in a gene called
GRK3, associated with the disorder. But it can't tell users for sure.
Today, a diagnosis of bipolar disorder depends on a doctor taking a careful
patient history, asking about symptoms over time. A family history of the
disorder increases a person's chances of getting it.
Bipolar Myth No. 6: Bipolar disorder can't be diagnosed until age 18.
Not true, says Sachs. But it is true that it's more difficult to diagnose it
in some people than in others, because of varying patterns of the disorder.
And typical childhood behavior -- such as
having a tantrum and recovering quickly to go to a birthday party -- can also
make it difficult to diagnose the condition in children.
"There are clearly cases of children who have classic presentation in
the early childhood years," he says. But if a child does not have a classic
pattern, it's usually more difficult to make the diagnosis.
Even so, the disorder may be present but not diagnosed until later, he says.
According to the National Institute of Mental Health, the median age of onset
for bipolar disorder is 25 years old (half are older, half are younger).
But Sachs says many adult patients report having symptoms before age 18,
whether they were officially diagnosed or not.
Bipolar Myth No. 7: People with bipolar disorder should not take antidepressants.
Not true, says Smith, who explains where the myth originated. "There's a
concern, and it's valid, that some people who are depressed and bipolar, if
they take antidepressants ... could flip
into a mania."
The thinking, however skewed, is that the mood will be elevated too much and
mania will result. Although the concern has some validity, Smith says,
"that does not mean you should always avoid antidepressants."
Sometimes, he says, people need the drugs, especially if the depression
In a study published in The New England Journal of Medicine, Sachs
and his colleagues randomly assigned 366 patients with bipolar disorder to a
treatment of mood stabilizer drugs and placebo or to mood stabilizer drugs and
an antidepressant, following them for up to 26 weeks.
They found no differences in adverse effects, including a shift from
depression to mania, between the two groups.
Bipolar Myth No. 8: Aside from taking medication and engaging in psychotherapy or "talk therapy," a person with bipolar disorder has few options for controlling the condition.
Not true. "Medication and therapy are important," says Ken
Duckworth, MD, medical director of the National Alliance on Mental Illness. But
paying attention to lifestyle can help, too, he says.
"Active" strategies, such as getting regular aerobic exercise , keeping a
regular bedtime, eating a healthful diet ,
and paying attention to personal warning signs that a shift to depression or
mania is coming can all help a person manage bipolar disorder , he
"If people know their warning signs, they can stave off disaster,"
Duckworth says. For instance: If a person with bipolar knows he starts to wake
up at 4 a.m. when he is shifting to mania he can pay attention to that
pattern, Duckworth says, and promptly seek medical help.
By Kathleen Doheny
Reviewed by Brunilda Nazario
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