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When not manic, patients either feel normal or depressed. Depression in bipolar disorder has same manifestation as major depression that consists of feelings of sadness associated with neurovegetative signs and symptoms such as inability to sleep, eat, and concentrate. Energy level is also impaired. In addition, patients experience a feeling of hopelessness, worthlessness, and helplessness. Suicidal ideation may ensue.
For individuals who develop mania, does it always mean that they suffer from bipolar disorder?
Not necessarily. Mania can be caused by various medical and neurologic conditions. For instance, multiple sclerosis and stroke can present with manic symptoms. Moreover, medications and street drugs may precipitate mania. Steroids, cocaine, and amphetamine are some examples. Even some antidepressants can induce mania.
So when a person shows mania, physician usually does intensive evaluation to rule out medical, neurologic, and medication-induced conditions before diagnosing bipolar disorder. This process is important because treatment varies depending upon cause. Once other conditions are ruled out, then bipolar disorder can be safely diagnosed and treated.
Copyright © 2004. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: A Personal Development and Emotional Skills Game. For more information, please visit www.oikosgame.com.