Mary was a successful businesswoman but, for many years, she was experiencing changes in the way she functioned. She would have periods in which she became very happy and overly confident.

"These were my most creative periods," she reported.

During these periods of change, she would also experience a dramatic increase in her energy level and decreased need for sleep.

"I would go to bed, have three hours sleep and feel rested. The next morning I would get up, all fired up and ready to go again," she commented.

The downside to these periods of 'highs', as Mary described it, is that she would frequently find herself in quarrels with her friends and on spending sprees.

"These were the times I would get into problems with my credit cards. I would shop excessively and either purchase things I did not want or purchase stuff and give them away. This for me was distressing as I am usually a disciplined spender. I knew something was wrong whenever I got into this state, " Mary lamented.

John's story

John was a happily married man. A devout Christian, he loved his wife and was very dedicated to his family. His wife reported that there were times when he would become very depressed and withdraw from the family. During these periods, he was not interested in anything. He lost interest in work and sex and would sit doing nothing all day.

She pointed out that he would go through another phase in which he would have excessive energy. He would work continuously and during these periods of 'highs', he would engage in indiscreet sexual activities such as making passes at a church sister or engage in sexual encounters with other women.

"I knew this was not my husband. I saw the changes and after a while I could predict the pattern of behaviour," John's wife lamented.

What is bipolar disorder?

Mary and John are suffering from bipolar disorder. This is a mental condition, previously referred to as manic depressive illness, which affects one in 100 persons. The condition is more common in men than women.

Common features associated with this condition are inflated self-esteem, decreased need for sleep, talking excessively and rapidly and increase in activities at work, school and in other areas of life. Persons with bipolar disorders may go through periods in which they engage in buying sprees, make foolish business investments and engage in inappropriate sexual behaviour. Many persons with bipolar disorder flip into the other phase of the illness and become depressed. That is why the disorder is referred to as bipolar illness; it has two poles.

How does one get this condition?

Bipolar disorder, like most mental disorders, is due to a chemical imbalance in the brain. In this disorder, certain chemicals such as norepinephrine and serotonin are elevated.

How do I know if I am bipolar?

Never try to diagnose yourself. If you suspect that you (or someone) have bipolar disorder, you should be properly assessed by a psychiatrist. Unfortunately, there is no blood test to establish the diagnosis; in some instances, a psychological test may be indicated but the time-tested method to establish the diagnosis is a clinical evaluation by a doctor.

Can it be treated?

Yes, bipolar disorder like most mental disorders can be treated. The problem with bipolar disorder is that many persons with the condition are well adjusted and unless there is a major crisis, they will not seek treatment early and, even when individuals seek treatment, the diagnosis is often missed.

For many persons, it takes five to 10 years for a proper diagnosis to be made. Treatment includes therapy, medication and lifestyle change.

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept. Of Community Health and Psychiatry, University of the West Indies, 977-1108; email: yourhealth@gleanerjm.com.