Bipolar Disorder

Bipolar Disorder includes elements of both depression and mania (uninhibited abnormal mood and behavior) in the syndrome. In the past it was called manic-depressive disorder. In the general population it is estimated that about 2% have Bipolar Disorder. Usually it starts at a young age but new diagnoses can occur in older persons. The frequency in adults with HIV is believed to be from 3 to 9%. The reasons for this increase are not clear. Bipolar Disorder is often a life-long problem. HIV infection might have occurred at a younger age in either the “at risk” periods of the mania or depression.

Cases of Bipolar Disorder usually begin with a manic episode. Typical symptoms include the need for less sleep, being very talkative, grand feelings, being easily distracted, and poor judgment. The latter could lead not only to bad business decisions but also to potential physical harm by driving fast or lack of care with various activities. Depressive symptoms are discussed in the psychosocial section of the site. These two sets of symptoms can rotate or be predominately one or the other with various time intervals. Consequently, a diagnosis of Bipolar Disorder can be a challenge. After diagnosis, treatment is aimed at stabilizing the emotions with medications called “mood stabilizers”. There are various medications that are typically used to accomplish both calming and prevention. It is likely you may have heard of one frequently used medication called lithium. The treatment requires specialty consultation and monitoring. Deep depression must be prevented because it could lead to suicidal actions. Also, treatment can be expanded to include various psychotherapy approaches, including talk therapy, which may be helpful.

What can you and your physician do to address the problem?

Because of the complexities of treating Bipolar Disorder, there will need to be close collaboration between the medical team treating your HIV and a specialist for treating your Bipolar Disorder. This will require added doctor visits, possible additional blood tests, and other medical care. In addition, you will need to be aware of the recurrence of symptoms, such as depressive symptoms and immediately contact your treating physicians for advice. Also, if you should decide to use any nutritional supplements, you must discuss this with your treatment team. Although there is some indication that supplements and foods may be helpful in certain cases, they could also cause harm and need careful consideration.


What can you do?

Bipolar Disorder is often a chronic condition, especially if you have had several episodes. Because of this, you may need to accept that this situation will require you having to take medication for a long time to prevent recurrences. This will require adherence to various medications and periodic visits to your physician. Also, you cannot let adherence to your HIV medication slip. However, you should be reassured there are a number of medications that can be successfully used to prevent recurrences. With the correct regimens for both your HIV and Bipolar Disorder, you should be able to maintain a satisfactory lifestyle.