Bipolar disorder, also known as bipolar affective disorder (and originally called manic-depressive illness), is a mental disorder characterized by periods of elevated mood and periods of depression. The elevated mood is significant and is known as mania or hypo-mania depending on the severity or whether there is psychosis. During mania an individual feels or acts abnormally happy, energetic, or irritable. They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. During periods of depression there may be crying, poor eye contact with others, and a negative outlook on life. The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self harm occurs in 30–40%. Other mental health issues such as anxiety disorder and drug misuse are commonly associated.
The cause is not clearly understood, but both genetic and environmental factors play a role. Many genes of small effect contribute to risk. Environmental factors include long term stress and a history of childhood abuse. It is divided into bipolar I disorder if there is at least one manic episode and bipolar II disorder if there are at least one hypomanic episode and one major depressive episode. In those with less severe symptoms of a prolonged duration the condition cyclothymic disorder may be present. If due to drugs or medical problems it is classified separately. Other conditions that may present in a similar manner include: drug misuse, personality disorders, attention deficit hyperactivity disorder, and schizophrenia as well as a number of medical conditions.
Treatment commonly includes psychotherapy and medications such as mood stabilizers or antipsychotics. Examples of mood stabilizers that are commonly used include: lithium and anticonvulsants. Treatment in hospital against a person’s wishes may be required at times as people may be at risk to themselves or others yet refuse treatment. Severe behavioural problems may be managed with short term benzodiazepines or antipsychotics. In periods of mania it is recommended that antidepressants be stopped. If antidepressants are used for periods of depression they should be used with a mood stabilizer. Electroconvulsive therapy may be helpful in those who do not respond to other treatments. If treatments are stopped it is recommended that this be done slowly. Most people have social, financial or work related problems due to the disorder. These difficulties occur a quarter to a third of the time on average. The risk of death from natural causes such as heart disease is twice that of the general population. This is due to poor lifestyle choices and the side effects from medications.
Medical Marijuana Efficacy
A study published in 1998 by Harvard professors documented 5 cases in which patients obtained significant relief from their bipolar-related symptoms through the use of medical marijuana. One of these patients, a 47-year-old woman, found cannabis to be more effective than other drugs in controlling her manic episodes. In another case, the husband of a bipolar sufferer told of numerous ways that cannabis seemed to help his wife in dealing with the disorder.
These cases were also cited alongside others in a review study conducted by a team of British researchers. The review, published in 2005 in the Journal of Psychopharmacology, presented evidence from a 1996 report that described 5 cases in which marijuana seemed to have a direct effect in countering depression. The researchers also cited 2 surveys conducted in 2003 which found that 15-27% of medical marijuana patients in California were prescribed the drug for various mood disorders, including depression, bipolar disorder, PTSD and ADHD.
CBD has also shown to have strong anti-psychotic and anti-anxiety affects and clinical tests have shown that cannabis users smoking lower cannabidiol strains are at a much higher risk of memory impairment. GW Pharmaceuticals are currently developing a high CBD rich strain to treat psychosis.
Official Research Reports
Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia (Ringen PA, Vaskinn A, Sundet K, Engh JA, Jónsdóttir H, Simonsen C, Friis S, Opjordsmoen S, Melle I, Andreassen OA, 2010)
The effect of extreme marijuana use on the long-term course of bipolar I illness: a single case study (El-Mallakh RS, Brown C, 2007)
The use of cannabis as a mood stabilizer in bipolar disorder: anecdotal evidence and the need for clinical research (Grinspoon L, Bakalar JB, 1998)
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