This issue of Psychiatric Annals, guest-edited by Martha Sajatovic, MD, deals with several important clinical concerns associated with bipolar disorder. It is an appropriate time for this focus, since May is the month when bipolar disorder is activated and suicides peak for the year, at least in the temperate zones.1
The heterogeneity of presentations of bipolar disorder, combined with the elusive etiology of mood swings and mixed states as well as the wide range of functional outcomes, differentiates it from other disorders. Recent findings raise questions about the efficacy of antidepressant medications in patients with bipolar depression. This, added to data that point to bipolar disorder being a frequent basis for treatment-resistant depression, means this diagnosis is among the most challenging for patients and clinicians.
The difficulty in predicting individual outcomes in patients with bipolar disorder provides a colorful metaphor for the unpredictability of our individual lives. With outcomes ranging from delightful creativity to disaster, bipolar patients remind us that in life, anything is possible.
- Goodwin FK, Jamison KR. Manic Depressive Illness: Bipolar Disorders and Recurrent Depression, 2nd Edition. New York, NY: Oxford University Press;2007:255.