iagnosed if an episode of mania occurs whetherdepression has been diagnosed or not (Goodwin, Guze, 1989, p 11). Mostcommonly, individuals with manic episodes experience a period ofdepression. Symptoms include elated, expansive, or irritable mood,hyperactivity, pressure of speech, flight of ideas, inflated selfesteem, decreased need for sleep, distractibility, and excessiveinvolvement in reckless activities (Hollandsworth, Jr. 1990 ). Rarestsymptoms were periods of loss of all interest and retardation oragitation (Weisman, 1991). As the National Depressive and Manic Depressive Association (MDMDA)has demonstrated, bipolar disorder can create substantial developmentaldelays, marital and family disruptions, occupational setbacks, andfinancial disasters. This devastating disease causes disruptions offamilies, loss of jobs and millions of dollars in cost to society. Manytimes bipolar patients report that the depressions are longer andincrease in frequency as the individual ages. Many times bipolar statesand psychotic states are misdiagnosed as schizophrenia. Speech patternshelp distinguish between the two disorders (Lish, 1994). The onset of Bipolar disorder usually occurs between the ages of 20and 30 years of age, with a second peak in the mid-forties for women. Atypical bipolar patient may experience eight to ten episodes in theirlifetime. However, those who have rapid cycling may experience moreepisodes of mania and depression that succeed each other without aperiod of remission (DSM III-R). The three stages of mania begin with hypomania, in which patientsreport that they are energetic, extroverted and assertive (Hirschfeld,1995). The hypomania state has led observers to feel that bipolarpatients are "addicted" to their mania. Hypomania progresses into maniaand the transition is marked by loss of judgment (Hirschfeld, 1995). Often, euphoric grandiose characteristics are displayed, and paranoid orirritable character...
