Bipolar Disorder Overview
Bipolar disorder is a mental health condition that causes extreme mood swings that include emotional mania-type highs and dangerous lows.
When you become depressed, you may feel sadness or hopeless and lose interest in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect energy, sleep, activity, behavior and the ability to think clearly.
Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.
In most cases, bipolar disorder is treated with medications and psychotherapy.
There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.
- Bipolar I Disorder.You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II Disorder.You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.
- Cyclothymic Disorder.You’ve had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types.These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing’s disease, multiple sclerosis or stroke.
Bipolar II disorder is not a milder form of bipolar I disorder, but a completely separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods of time. Symptoms can vary from person to person, and symptoms may vary over time.
Mania and Hypomania
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
- Abnormally upbeat, jumpy or wired
- Increased activity, energy or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments
Major Depressive Episode
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
- Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Marked loss of interest or feeling no pleasure in all — or almost all — activities
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
- Insomnia or sleeping too much
- Restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning or attempting suicide
Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.
The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:
- People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
- Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
- Drug and Alcohol Misuse
- Suicide or suicide attempts
- Legal or financial problems
- Damaged relationships
- Poor work or school performance
If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:
- Anxiety disorder
- Eating disorder
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug use
- Physical health problems, such as heart disease, thyroid problems, headaches or obesity
There’s no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
- Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel you’re falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.
- Don’t use drugs or alcohol. Using alcohol or drugs can make your symptoms worse and make them more likely to return
- Take your medications exactly as directed. Don’t stop your treatment and don’t stop taking your medication. Discontinuing your medication or lower the dose with out talking to a doctor can cause withdrawal and your symptoms may return.