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Bipolar Disorder


What is Bipolar Disorder?

Bipolar disorder, formerly known as manic depression, is a mood disorder that causes radical emotional changes and mood swings, from manic, restless highs to depressive, listless lows. Most bipolar individuals experience alternating episodes of mania and depression.

Alternative Names

Manic depression; Bipolar affective disorde

Signs and Symptoms of Bipolar Disorder

Bipolar disorder is divided into several subtypes. Each has a different pattern of symptoms. Types of bipolar disorder include:

  • Bipolar I disorder. Mood swings with bipolar I cause significant difficulty in your job, school or relationships. Manic episodes can be severe and dangerous.
  • Bipolar II disorder. Bipolar II is less severe than bipolar I. You may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine. Instead of full-blown mania, you have hypomania - a less severe form of mania. In bipolar II, periods of depression typically last longer than periods of hypomania.
  • Cyclothymia. Cyclothymia is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disruptive, but the highs and lows are not as severe as they are with other types of bipolar disorder.

The exact symptoms of bipolar disorder vary from person to person. For some people, depression causes the most problems; for other people manic symptoms are the main concern. Symptoms of depression and symptoms of mania or hypomania may also occur together. This is known as a mixed episode.

Manic phase of Bipolar Disorder

Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:

Bipolar Disorder
  • Euphoria
  • Extreme optimism
  • Inflated self-esteem
  • Poor judgment
  • Rapid speech
  • Racing thoughts
  • Aggressive behavior
  • Agitation or irritation
  • Increased physical activity
  • Risky behavior
  • Spending sprees or unwise financial choices
  • Increased drive to perform or achieve goals
  • Increased sex drive
  • Decreased need for sleep
  • Inability to concentrate
  • Careless or dangerous use of drugs or alcohol
  • Frequent absences from work or school
  • Delusions or a break from reality (psychosis)
  • Poor performance at work or school

Depressive phase of Bipolar Disorder

Signs and symptoms of the depressive phase of bipolar disorder can include:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Low appetite or increased appetite
  • Fatigue
  • Loss of interest in daily activities
  • Problems concentrating
  • Irritability
  • Chronic pain without a known cause
  • Frequent absences from work or school
  • Poor performance at work or school

Other signs and symptoms of Bipolar Disorder

Signs and symptoms of bipolar disorder can also include:

  • Seasonal changes in mood. As with seasonal affective disorder (SAD), some people with bipolar disorder have moods that change with the seasons. Some people become manic or hypomanic in the spring or summer and then become depressed in the fall or winter. For other people, this cycle is reversed - they become depressed in the spring or summer and manic or hypomanic in the fall or winter.
  • Rapid cycling bipolar disorder. Some people with bipolar disorder have rapid mood shifts. This is defined as having four or more mood swings within a single year. However, in some people moods shifts occur much more quickly, sometimes within just hours.
  • Psychosis. Severe episodes of either mania or depression may result in psychosis, a detachment from reality. Symptoms of psychosis may include false but strongly held beliefs (delusions) and hearing or seeing things that aren't there (hallucinations). In some people, sudden psychosis (a psychotic break) is the first sign of bipolar disorder.

Symptoms in children and adolescents

Instead of clear-cut depression and mania or hypomania, the most prominent signs of bipolar disorder in children and adolescents can include explosive temper, rapid mood shifts, reckless behavior and aggression. In some cases, these shifts occur within hours or less - for example, a child may have intense periods of giddiness and silliness, long bouts of crying and outbursts of explosive anger all in one day. Changing sleep patterns are also a common indicator of childhood bipolar disorder.

Causes and Risk Factors of Bipolar Disorder

Genetic or hereditary factors contribute to the risk of bipolar disorder. Studies have demonstrated that the prevalence of bipolar disorder is higher among the parents of bipolar patients. However, hereditary factors are not the only cause of bipolar disorder.

Studies of identical twins suggest that both genes and other factors play a role in the cause of bipolar disorder. Identical twins share all the same genes. If bipolar disorder were caused entirely by genes, then the identical twin of a patient with the illness would always develop the illness, which is not the case. However, if one twin has bipolar disorder, the other twin is more likely to develop the illness. There is a slightly greater risk of developing the disease among siblings as well.

Other than genetic factors, there are no other known risk factors for bipolar disorder. Lack of sleep may predispose individual patients to a recurrence of symptoms. Psychological and hormonal factors are suspected of playing a role as well. Some medications and illnesses cause symptoms that mimic bipolar disorder. It is important for these to be ruled out before a diagnosis of bipolar disorder is made.

Treatment for Bipolar Disorder

Bipolar disorder is a lifelong condition. It runs an unpredictable course of ups and downs. When left untreated, these ups and downs can be devastating. The recurring manic and depressive episodes that characterize the disease make it difficult to lead a stable, productive life. In the manic phase, you may be hyperactive and irresponsible. In the depressive phase, it may be difficult to do anything at all. Early diagnosis and treatment can help you avoid these problems.

Successful treatment of bipolar disorder depends on a combination of factors. Medication alone is not enough. In order to get the most out of treatment, it's important to educate yourself about the illness, communicate with your doctors and therapists, have a strong support system, make healthy lifestyle choices, and stick to your treatment plan.

Recovering from bipolar disorder doesn’t happen overnight. As with the mood swings of bipolar disorder, treatment has its own ups and downs. Finding the right treatments takes time and setbacks happen. But with careful management and a commitment to getting better, you can get your symptoms under control and live fully.

Complications of Bipolar Disorder

Stopping or improperly taking medication can cause your symptoms to come back, and lead to the following complications:

  • Alcohol and/or drug abuse as a strategy to "self-medicate"
  • Personal relationships, work, and finances suffer
  • Suicidal thoughts and behaviors

This illness is challenging to treat. Patients and their friends and family must be aware of the risks of neglecting to treat bipolar disorder.

Prevention of Bipolar Disorder

The ongoing medical management of bipolar disorder is critical to preventing relapse (recurrence) of manic episodes. Even in carefully controlled treatment programs, bipolar patients may experience recurring episodes of the disorder. Patient education in the form of psychotherapy or self-help groupsis crucial for training bipolar patients to recognize signs of mania and depression and to take an active part in their treatment program.


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