Bipolar disorder, formerly known as manic-depressive illness, is a biological brain disorder that results in extreme psychological and emotional mood swings. Mood swings associated with bipolar disorder are so severe that, if left untreated, they become an obstacle to living a normal life. Bipolar disorder affects all aspects of a person's life, from family to friendships and work.
While everyone goes through periods of highs and lows, bipolar disorder magnifies and intensifies ups and downs to an extreme. A person suffering from bipolar disorder does not just feel "blue" but utterly hopeless, ineffectual and nonvital. These feelings of intense depression often lead to suicidal thoughts or an obsession with suicide.
The manic or "high" end of bipolar disorder also grossly exaggerates reality. Extreme energy and exuberance, visions of grandiosity, and delusions of being all-powerful are common. Though the person might feel empowered, practical dividends are rare. Ideas race through the mind and focus is limited or impossible. The personality is often uncharacteristically verbose, self-aggrandizing, and immoral aggressive or promiscuous in inappropriate situations and circumstances.
While those close to the sufferer often mistake the lows of bipolar disorder for common depressive episodes, the highs can be alarming. A person in the throes of a manic mood swing can appear psychotic to the point of potentially being misdiagnosed as schizophrenic.
Those suffering from bipolar disorder cycle throughout life from one state to the other. Between the manic and depressive states there is often a period of normality. For some, the manic mood might be less pronounced than the depressive mood.
Time periods for completed cycles also vary. A cycle might take a week or longer, or one might experience many cycles within a single day. This is referred to as rapid-cycling.
Medical experts report that bipolar disorder can occur in any age group. Children of parents with bipolar disorder who develop it themselves tend to rapid-cycle, sometimes making it difficult to diagnose against the backdrop of other childhood behavioral problems. Fortunately, there are many treatment options for bipolar disorder. Mood stabilizing medications, talk therapy and other regimens can make the difference between living life on a roller coaster and regaining the ability to be stable and happy. Treatment is ongoing, as the disorder is not cured but managed.
Though scientists don't yet know what causes bipolar disorder, they do recognize that is it passed down in families. A genetic component is likely part of a larger interplay of various factors, as evidence suggests it is not genetic alone. One twin, for example, might have bipolar disorder, while the other does not.
Millions of people suffer from bipolar disorder. According to the National Institute for Mental Health (NIMH) in the United States, about 1% of the American population is affected.
Threats or talk of suicide should always be taken seriously. If you or anyone you know suffers from extreme moods or depression, see a doctor without delay.
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.
Cyclothymic disorder. Cyclothymic disorder, also known as 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.
Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:
Euphoria
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
Decreased need for sleep
Easily distracted
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 activities once considered enjoyable
Problems concentrating
Irritability
Chronic pain without a known cause
Frequent absences from work or school
Poor performance at work or school
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 mood 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).
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.
If you have any symptoms of depression or mania, see your doctor or mental health provider. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health provider with experience in bipolar disorder can help you get your symptoms under control.
Many people with bipolar disorder don't get the treatment they need. Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones. And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.
If you're reluctant to seek treatment, confide in a friend or loved one, a health care professional, or someone else you trust. They may be able to help you take the first steps to successful treatment.
Suicidal thoughts and behavior are common among people with bipolar disorder. If you or someone you know is having suicidal thoughts, get help right away. Here are some steps you can take:
Contact a family member or friend.
Seek help from your doctor, a mental health provider or other health care professional.
Call a suicide hot line number — in the United States, you can reach the toll-free, 24-hour hot line of the National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor.
Contact a minister, spiritual leader or someone in your faith community.
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately. If you have a loved one who has harmed himself or herself, or is seriously considering doing so, make sure someone stays with that person. Take him or her to the hospital or call for emergency help.
There is no cure for BD but, with proper therapy, people with this disease can lead stable and productive lives. Bipolar disorder will not get better without medical treatment.
Treatment of bipolar disorder centers on (1) medications to stabilize mood swings and (2) counseling with a therapist. However, therapy is more successful with strong support from family and loved ones.
Medications don't always work the first time and may need to be changed many times until the right medication or combination of medicines is found.
While this change is happening, people with bipolar disorder need to feel that they can count on their friends and family not to give up on them and to bear with them even though their mood swings are causing grief and pain.
Periods of stress may throw people with bipolar disorder into one of the extremes of mania or depression, and they need strong support systems to help them deal with the disease.
Those people who are a danger to themselves or others will have their medications started in the hospital and will remain there until they are able to control their emotions enough to function at home.
Psychiatric hospitalization protects the safety of the person with bipolar disorder and loved ones.
Medical staff can monitor the effects of medications when a person is in the hospital.
Medications can be adjusted more quickly in the hospital than over a series of outpatient visits.
Group therapy or one-on-one sessions with a psychiatrist also start while in the hospital.
Not all episodes are serious enough to require hospitalization. Many people can be treated as outpatients.