Bipolar Disorder (Mania)

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideBipolar Disorder: Symptoms, Testing for Bipolar Depression

Bipolar Disorder: Symptoms, Testing for Bipolar Depression

What are bipolar disorder causes and risk factors?

One frequently asked question about bipolar disorder is if it is hereditary. As with most other mental disorders, bipolar disorder is not directly passed from one generation to another genetically. Rather, it is the result of a complex group of genetic, psychological, and environmental vulnerabilities. Genetically, bipolar disorder and schizophrenia have much in common, in that the two disorders share a number of the same risk genes. However, both illnesses also have some genetic risk factors that are unique.

Stress has been found to be a significant contributor to the development of most mental-health conditions, including bipolar disorder. For example, gay, lesbian, and bisexual people are thought to experience increased emotional struggles associated with the multiple social stressors that are linked to coping with societal reactions to their homosexuality or bisexuality.

What are bipolar disorder symptoms and signs in adults, teenagers, and children?

As indicated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), in order to qualify for the diagnosis of bipolar disorder, a person must experience at least one manic episode. Characteristics of mania must last at least a week (unless it is part of mixed features) and include

  • elevated, expansive, or irritable mood;
  • racing thoughts;
  • pressured speech (rapid, excessive, and frenzied speaking);
  • decreased need for sleep;
  • grandiose ideas (for example, false beliefs of superiority or failures);
  • tangential speech (repeatedly changing conversational topics to topics that are hardly related);
  • restlessness/increased goal-directed activity;
  • impulsivity, poor judgment or engaging in risky activity (like spending sprees, promiscuity, or excess desire for sex).

Symptoms of the manic episode of early onset bipolar disorder in childhood or adolescence tend to include outbursts of anger, rage, and aggression, as well as irritability, as opposed to the expansive, excessively elevated mood seen in adults. The adolescent with bipolar disorder is more likely to exhibit depression and mixed episodes with rapid changes in mood. Despite differences in the symptoms of bipolar disorder in teens and children compared to adults, many who are diagnosed with certain kinds of pediatric bipolar disorder continue to have those symptoms as adults.

Symptoms of bipolar disorder in women tend to include more depression and anxiety and a rapid cycling pattern compared to symptoms in men, and men with bipolar disorder are more at risk for having an alcohol or other substance use disorder compared to women with the mood disorder. Women bipolar disorder sufferers are also more prone to experience thyroid disease or obesity compared to men.

Although a major depressive episode is not required for the diagnosis of bipolar disorder, such episodes often alternate with manic episodes. In fact, persistent sadness tends to occur more often than mania in many people with bipolar disorder.

Characteristics of depressive episodes (bipolar depression) include a number of the following symptoms: persistently depressed or irritable mood; feelings of apprehension; frequent crying, inability to feel pleasure; loss of interest in previously pleasurable activities; apathy, low motivation; increased or decreased appetite, weight loss or weight gain, difficulty falling asleep; excess sleepiness, agitation or lack of activity; fatigue/low energy; feelings of worthlessness; lack of concentration; slowness in activity and thought; inappropriate feelings of guilt; hopelessness; thoughts of death, self-harm or suicidal thoughts, plans, or actions.

Medically Reviewed by a Doctor on 2/22/2017

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