Introduction to bipolar disorder
Bipolar disorder, otherwise known as manic depression or bipolar
depression, is a relatively common mood disorder that affects about 5.7 million
Americans. Characterized by episodes of depression alternating with euphoric
(manic) states, the symptoms of bipolar disorder are varied and often affect an individual's daily functioning
and interpersonal relationships.
Bipolar disorder symptoms include depression and
feelings of hopelessness during the depressive phase of the condition. Other
depressive symptoms include thoughts of suicide, alterations in sleep patterns, and
loss of interest in activities that once were a source of pleasure. What
differentiates bipolar disorder from major depression is the occurrence of manic
episodes, often described as emotional "highs," between the episodes of
depression. Symptoms of manic states are varied and include restlessness,
increased energy, euphoric mood, racing thoughts, poor judgment, intrusive or
provocative behavior, difficulty concentrating, and a decreased need for sleep.
People experiencing manic episodes often speak very rapidly, seem overly
irritable, and may have unrealistic beliefs about their own power and
Fortunately, bipolar disorder is a treatable condition. With appropriate
treatment, most people suffering from bipolar disorder can achieve substantial
stabilization of their mood swings and are able to lead a normal life. Treatment
of bipolar disorder often involves medications known as "mood stabilizers." Lithium (Eskalith,
Lithobid) is the most commonly prescribed mood stabilizer for people with
bipolar disorder, but some anticonvulsant medications, including valproate
(Depakote) or carbamazepine (Tegretol), also can have mood-stabilizing effects
and may be used in the treatment of bipolar disorder.
MedicineNet Medical Author: Melissa Conrad Stöppler, MD
MedicineNet Medical Editor: William C. Shiel Jr., MD, FACP, FACR
The following information is provided by the National Institutes of Health.
What is bipolar disorder?
Bipolar disorder, also known as manic-depressive illness, is a brain disorder
that causes unusual shifts in mood, energy, activity levels, and the ability to
carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are
different from the normal ups and downs that everyone goes through from time to
time. Bipolar disorder symptoms can result in damaged relationships, poor job or
school performance, and even suicide. But bipolar disorder can be treated, and
people with this illness can lead full and productive lives.
Bipolar disorder often develops in a person's late teens or early adult
years. At least half of all cases start before age 25. Some people have their
first symptoms during childhood, while others may develop symptoms late in life.
Bipolar disorder is not easy to spot when it starts. The symptoms may seem
like separate problems, not recognized as parts of a larger problem. Some people
suffer for years before they are properly diagnosed and treated. Like diabetes
or heart disease, bipolar disorder is a long-term illness that must be carefully
managed throughout a person's life.
What are bipolar disorder symptoms and signs?
People with bipolar disorder experience unusually intense emotional states
that occur in distinct periods called "mood episodes." An overly joyful or
overexcited state is called a manic episode, and an extremely sad or hopeless
state is called a depressive episode. Sometimes, a mood episode includes
symptoms of both mania and depression. This is called a mixed state. People with
bipolar disorder also may be explosive and irritable during a mood episode.
Extreme changes in energy, activity, sleep, and behavior go along with these
changes in mood. It is possible for someone with bipolar disorder to experience
a long-lasting period of unstable moods rather than discrete episodes of
depression or mania.
A person may be having an episode of bipolar disorder if he or she has a
number of manic or depressive symptoms for most of the day, nearly every day,
for at least one or two weeks. Sometimes symptoms are so severe that the person
cannot function normally at work, school, or home.
Symptoms of bipolar disorder are described below.
|Symptoms of mania or a manic episode include:
||Symptoms of depression or a depressive episode include:
- A long period of feeling "high," or an overly happy or outgoing mood
- Extremely irritable mood, agitation, feeling "jumpy" or "wired."
- Talking very fast, jumping from one idea to another, having racing thoughts
- Being easily distracted
- Increasing goal-directed activities, such as taking on new projects
- Being restless
- Sleeping little
- Having an unrealistic belief in one's abilities
- Behaving impulsively and taking part in a lot of pleasurable, high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.
- A long period of feeling worried or empty
- Loss of interest in activities once
enjoyed, including sex.
- Feeling tired or "slowed down"
- Having problems concentrating, remembering,
and making decisions
- Being restless or irritable
- Changing eating, sleeping, or
- Thinking of death or suicide, or attempting suicide.
In addition to mania and depression, bipolar disorder can cause a range of
moods, as shown on the scale.
One side of the scale includes severe depression, moderate depression, and
mild low mood. Moderate depression may cause less extreme symptoms, and mild low
mood is called dysthymia when it is chronic or long-term. In the middle of the
scale is normal or balanced mood.
At the other end of the scale are hypomania and severe mania. Some people
with bipolar disorder experience hypomania. During hypomanic episodes, a person
may have increased energy and activity levels that are not as severe as typical
mania, or he or she may have episodes that last less than a week and do not
require emergency care. A person having a hypomanic episode may feel very good,
be highly productive, and function well. This person may not feel that anything
is wrong even as family and friends recognize the mood swings as possible
bipolar disorder. Without proper treatment, however, people with hypomania may
develop severe mania or depression.
During a mixed state, symptoms often include agitation, trouble sleeping,
major changes in appetite, and suicidal thinking. People in a mixed state may
feel very sad or hopeless while feeling extremely energized.
Sometimes, a person with severe episodes of mania or depression has psychotic
symptoms too, such as hallucinations or delusions. The psychotic symptoms tend
to reflect the person's extreme mood. For example, psychotic symptoms for a
person having a manic episode may include believing he or she is famous, has a
lot of money, or has special powers. In the same way, a person having a
depressive episode may believe he or she is ruined and penniless, or has
committed a crime. As a result, people with bipolar disorder who have psychotic
symptoms are sometimes wrongly diagnosed as having schizophrenia, another severe
mental illness that is linked with hallucinations and delusions.
People with bipolar disorder may also have behavioral problems. They may
abuse alcohol or substances, have relationship problems, or perform poorly in
school or at work. At first, it's not easy to recognize these problems as signs
of a major mental illness.