Table of Contents
Overview
Bipolar disorder, formerly known as manic depression, is a mental health condition that leads to significant mood fluctuations. These include emotional highs, referred to as mania or hypomania, and emotional lows, known as depression. Hypomania is a less severe form of mania.
During depressive episodes, you may feel sad or hopeless or lose interest in activities that once brought you joy. On the other hand, during mania or hypomania, you might feel extremely euphoric, energetic, or unusually irritable. These mood changes can affect your sleep, energy levels, decision-making, judgment, and ability to think clearly.
Mood swings in bipolar disorder, ranging from depression to mania, may happen infrequently or several times throughout the year. Each episode usually lasts for several days. Some people experience extended periods of emotional stability between episodes, while others may go through frequent mood changes or even experience depression and mania at the same time.
Although bipolar disorder is a lifelong condition, it can be managed effectively with an appropriate treatment plan. Healthcare providers often use a combination of medications and psychotherapy to help control mood swings and symptoms.
Symptoms
There are various types of bipolar and related disorders, including:
- Bipolar I Disorder: This type occurs when you have experienced at least one manic episode, which may be followed or preceded by hypomanic or major depressive episodes. In certain cases, mania can result in a detachment from reality, a condition referred to as psychosis.
- Bipolar II Disorder: This condition is characterized by having at least one major depressive episode and one hypomanic episode, but without ever experiencing a manic episode.
- Cyclothymia: YCyclothymia involves experiencing at least two years (or one year for children and teens) of multiple periods with hypomanic and depressive symptoms. These symptoms are less severe than those observed in major depression.
- Other types of bipolar and related disorders can be triggered by factors such as substance abuse, alcohol use, or underlying medical conditions like Cushing’s disease, multiple sclerosis, or stroke.
Bipolar disorder is characterized by mood swings that include episodes of mania or hypomania (a milder form of mania) and depression. These mood shifts can lead to unpredictable changes in behavior and emotions, causing significant distress and making daily life challenging.
Bipolar II disorder is a distinct diagnosis from bipolar I disorder. It is not simply a less severe version of bipolar I. While bipolar I involves intense and potentially dangerous manic episodes, bipolar II is marked by longer periods of depression.
Bipolar disorder can develop at any age, but it is often diagnosed in teenagers or early 20s. Symptoms differ from person to person and may evolve.
Mania and hypomania
Mania and hypomania have similar symptoms, but mania is much more intense. Mania can cause major disruptions in work, school, and social settings, leading to difficulties in relationships. It may also involve psychosis, where a person loses touch with reality. In severe cases, hospitalization may be required for proper treatment.
Manic and hypomanic episodes are characterized by at least three of the following symptoms:
- Exhibiting unusually high levels of activity, energy, or restlessness compared to typical behavior.
- Experiencing excessive self-confidence or an inflated sense of well-being.
- Require significantly less sleep than usual.
- Talking more than usual and at a faster pace.
- Experiencing rapid thoughts or jumping quickly between topics.
- Having difficulty focusing or being easily sidetracked.
- Making impulsive decisions, like overspending, engaging in risky behavior, or making poor investments.
Major depressive episode
A major depressive episode consists of symptoms severe enough to disrupt daily life, such as work, school, social activities, and relationships.
An episode involves five or more of the following symptoms:
- Experiencing a depressed mood, which may include feelings of sadness, emptiness, hopelessness, or tearfulness. In children and teens, depression can manifest as irritability, anger, or hostility.
- Losing interest or feeling no pleasure in nearly all activities.
- Experiencing notable weight loss without intentional dieting or overeating, or significant weight gain. In children, failure to gain weight as expected can also indicate depression.
- Sleeping excessively or having difficulty sleeping.
- Feeling agitated or physically slowed down.
- Feeling extremely fatigued or lacking energy.
- Feeling worthless, overwhelmingly guilty, or guilty without reason.
- Struggling to think, concentrate, or make decisions.
- Contemplating, planning, or attempting suicide.
Other features of bipolar disorder
Symptoms of bipolar disorders, including depressive episodes, may also include other features such as:
- Anxious distress occurs when you experience symptoms of anxiety and fear, which can make you feel as though you’re losing control.
- Melancholy refers to feeling deeply sad and experiencing a profound loss of pleasure in activities you normally enjoy.
- Psychosis occurs when your thoughts or emotions feel detached from reality.
The timing of symptoms may be described as:
- Mixed refers to experiencing symptoms of both depression and mania or hypomania simultaneously.
- Rapid cycling occurs when you experience four mood episodes within a year, alternating between mania, hypomania, and major depression.
Bipolar symptoms can also emerge during pregnancy or shift with the changing seasons.
Symptoms in children and teens
Diagnosing bipolar disorder in children and teens can be difficult. Their symptoms might mimic typical mood swings, stress, or trauma, which makes it hard to distinguish from other mental health conditions.
Young individuals with bipolar disorder may experience distinct episodes of depression or mania/hypomania, but their patterns often differ from those seen in adults. Mood changes can be rapid, and some may have symptom-free periods in between.
The most prominent signs in children and teens are extreme mood swings that stand out from their usual behavior.
When to see a doctor
Individuals with bipolar disorder may not always recognize the impact of their mood swings on both their lives and the lives of those around them. This lack of awareness can result in not seeking the treatment they need.
Some people may even enjoy the euphoric feelings and increased productivity during manic or hypomanic episodes. However, these periods are often followed by a major emotional crash, leading to depression and exhaustion. This can strain relationships and lead to financial or legal complications.
If you notice signs of depression or mania, it is crucial to reach out to a healthcare or mental health professional. Bipolar disorder doesn’t improve on its own, and a professional can help manage and control the symptoms effectively.
When to get emergency help
Thoughts of suicide and actions related to these thoughts are common among individuals with bipolar disorder. If you or someone you know is struggling with self-harm or suicidal thoughts, it is essential to seek help immediately. You can reach out to a trusted family member or friend, contact a suicide hotline, dial 911 or your local emergency number, or visit the nearest emergency department. In the U.S., you can call or text 988 to connect with the 988 Suicide & Crisis Lifeline, which operates 24/7. You can also use Lifeline Chat for support. These services are free and confidential.
Causes
The exact cause of bipolar disorder is not completely understood, but various factors are believed to contribute to its development. These include genetic influences, as the disorder often runs in families, chemical imbalances in the brain, and alterations in brain structure or function. Environmental factors such as stressful life events, trauma, or major life changes can also play a significant role. Additionally, changes in brain chemistry and hormonal fluctuations may impact mood regulation, further contributing to the onset of the disorder.
- Biological differences: Individuals with bipolar disorder often exhibit physical changes in their brains. While the precise meaning of these changes remains unclear, ongoing research may shed light on why they occur and how they are connected to the disorder.
- Genetics: Individuals with a close family member, such as a parent or sibling, who has bipolar disorder are at a higher risk of developing the condition themselves. Ongoing research aims to identify specific genes that may contribute to the onset of bipolar disorder.
Risk factors
Risk Factors: Several factors may increase the likelihood of developing bipolar disorder or trigger its first episode, including:
- Having a close family member, such as a parent or sibling, with bipolar disorder.
- High-stress situations, such as the loss of a loved one or other traumatic events.
- Substance abuse, including drug or alcohol misuse.
Complications
If bipolar disorder goes untreated, it can result in significant issues that impact all aspects of your life, including:
- Issues related to substance abuse, including drugs and alcohol.
- Suicidal thoughts or suicide attempts.
- Legal problems or financial difficulties.
- Struggles in maintaining relationships with others.
- Challenges with work or academic performance.
Conditions that occur at the same time
At times, what seems like bipolar disorder could be a different condition. The symptoms of bipolar disorder can resemble those of other disorders, and there might be an additional health issue requiring treatment alongside bipolar disorder. Certain conditions can exacerbate bipolar disorder symptoms or reduce the effectiveness of treatment.
Some examples are:
- Anxiety disorders.
- Eating disorders.
- Attention-deficit/hyperactivity disorder (ADHD).
- Post-traumatic stress disorder (PTSD).
- Substance abuse (alcohol or drugs).
- Borderline personality traits or disorders.
- Physical health conditions, such as heart disease, thyroid problems, headaches, or obesity.
Prevention
While there’s no surefire way to prevent bipolar disorder, seeking treatment early when you notice mental health concerns can help prevent bipolar disorder or other conditions from getting worse.
If you have bipolar disorder, you can take proactive steps to stop minor symptoms from developing into severe episodes of mania or depression:
- Monitor warning signs: Addressing symptoms early with your care team can help prevent episodes from intensifying. If you identify patterns or triggers for your bipolar episodes, inform your healthcare or mental health professional if you sense an episode starting. Additionally, ask family and friends to be on the lookout for warning signs.
- Ensure adequate sleep: Sleep disruptions can frequently trigger instability in bipolar disorder.
- Stay away from drugs and alcohol: Consuming alcohol or using street drugs can intensify your symptoms and heighten the likelihood of them recurring.
- Take your medicines as directed: It may be tempting to discontinue your treatment, but it’s crucial not to do so. Stopping your medication or lowering the dose on your own can lead to withdrawal symptoms and might worsen your condition or cause it to return.
Conclusion
Bipolar disorder is a complicated mental health condition marked by severe mood swings, which include episodes of mania or hypomania and depression. This condition can greatly disrupt daily activities, affecting work, relationships, and overall well-being. Early diagnosis and ongoing treatment, including medication and therapy, are essential for effectively managing symptoms. Recognizing triggers, keeping a stable routine, and avoiding substances like alcohol and drugs can help manage mood fluctuations. With proper care and support, people with bipolar disorder can lead fulfilling lives, despite the challenges it presents.
