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Bipolar disorder is a mental health illness that causes dramatic shifts in a persons mood, energy, and ability to think clearly. People with bipolar experience high and low moods, known as mania and depression, which differ from the typical ups-and-downs most people experience.
People with bipolar disorder may have trouble managing everyday life tasks at school, work, or maintaining relationships. If left untreated, bipolar usually worsens. There is no cure, but there are many different treatment options available that can help to manage the symptoms. Many people live well with the disorder.
The average age-of-onset is about 25, but it can occur in teens or children. The condition affects men and women equally. About 2.8% of the U.S. population is diagnosed with bipolar disorder, with nearly 83% of cases classified as severe.
There are three main symptoms that can occur with bipolar disorder: mania, hypomania, and depression.
Symptoms and their severity can vary. A person with bipolar disorder may have distinct manic and depressive states but may also have extended periods of time without symptoms. A person can also experience both extremes simultaneously or in rapid sequence.
Severe bipolar episodes of mania or depression may include psychotic symptoms such as hallucinations and delusions. Usually, these symptoms mirror a person's extreme mood. People with bipolar disorder with psychotic symptoms can be wrongly diagnosed as having schizophrenia.
To be diagnosed with bipolar disorder, a person must have experience at least one episode of mania or hypomania. Hypomania is a milder form of mania that doesn't include psychotic episodes. People with hypomania can often function well in social situations or at work. Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life; other may experience them only rarely.
Although someone with bipolar may find the elevated mood of mania appealing, the "high" does not stop at a comfortable or controllable level. Moods can rapidly become more irritable, behavior more unpredictable, and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions, and take unusual risks.
Most of the time, people in manic states are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger because some people become suicidal even in manic states. Learning from prior episodes what kinds of behavior signals "red flags" of manic behavior can help manage the symptoms of the illness.
The lows of bipolar depression are often so debilitating that people are unable to get out of bed. Typically, people experiencing a depressive episode have difficulty falling and staying asleep, while others sleep far more than usual. When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt, or hopelessness. This negative thinking can lead to thoughts of suicide.
The depressive symptoms that obstruct a person's ability to function must be present nearly everyday for a period of at least two weeks for a diagnosis. Depression associated with bipolar disorder may be more difficult to treat and require a customized treatment plan.
Men and women are diagnosed with bipolar disorder in equal numbers. However, the main symptoms of the disorder may be different between them. In many cases a woman with bipolar disorder may:
Women with bipolar disorder may also relapse more often than men. This is believed to be caused by hormone changes during menstruation, pregnancy, and menopause.
Men and women both experience common symptoms of bipolar disorder. However, men may experience symptoms differently than women. Men with bipolar disorder may:
Men with bipolar disorder are less likely than women to seek medical care on their own. They're also more likely to die by suicide.
Diagnosing bipolar disorder in children is controversial. This is largely because children don't always display the same symptoms as adults. Their moods and behaviors may also not follow the standards doctors use to diagnose the disorder in adults.
Many bipolar disorder symptoms that appear in children also overlap with a several other disorders that can occur in children, such as ADHD.
Like adults, children with bipolar disorder experience episodes of elevated mood. They can appear very happy and show signs of excitable behavior. These periods are then followed by depression. While all children experience mood changes, changes caused by bipolar disorder are very pronounced. They are also more extreme than a child's typical change in mood.
Angst-filled behavior is nothing new to the average parent of a teenager. The shifts in hormones, plus the life changes that come with puberty, can make even the most well-behaved teen seem a little upset or emotional from time to time. However, some teenage changes in mood may be the result of a more serious condition, such as bipolar disorder.
A bipolar diagnosis is most common in the late teens and early adult years.
Bipolar is a common mental health disorder, but scientists have not yet discovered a single cause for the disorder. Currently, they believe several factors may contribute, including:
The chances of developing bipolar disorder are increased if a child's parents or siblings have the disorder. But the role of genetics is not absolute: A child from a family with a history of bipolar disorder may never develop the disorder. Studies of identical twins have found that, even if one twin develops the disorder, the other may not.
A stressful event such as a death in the family, an illness, a difficult relationship, divorce, or financial problems can trigger a manic or depressive episode. Thus, a person's handling of stress may also play a role in the development of the illness.
Brain scans cannot diagnose bipolar disorder, yet researchers have identified subtle differences in the average size or activation in some brain structures in people with bipolar disorder.
To diagnose bipolar disorder, a doctor may preform a physical examination, conduct an interview, and order lab tests. While bipolar disorder cannot be seen on a blood test or body scan, these tests can help rule out other conditions that can resemble bipolar disorder, such as hyperthyroidism. If no other illness is causing the symptoms, the doctor may recommend mental health care.
To be diagnosed with bipolar disorder, a person must have experienced at least one episode of mania or hypomania. Mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose the "type" of bipolar disorder a person may be experiencing. To determine what type of bipolar disorder someone has, mental health care professionals asses the pattern of symptoms and how impaired the person is during their most severe episodes.
Is an illness where people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, though depression is not necessary for a diagnosis. To be diagnosed with bipolar I, a person's manic episodes must last at least seven days or be so severe that hospitalization is required.
Is a subset of bipolar disorder where people experience depressive episodes shifting back and forth with hypomanic episodes, but never a "full" manic episode.
Is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks.
Is when a person does not meet the criteria for bipolar I, II, or cyclothymia but still has experienced periods of clinically significant abnormal mood elevation.
Bipolar disorder is treated and managed in several ways:
Cognitive behavioral therapy (CBT) is a type of talk therapy. The individual and their therapist will talk about ways to manage bipolar disorder. They will help the person to understand their thinking patterns and come up with positive coping strategies.
Psychoeducation is a kind of counseling that people with bipolar disorder and their loved ones to understand the disorder. Knowing more about bipolar disorder will help to manage it throughout life.
Interpersonal and social rhythm therapy (IPSRT) focusses on regulating daily habits,, such as sleeping, eating, and exercising. Balancing these daily activities can help to manage bipolar disorder.
Such as mood stabilizers, antipsychotic medications and, to a lesser extent, antidepressants.
Like education and recognition of an episode's early symptoms.
Such as aerobic exercise, meditation, faith, and prayer can support, but not replace, treatment.
The largest research project to asses what treatment methods work for people with bipolar disorder is the Systematic Enhancement for Bipolar Disorder, otherwise known as Step-BD. Step-BD followed over 4,000 people diagnosed with bipolar disorder over time with different treatments.