Bipolar Disorder: What Is It?

Reviewed Oct 19, 2017

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Summary

  • Involves both depression and mania
  • Is sometimes hereditary
  • Disrupts normal life
  • Is treatable

Bipolar disorder is a mental condition marked by great changes in mood, activity level, energy, and thinking. It is more of a spectrum than a well-defined set of symptoms. There is overlap, ranging from mania to deep depression. There are combinations of symptoms which are called mixed state.

A person with bipolar may have changes in what they feel with each episode. All people feel sadness, anger, fearfulness, joy, and optimism at times. A person with bipolar has these feelings to the extreme. Energy, focus, activity, sleep, and hunger may also change.

Mania

Mania can cause big problems at home, work, or school. During an episode, the person is overactive, easily stimulated, and often irritable. The person may:

  • Have a very high regard for themselves
  • Believe they can do things they can’t likely do
  • Engage in risky sex
  • Start risky businesses
  • Go on spending sprees without having enough money
  • Feel rested after three hours of sleep or go for days without sleep
  • Have thoughts that race and jump from topic to topic
  • Lash out if someone tries to limit their actions 

The person within a manic episode may not realize she is doing anything wrong. It is easy to see how mania can result in great losses for those who go through it, as well as those who love them.

Depression

All people feel sadness, disappointment, and self-doubt at some point in their lives. Anyone who has lost a loved one or pet can have grief. A person with ongoing depression may:

  • Lose interest in grooming, social events, or future planning 
  • Think they are not worth anything 
  • Want to stay away from people 
  • Have trouble thinking 
  • Find most acts to be an effort
  • Not be able to sleep, or sleep too much
  • Eat too much or not enough 
  • Have thoughts of guilt (undeserved) 
  • Think about killing themselves  

Those with bipolar often have depression before mania. Because of this, they can be misdiagnosed. Treatment is very different for bipolar manic, manic/mixed, mixed, and depressed/mixed episodes than it is for depression. A person who has depression should know the symptoms of a mixed state. 

Mixed state

This involves having some of the symptoms of mania and depression at the same time. Any group of symptoms can happen together. For example, a person may be:

  • Depressed
  • Restless and irritable
  • Not able to sleep but tired
  • Not able to stop racing thoughts

This person might not have the manic feeling of being able to do all things, and be smarter, better, and more attractive than others. It is a very painful mental state in which a person simply feels bad. Persons in a mixed state may think about taking their own life.

Types of bipolar disorder

These are the main types:

  • Bipolar I disorder involves severe depression, in which the symptoms occur daily for two weeks, and one or more periods of mania, in which the symptoms occur daily for one week or less if a hospital stay occurred.
  • Bipolar II disorder includes periods of change in mood, energy, and activity which is different from the person’s usual behavior and that lasts for four days. It is not severe enough to cause a great change in functioning but is clear to others.
  • Unspecified bipolar and related disorder cannot be classified as type I or II, but is still not considered normal behavior.
  • Cyclothymic disorder involves mood swings for at least two years which do not greatly disturb daily functioning and do not meet the level of depression, mania, or hypomania. Persons with this disorder do not have more than a two-month period in which they are free of symptoms.
  • Rapid-cycling is diagnosed when there are four episodes of mania, depression, or mixed state within a 12-month period.

Possible causes

Bipolar disorder often runs in families. Other conditions that may lead to bipolar disorder are chemical imbalances, brain development problems, and environmental factors. It usually starts in the late teens, but can happen at any age. Many other disorders can look like bipolar. These include:

  • Medical diseases, such as thyroid disorders
  • Genetic diseases
  • Post-traumatic stress disorder
  • Attention-deficit/hyperactivity disorder
  • Anxiety disorders
  • Substance use disorder 

It is very important to get an evaluation so a diagnosis can be made. Early treatment of bipolar disorder has been shown to be related to fewer episodes and better functioning.

Treatment

Bipolar disorder is usually a lifelong illness, but treatment can be effective. Like any chronic illness such as diabetes or asthma, it is still necessary to continue treatment in between episodes. It is very important for a person with bipolar disorder to keep a daily life chart tracking moods, sleep patterns, and life events. The chart will be a record of triggers as well as activities that relieve the symptoms. 

Many people are helped by medications combined with talk therapy. In some cases, electroconvulsive therapy—in which an electric impulse is sent to the brain—is a helpful treatment. Support groups, a healthy lifestyle, and identifying and reducing stress can go a long way toward better results.

When to seek help

Mood swings are a part of life. Everyone has periods of ups and downs. If these mood swings are severe, not like your usual behavior, upset your normal life, or last more than one or two weeks, you should seek care.

If you are having thoughts of killing yourself, seek help right away. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK.

Resources

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance 
www.dbsalliance.org/

National Institute of Mental Health/Bipolar Disorder
www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Suicide Prevention Lifeline
Call the toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) to talk with a trained counselor.

By Cynthia Scott, MD, Physician Advisor, Beacon Health Options and Kevin Rizzo
Source: National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; Depression and Bipolar Support Alliance, www.dbsalliance.org/site/PageServer?pagename=home; National Library of Medicine National Institute of Health, www.nlm.nih.gov/medlineplus/ency/article/000926.htm; Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition edited by the American Psychiatric Association, 2013.

Summary

  • Involves both depression and mania
  • Is sometimes hereditary
  • Disrupts normal life
  • Is treatable

Bipolar disorder is a mental condition marked by great changes in mood, activity level, energy, and thinking. It is more of a spectrum than a well-defined set of symptoms. There is overlap, ranging from mania to deep depression. There are combinations of symptoms which are called mixed state.

A person with bipolar may have changes in what they feel with each episode. All people feel sadness, anger, fearfulness, joy, and optimism at times. A person with bipolar has these feelings to the extreme. Energy, focus, activity, sleep, and hunger may also change.

Mania

Mania can cause big problems at home, work, or school. During an episode, the person is overactive, easily stimulated, and often irritable. The person may:

  • Have a very high regard for themselves
  • Believe they can do things they can’t likely do
  • Engage in risky sex
  • Start risky businesses
  • Go on spending sprees without having enough money
  • Feel rested after three hours of sleep or go for days without sleep
  • Have thoughts that race and jump from topic to topic
  • Lash out if someone tries to limit their actions 

The person within a manic episode may not realize she is doing anything wrong. It is easy to see how mania can result in great losses for those who go through it, as well as those who love them.

Depression

All people feel sadness, disappointment, and self-doubt at some point in their lives. Anyone who has lost a loved one or pet can have grief. A person with ongoing depression may:

  • Lose interest in grooming, social events, or future planning 
  • Think they are not worth anything 
  • Want to stay away from people 
  • Have trouble thinking 
  • Find most acts to be an effort
  • Not be able to sleep, or sleep too much
  • Eat too much or not enough 
  • Have thoughts of guilt (undeserved) 
  • Think about killing themselves  

Those with bipolar often have depression before mania. Because of this, they can be misdiagnosed. Treatment is very different for bipolar manic, manic/mixed, mixed, and depressed/mixed episodes than it is for depression. A person who has depression should know the symptoms of a mixed state. 

Mixed state

This involves having some of the symptoms of mania and depression at the same time. Any group of symptoms can happen together. For example, a person may be:

  • Depressed
  • Restless and irritable
  • Not able to sleep but tired
  • Not able to stop racing thoughts

This person might not have the manic feeling of being able to do all things, and be smarter, better, and more attractive than others. It is a very painful mental state in which a person simply feels bad. Persons in a mixed state may think about taking their own life.

Types of bipolar disorder

These are the main types:

  • Bipolar I disorder involves severe depression, in which the symptoms occur daily for two weeks, and one or more periods of mania, in which the symptoms occur daily for one week or less if a hospital stay occurred.
  • Bipolar II disorder includes periods of change in mood, energy, and activity which is different from the person’s usual behavior and that lasts for four days. It is not severe enough to cause a great change in functioning but is clear to others.
  • Unspecified bipolar and related disorder cannot be classified as type I or II, but is still not considered normal behavior.
  • Cyclothymic disorder involves mood swings for at least two years which do not greatly disturb daily functioning and do not meet the level of depression, mania, or hypomania. Persons with this disorder do not have more than a two-month period in which they are free of symptoms.
  • Rapid-cycling is diagnosed when there are four episodes of mania, depression, or mixed state within a 12-month period.

Possible causes

Bipolar disorder often runs in families. Other conditions that may lead to bipolar disorder are chemical imbalances, brain development problems, and environmental factors. It usually starts in the late teens, but can happen at any age. Many other disorders can look like bipolar. These include:

  • Medical diseases, such as thyroid disorders
  • Genetic diseases
  • Post-traumatic stress disorder
  • Attention-deficit/hyperactivity disorder
  • Anxiety disorders
  • Substance use disorder 

It is very important to get an evaluation so a diagnosis can be made. Early treatment of bipolar disorder has been shown to be related to fewer episodes and better functioning.

Treatment

Bipolar disorder is usually a lifelong illness, but treatment can be effective. Like any chronic illness such as diabetes or asthma, it is still necessary to continue treatment in between episodes. It is very important for a person with bipolar disorder to keep a daily life chart tracking moods, sleep patterns, and life events. The chart will be a record of triggers as well as activities that relieve the symptoms. 

Many people are helped by medications combined with talk therapy. In some cases, electroconvulsive therapy—in which an electric impulse is sent to the brain—is a helpful treatment. Support groups, a healthy lifestyle, and identifying and reducing stress can go a long way toward better results.

When to seek help

Mood swings are a part of life. Everyone has periods of ups and downs. If these mood swings are severe, not like your usual behavior, upset your normal life, or last more than one or two weeks, you should seek care.

If you are having thoughts of killing yourself, seek help right away. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK.

Resources

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance 
www.dbsalliance.org/

National Institute of Mental Health/Bipolar Disorder
www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Suicide Prevention Lifeline
Call the toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) to talk with a trained counselor.

By Cynthia Scott, MD, Physician Advisor, Beacon Health Options and Kevin Rizzo
Source: National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; Depression and Bipolar Support Alliance, www.dbsalliance.org/site/PageServer?pagename=home; National Library of Medicine National Institute of Health, www.nlm.nih.gov/medlineplus/ency/article/000926.htm; Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition edited by the American Psychiatric Association, 2013.

Summary

  • Involves both depression and mania
  • Is sometimes hereditary
  • Disrupts normal life
  • Is treatable

Bipolar disorder is a mental condition marked by great changes in mood, activity level, energy, and thinking. It is more of a spectrum than a well-defined set of symptoms. There is overlap, ranging from mania to deep depression. There are combinations of symptoms which are called mixed state.

A person with bipolar may have changes in what they feel with each episode. All people feel sadness, anger, fearfulness, joy, and optimism at times. A person with bipolar has these feelings to the extreme. Energy, focus, activity, sleep, and hunger may also change.

Mania

Mania can cause big problems at home, work, or school. During an episode, the person is overactive, easily stimulated, and often irritable. The person may:

  • Have a very high regard for themselves
  • Believe they can do things they can’t likely do
  • Engage in risky sex
  • Start risky businesses
  • Go on spending sprees without having enough money
  • Feel rested after three hours of sleep or go for days without sleep
  • Have thoughts that race and jump from topic to topic
  • Lash out if someone tries to limit their actions 

The person within a manic episode may not realize she is doing anything wrong. It is easy to see how mania can result in great losses for those who go through it, as well as those who love them.

Depression

All people feel sadness, disappointment, and self-doubt at some point in their lives. Anyone who has lost a loved one or pet can have grief. A person with ongoing depression may:

  • Lose interest in grooming, social events, or future planning 
  • Think they are not worth anything 
  • Want to stay away from people 
  • Have trouble thinking 
  • Find most acts to be an effort
  • Not be able to sleep, or sleep too much
  • Eat too much or not enough 
  • Have thoughts of guilt (undeserved) 
  • Think about killing themselves  

Those with bipolar often have depression before mania. Because of this, they can be misdiagnosed. Treatment is very different for bipolar manic, manic/mixed, mixed, and depressed/mixed episodes than it is for depression. A person who has depression should know the symptoms of a mixed state. 

Mixed state

This involves having some of the symptoms of mania and depression at the same time. Any group of symptoms can happen together. For example, a person may be:

  • Depressed
  • Restless and irritable
  • Not able to sleep but tired
  • Not able to stop racing thoughts

This person might not have the manic feeling of being able to do all things, and be smarter, better, and more attractive than others. It is a very painful mental state in which a person simply feels bad. Persons in a mixed state may think about taking their own life.

Types of bipolar disorder

These are the main types:

  • Bipolar I disorder involves severe depression, in which the symptoms occur daily for two weeks, and one or more periods of mania, in which the symptoms occur daily for one week or less if a hospital stay occurred.
  • Bipolar II disorder includes periods of change in mood, energy, and activity which is different from the person’s usual behavior and that lasts for four days. It is not severe enough to cause a great change in functioning but is clear to others.
  • Unspecified bipolar and related disorder cannot be classified as type I or II, but is still not considered normal behavior.
  • Cyclothymic disorder involves mood swings for at least two years which do not greatly disturb daily functioning and do not meet the level of depression, mania, or hypomania. Persons with this disorder do not have more than a two-month period in which they are free of symptoms.
  • Rapid-cycling is diagnosed when there are four episodes of mania, depression, or mixed state within a 12-month period.

Possible causes

Bipolar disorder often runs in families. Other conditions that may lead to bipolar disorder are chemical imbalances, brain development problems, and environmental factors. It usually starts in the late teens, but can happen at any age. Many other disorders can look like bipolar. These include:

  • Medical diseases, such as thyroid disorders
  • Genetic diseases
  • Post-traumatic stress disorder
  • Attention-deficit/hyperactivity disorder
  • Anxiety disorders
  • Substance use disorder 

It is very important to get an evaluation so a diagnosis can be made. Early treatment of bipolar disorder has been shown to be related to fewer episodes and better functioning.

Treatment

Bipolar disorder is usually a lifelong illness, but treatment can be effective. Like any chronic illness such as diabetes or asthma, it is still necessary to continue treatment in between episodes. It is very important for a person with bipolar disorder to keep a daily life chart tracking moods, sleep patterns, and life events. The chart will be a record of triggers as well as activities that relieve the symptoms. 

Many people are helped by medications combined with talk therapy. In some cases, electroconvulsive therapy—in which an electric impulse is sent to the brain—is a helpful treatment. Support groups, a healthy lifestyle, and identifying and reducing stress can go a long way toward better results.

When to seek help

Mood swings are a part of life. Everyone has periods of ups and downs. If these mood swings are severe, not like your usual behavior, upset your normal life, or last more than one or two weeks, you should seek care.

If you are having thoughts of killing yourself, seek help right away. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK.

Resources

The Balanced Mind Foundation
www.dbsalliance.org/site/PageServer?pagename=bmpn_landing

Depression and Bipolar Support Alliance 
www.dbsalliance.org/

National Institute of Mental Health/Bipolar Disorder
www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Suicide Prevention Lifeline
Call the toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) to talk with a trained counselor.

By Cynthia Scott, MD, Physician Advisor, Beacon Health Options and Kevin Rizzo
Source: National Institute of Mental Health, www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml; Depression and Bipolar Support Alliance, www.dbsalliance.org/site/PageServer?pagename=home; National Library of Medicine National Institute of Health, www.nlm.nih.gov/medlineplus/ency/article/000926.htm; Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition edited by the American Psychiatric Association, 2013.

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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