Bipolar Disorder

(Manic-Depressive Illness; Manic Depression; Manic Disorder; Manic Affective Disorder)

Definition

Bipolar disorder is a mental health condition marked by extreme swings in mood, energy, and the ability to function. The mood changes of bipolar disorder are more dramatic than normal ups and downs. They can hurt relationships and cause poor job or school performance. The two mood extremes of bipolar disorder are mania and depression. In mania, one of the defining symptoms is an increase in energy and a decreased need for sleep. The mood may be overly happy or irritable. In depression, a down mood with fatigue takes over, often accompanied by irritability. There are 4 forms of this condition:
  • Bipolar I disorder—Recurrent episodes of mania often immediately followed by depression; episodes can be severe.
  • Bipolar II disorder—Episodes of less severe mania (called hypomania) that alternate with episodes of major depression.
  • Bipolar disorder not otherwise specified (BP-NOS)—The person has symptoms of bipolar disorder, but the symptoms do meet the specific criteria for bipolar I or bipolar II disorder.
  • Cyclothymia—Episodes of hypomania that alternate with episodes of mild depression that last for at least 2 years.

Causes

The cause of bipolar disorder is unknown. This condition tends to run in families. Specific genes may play a role. It is most likely many different genes that act together.
The Brain
Color coded brain
Bipolar disorder may be a result of genetic influences on the brain.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

A family history of the disorder increases your chance of developing it. Tell your doctor if you have a family member with bipolar disorder.

Symptoms

Symptoms include:
  • Dramatic mood swings—This can range from elated excitability, unrealistic goal setting, and an exaggerated sense of self to feelings of hopelessness.
  • Periods of normal mood in between ups and downs.
  • Extreme changes in energy and behavior.
Mania may cause:
  • A mood that is extremely high or overly good
  • Increased energy and effort toward goal-directed activities
  • Restlessness and agitation
  • Racing thoughts, jumping from one idea to another
  • Rapid speech or pressure to keep talking
  • Trouble concentrating
  • Decreased need for sleep
  • Overconfidence or inflated self-esteem
  • Poor judgment, often involving spending sprees and sexual indiscretions
Depression may cause:
  • Prolonged sad, hopeless, or empty mood
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in activities once enjoyed, including sex
  • Decreased energy or fatigue
  • Trouble concentrating, remembering, and/or making decisions
  • Restlessness or diminished movements
  • Agitation
  • Sleeping too much or too little
  • Unintended weight loss or gain
  • Thoughts of death or suicide with or without suicide attempts
Severe episodes of mania or depression may sometimes be associated with psychotic symptoms, such as:
  • Hallucinations
  • Delusions
  • Disorders of thought

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