What is Bipolar Disorder?
Bipolar disorder is a mental illness that causes strong or abrupt changes in a person’s mood and energy levels. These moods can range from “manic” episodes, which include periods of high levels of energy or feelings of happiness, to “depressive” episodes of low energy and feelings of hopelessness or sadness. Because of these shifts, this brain disorder was previously known as manic-depressive illness.
Everyone’s emotions change over the course of a day or week, from sadness to happiness and everything in-between. With a mental illness like bipolar disorder, however, those mood changes can interfere with a person’s ability to complete daily tasks, do their jobs, manage their health, and maintain healthy relationships.
There are four basic types of bipolar disorder, each defined by a particular set of symptoms:
- Bipolar I Disorder: This type features manic episodes that last at least 7 days, or manic symptoms severe enough to require immediate hospital care. If there are depressive episodes, they usually last at least 2 weeks. Some people with this type may have episodes of depression with both depression and manic symptoms at the same time.
- Bipolar II Disorder: This type also features a pattern of depressive episodes. Manic episodes are less extreme, and so are known as hypomanic episodes.
- Cyclothymic Disorder (cyclothymia): This type combines several periods of hypomanic symptoms with several periods of depressive symptoms, lasting a total of at least 2 years for adults, or 1 year in children and adolescents.
- Other Specified and Unspecified Bipolar and Related Disorders: This type is a general term used when a person shows bipolar disorder symptoms that do not clearly match the three previous types.
What causes bipolar disorder?
Experts are not certain what causes bipolar disorder, but it may be a combination of factors that may include:
- Biological differences, including physical changes in the brain
- Genetics, since bipolar disorder is more common in people whose sibling or parent also has the condition
- Environmental factors, including extreme stress, trauma, or drug and alcohol abuse
Bipolar disorder can have different effects on a person’s life. During manic episodes, a person may engage in risky behaviors, including drug and alcohol use or overspending. This may lead to legal or financial problems. Depressive episodes may lead a person to think about suicide or make suicide attempts. Bipolar disorder symptoms also may affect work or school performance or create relationship strain.
The “high” of a manic episode may seem appealing, especially when compared to the “low” point of a depressive episode. However, episodes of mania can spiral out of control, leading to increased irritability, more impulsive behavior, and potentially damaging risks. During a manic state, a person with bipolar disorder may not be aware of the risks or negative consequences of their behavior. Suicidal behavior is possible even during episodes of mania.
What are the signs and symptoms of bipolar disorder?
Not everyone with bipolar disorder will show all the same symptoms. Symptoms also vary between manic and depressive episodes.
Manic episodes of bipolar disorder
During an episode of mania, most people will show at least three of the following symptoms:
- Unusually active, energized, cheerful, or agitated
- Feeling or showing euphoria, exaggerated well-being, and excessive confidence
- Needing less sleep
- Talking more or faster than usual
- Racing thoughts
- Easily distracted and less focused
- Poor decision-making and increased risk-taking, such as with finances, sexual activity, driving, and other behaviors
Because mania is more severe than hypomania, it usually creates more obvious problems in relationships, quality of life, and work. In severe cases, mania may cause an episode of psychosis, or a break from reality, that requires immediate treatment and even hospitalization.
Depressive episodes of bipolar disorder
During a depressive episode, symptoms interfere with normal functioning and relationships. Most people with bipolar disorder will show at least five of the following symptoms in a depressive episode:
- Feeling sad, empty, or hopeless
- Crying often
- Increased irritability, particularly in children and teens
- Loss of interest or pleasure in otherwise enjoyable activities
- Significant, unexplained weight loss or weight gain (or, in growing children, a failure to gain weight appropriately)
- Appetite changes
- Sleep disruptions, either trouble sleeping or sleeping too much
- Unusual restlessness
- Fatigue, moving more slowly, or reduced energy
- Feeling worthless or excessively guilty
- Reduced ability to think, concentrate, or make decisions
- Contemplating, planning, or attempting suicide
How do I learn if I have bipolar disorder?
To be diagnosed with bipolar disorder, you must have experienced mania or hypomania at least once. Because hypomania is milder than mania, without psychotic episodes, it may be harder to detect. Even in people with diagnosed bipolar disorder, manic episodes may occur only rarely. Others may experience many episodes of mania or hypomania.
Only a doctor can diagnose you with bipolar disorder. If you are concerned about symptoms of bipolar disorder, talk to your primary-care provider, psychiatrist, or other physician. Discuss the specific symptoms that concern you, even if you are not sure about their cause.
To determine if you have bipolar disorder, your doctor may give you a physical examination and discuss your specific symptoms and concerns. Depending on your symptoms, he or she may order lab work, such as a blood test. Some illnesses, like hyperthyroidism, or medicines, such as steroids, may have symptoms or side effects that resemble bipolar disorder. If other causes can be ruled out, your doctor may diagnose bipolar disorder and recommend mental health treatment.
An appointment with your provider can help you get the right treatment sooner, preventing additional complications. It is especially important to talk to your provider if you have other mental-health concerns, such as suicidal thoughts or struggles with substance use.
We also offer an anonymous online screening to find out if you should seek treatment.