Bipolar disorder, also known as manic-depression, is a treatable condition that typically causes extreme swings in mood, thought, energy, and behavior. There can often periods of normal mood between episodes. This medical problem is not due to personal weakness or a character flaw.
The mood swings associated with bipolar disorder are different from the average ups and downs experienced by everybody in life. In severe cases, bipolar disorder can be associated with psychotic symptoms, such as hallucinations, delusions, or thought disorganization. These symptoms can result in damaged relationships, poor job or school performance, and even suicide. When treated appropriately, people with this condition can lead full and productive lives.
Bipolar disorder affects an estimated 2.6% of American adults (18 and older). The condition typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop symptoms late in life. Bipolar disorder is a long-term illness that must be carefully managed by a medical professional throughout a person's life.
The cause of bipolar disorder is unknown, but it tends to run in families. Specific genes may play a role, but it is not caused by one single gene. Additional factors, including stressors at home, work, or school, are believed to be involved in its onset.
People with bipolar disorder are at increased risk for suicide, substance abuse, and high risk behaviors such as reckless driving and sexual promiscuity. Anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, tend to occur at a higher rate in people with bipolar disorder.
What are the risk factors for bipolar disorder?
[What are the symptoms of bipolar disorder?
[How is bipolar disorder diagnosed?
What are the treatments for bipolar disorder?
Are there screening tests for bipolar disorder?
[How can I reduce my risk of bipolar disorder?
References:
American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders. 4th ed. Arlington, VA: American Psychiatric Publishing, Inc.; 2000.
Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/publicat/bipolar.cfm . Revised 2008. Accessed on November 22, 2009.
Centers for Disease Control and Prevention. Web-based injury statistics query and reporting system (WISQARS). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncipc/wisqars . Accessed November 22, 2009.
Estevez RF, Suppes T. Maintenance treatment in bipolar I disorder. In: Yatham LN, Kusumakar V, ed. Bipolar Disorder: A Clinician’s Guide to Biological Treatments.New York, NY: Taylor & Francis Group, LLC; 2009: 107-152.
Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. Arch Gen Psychiatry.2007;64:543-552.
The numbers count: mental disorders in America. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america.shtml#Bipolar . Updated 2010. Accessed August 24, 2010.
References:
Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/publicat/bipolar.cfm . Updated 2008. Accessed on November 22, 2009.
Carson RC, Butcher JN. Abnormal Psychology and Modern Life .11th ed. New York, NY: Allyn and Bacon; 2000.
Estevez RF, Suppes T. Maintenance treatment in bipolar I disorder. In: Yatham LN, Kusumakar V, eds. Bipolar Disorder: A Clinician’s Guide to Biological Treatments. New York, NY: Taylor & Francis Group, LLC.; 2009: 107-152.
Salvadore G, Drevets WC, Henter ID, Zarate CA, Manji HK. Early intervention in Bipolar Disorder, Part II: Therapeutics. Early Interv Psychiatry. 2008;2(3):136-146.
A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop bipolar disorder with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing bipolar disorder. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
Risk factors for bipolar disorder include:
Bipolar disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again to the high point. Often, there are periods of normal mood patterns in between these highs and lows. Severe changes in energy and behavior go along with these changes in mood. The periods of highs are called mania, and those of the lows are called depression.
Symptoms of bipolar disorder include:
Symptoms of depressive episodes include:
Periods of highs are called mania. Symptoms include:
A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with good functioning and enhanced productivity. Without proper treatment, however, hypomania can become severe mania or can switch over into depression.
People with bipolar disorder may also experience:
Sometimes, severe episodes of mania or depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are:
Psychotic symptoms in bipolar disorder tend to reflect the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the President or has special powers or wealth, may occur during mania. Delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression.
Some people with bipolar disorder become suicidal. Anyone who is thinking about committing suicide needs immediate attention, preferably from a mental health professional or a doctor. Anyone who talks about suicide should be taken seriously. Risk for suicide appears to be higher earlier in the course of the illness. Therefore, recognizing bipolar disorder early and learning how best to manage it may decrease the risk of death by suicide.
Signs and symptoms that may accompany suicidal feelings include:
As the above lists of symptoms illustrate, bipolar disorder can range from mild to severe. If you have depression symptoms, for example, you may have a low mood, feel moderately depressed, or suffer from major depression. The symptoms of mania can also be in a range from experiencing more energy to being in an extremely euphoric mood.
The condition is even more complex because there is also a “mixed” state, where you may feel energized, but also sad, agitated, and suicidal. In between these changes in mood, you could have periods of normal mood.
Bipolar disorder is also broken down into four main types. These types, identified in the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV), have specific symptoms, such as:
Bipolar Disorder Type I:
Bipolar Disorder Type II:
Bipolar Disorder Type III:
Mild Form (called cyclothymia):
There is another type called rapid-cycling. This is more likely to happen if you have severe bipolar disorder. Rapid cycling means that you experience four or more episodes of major depression, mania, hypomania, or mixed state in one year.
While these symptoms of bipolar disorder may seem straight-forward, it is actually a difficult condition for doctors to diagnose. One reason is because most patients—60% to 80%—who have undiagnosed bipolar disorder seek help from their doctors because of the depressive symptoms. Patients may not share information about their episodes of elevated mood, and doctors may not ask questions about mood changes.
Some symptoms that may help doctors to identify bipolar disorder include:
Major depression, on the other hand, includes symptoms like feelings of guilt, worthlessness, or helplessness, which last for at least two weeks. If you have depression, you may have one episode or many episodes. The main difference between a diagnosis of depression and bipolar disorder is that there are no episodes of mania or hypomania in people who have depression.
There are no guidelines for preventing bipolar disorder because the cause is unknown. Scientists are actively searching for a better understanding of bipolar disorder and ways to prevent it.
Bipolar disorder, also known as manic-depression, is a treatable condition that typically causes extreme swings in mood, thought, energy, and behavior. There can often periods of normal mood between episodes. This medical problem is not due to personal weakness or a character flaw.
The mood swings associated with bipolar disorder are different from the average ups and downs experienced by everybody in life. In severe cases, bipolar disorder can be associated with psychotic symptoms, such as hallucinations, delusions, or thought disorganization. These symptoms can result in damaged relationships, poor job or school performance, and even suicide. When treated appropriately, people with this condition can lead full and productive lives.
Bipolar disorder affects an estimated 2.6% of American adults (18 and older). The condition typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop symptoms late in life. Bipolar disorder is a long-term illness that must be carefully managed by a medical professional throughout a person's life.
The cause of bipolar disorder is unknown, but it tends to run in families. Specific genes may play a role, but it is not caused by one single gene. Additional factors, including stressors at home, work, or school, are believed to be involved in its onset.
People with bipolar disorder are at increased risk for suicide, substance abuse, and high risk behaviors such as reckless driving and sexual promiscuity. Anxiety disorders, such as post-traumatic stress disorder and obsessive-compulsive disorder, tend to occur at a higher rate in people with bipolar disorder.
What are the risk factors for bipolar disorder?
What are the symptoms of bipolar disorder?
How is bipolar disorder diagnosed?
What are the treatments for bipolar disorder?
Are there screening tests for bipolar disorder?
How can I reduce my risk of bipolar disorder?
References:
American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders. 4th ed. Arlington, VA: American Psychiatric Publishing, Inc; 2000.
American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry.2002;159:1-50.
Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ . Updated June 2008. Accessed September 9, 2008.
Carson RC, Butcher JN. Abnormal Psychology and Modern Life. 11th ed. New York, NY: Allyn and Bacon; 2000.
Kaye NS. Is your depressed patient bipolar? J Am Board Am Pract.2005;18:271-281.
References:
American Psychiatric Association website. Available at: http://www.psych.org/ .
Brendel D. What is the difference between major depression and bipolar disorder? ABC News/Health website. Available at: http://abcnews.go.com/Health/DepressionScreening/story?id=4355225 . Published February 27, 2008. Accessed August 26, 2010.
DynaMed Editorial Team. Bipolar disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 18, 2010. Accessed August 26, 2010.
Friedel R. Bipolar disorder-depressed and major depressive disorder co-occurring with borderline disorder. National Alliance on Mental Illness website. http://www.nami.org/Template.cfm?Section=by_illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=43147 . Accessed August 26, 2010.
Grohol J. What's the difference between bipolar disorder and depression? Psych Central website. Available at: http://psychcentral.com/lib/2007/whats-the-difference-between-bipolar-disorder-and-depression/ . Updated September 2009. Accessed August 26, 2010.
Kaye NS. Is your depressed patient bipolar? J Am Board Am Pract.2005;18:271-281.
Manning J, Connor P, Sahai A. The bipolar spectrum: a review of current concepts and implications for the management of depression in primary care. Arch Fam Med.1998;7:63-71.
National Institute of Mental Health. Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml#pub3 . Updated 2008. Accessed August 26, 2010.
National Institute of Mental Health. Depression. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml#pub3 . Updated August 25, 2010. Accessed August 26, 2010.
References:
American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders. 4th ed. Arlington, VA: American Psychiatric Publishing, Inc.; 2000.
Bipolar disorder. Depression and Bipolar Support Alliance website. Available at: http://www.ndmda.org/ . Updated October 2007. Accessed September 9, 2008.
Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ . Updated June 2008. Accessed September 9, 2008.
Carson RC, Butcher JN. Abnormal Psychology and Modern Life .11th ed. New York, NY: Allyn and Bacon; 2000.
Like other mental illnesses, bipolar disorder cannot be identified physiologically—for example, through a blood test or a brain scan. A diagnosis of bipolar disorder is made on the basis of symptoms, course of illness, and, when available, family history. The diagnostic criteria for bipolar disorder are described in the Diagnostic and Statistical Manual for Mental Disorders, fourth edition (DSM-IV). Bipolar disorder is often diagnosed based on the following:
Mania is diagnosed if abnormally elevated mood (lasting at least one week) occurs with three or more of the other symptoms of mania. If your mood is irritable, four additional symptoms must be present.
Depression is diagnosed if depressed mood or loss of interest in pleasure occurs every day (or nearly every day) over the last two weeks, and it is accompanied by five or more of the symptoms.
A diagnostic evaluation may include a mental status exam to determine if your speech, thought patterns, or memory have been affected, as sometimes happens in the case of bipolar disorder.
You may also be evaluated for other psychiatric conditions, such as anxiety disorders and alcohol or drug abuse.
Some symptoms that may help doctors to identify bipolar disorder include:
Major depression, on the other hand, includes symptoms like feelings of guilt, worthlessness, or helplessness, which last for at least two weeks. If you have depression, you may have one episode or many episodes. The main difference between a diagnosis of depression and bipolar disorder is that there are no episodes of mania or hypomania in people who have depression.
Address:
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847-492-8519
Internet Address:
http://www.bpkids.org
Description of Services Provided:
CABF provides articles, journals, families' stories, current research, news, a message board, and support for the families of children and teens with bipolar disorder.
Address:
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Chicago, IL 60610-7224
Phone:
1-800-826-3632
Internet Address:
http://www.dbsalliance.org
Description of Services Provided:
DBSA provides information on mood disorders, a list of support groups with chapters, personal stories, programs, publications, resources, and advocacy.
Address:
Science Writing, Press, and Dissemination
6001 Executive Blvd., Rm. 8184, MSC 96634
Bethesda, MD 20892-9663
Phone:
1-866-615-6464
Email Address:
nimhinfo@nih.gov
Internet Address:
http://www.nimh.nih.gov
Description of Services Provided:
NIMH is part of the National Institutes of Health. The website provides information about bipolar disorder, including symptoms and treatment, as well as ways to locate mental health services in your area.
Internet Address:
http://www.pendulum.org
Description of Services Provided:
Pendulum provides information for consumers and professionals on bipolar disorder, including information on diagnostic criteria, medicines, alternative treatments, and support groups, as well as related links.
References:
American Psychiatric Association. Diagnosis and Statistical Manual of Mental Disorders. 4th ed. Arlington, VA: American Psychiatric Publishing, Inc.; 2000.
Bipolar disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 2008. Accessed September 9, 2008.
Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ . Updated June 2008. Accessed September 9, 2008.
Screening for bipolar disorder. The American Journal of Managed Care.2007;13:S164-S169.
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
There are some screening tools for bipolar disorder, such as the Mood Disorder Questionnaire. This one-page report has 13 yes-or-no questions that are based on the Diagnostic and Statistical Manual'scriteria for bipolar disorder.
References:
Belmaker RH. Bipolar disorder. N Engl J Med. 2004;351:476-486.
Bipolar disorder. American Psychological Association website. Available at: http://www.apa.org/topics/topicbipolar.html . Accessed September 9, 2008.
Bipolar disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ . Updated June 2008. Accessed September 9, 2008.
Hirschfeld RMA. G uideline Watch: Practice Guideline for the Treatment of Patients with Bipolar Disorder.2nd ed. Arlington, VA: American Psychiatric Association; 2005.
Hirschfeld RMA, Bowden CL, Gitlin MJ, et al. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry.2002;159:1-50.
You have a unique medical history. Therefore, it is essential to talk with your doctor about your personal risk factors and/or experience with bipolar disorder. By talking openly and regularly with your doctor, you can take an active role in your care.
General Tips for Gathering Information
Here are some tips that will make it easier for you to talk to your doctor:
Specific Questions to Ask Your doctor
About Bipolar Disorder
About Treatment Options
About Counseling
If you decide to try counseling , interview counselors, social workers, psychologists, and/or family therapists who specialize in working with people (and their families) who have bipolar disorder. Make sure that you feel comfortable with the mental health professional. Some questions you may want to ask are:
About Lifestyle Changes
About Outlook
