Bipolar

Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). It is a chronic condition that can affect a person's energy, activity levels, judgment, behavior, and ability to think clearly.

Types of Bipolar Disorder

Bipolar disorder is classified into several types, each defined by the pattern and severity of mood episodes:

• Bipolar I Disorder: This type is characterized by manic episodes that last at least seven days, or by manic symptoms that are so severe that immediate hospital care is needed. Depressive episodes occur as well, typically lasting at least two weeks.

• Bipolar II Disorder: This type involves a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes that are typical of Bipolar I Disorder.

• Cyclothymic Disorder (Cyclothymia): This type is defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least two years (one year in children and adolescents), but the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

• Other Specified and Unspecified Bipolar and Related Disorders: These are bipolar disorder symptoms that do not match the three categories listed above.

Symptoms

The symptoms of bipolar disorder can vary widely in their pattern, severity, and frequency. The main symptoms are:

Manic and Hypomanic Episodes

• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, inability to concentrate
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior

Depressive Episodes

• Lasting sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or can't sleep
• Change in appetite and/or unintended weight loss or gain
• Chronic pain or other persistent bodily symptoms not caused by physical illness or injury
• Thoughts of death or suicide, or suicide attempts

Causes

The exact cause of bipolar disorder is unknown, but several factors may be involved, including:

• Genetics: Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition.
• Biological differences: People with bipolar disorder appear to have physical changes in their brains.
• Neurotransmitters: An imbalance in naturally occurring brain chemicals may play a significant role.
• Environment: Stress, abuse, significant loss, or other traumatic experiences may trigger or exacerbate the condition.

Diagnosis

Diagnosing bipolar disorder involves a careful evaluation by a mental health professional. This includes:

• A physical exam to rule out other conditions
• A psychiatric assessment
• Mood charting to track mood changes over time
• Criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Treatment

Bipolar disorder is a lifelong condition, but it can be managed with a combination of medications and psychotherapy. Treatment options include:

• Medications: Mood stabilizers, antipsychotics, antidepressants, and anti-anxiety medications.
• Psychotherapy: Cognitive behavioral therapy (CBT), psychoeducation, and family therapy.
• Lifestyle changes: Regular exercise, a healthy diet, and a regular sleep schedule.
• Support: Joining a support group or seeking support from family and friends.

Prognosis

With proper treatment, many people with bipolar disorder can lead full and productive lives. However, it is a chronic condition that requires ongoing management.

See Also

• Major depressive disorder
• Schizophrenia
• Anxiety disorder

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• National Institute of Mental Health. Bipolar Disorder.

External Links

• National Institute of Mental Health - Bipolar Disorder
• Mayo Clinic - Bipolar Disorder