Overview
Bipolar disorder, formerly called manic depression, is a mental illness that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
When you are depressed, you may feel sad or hopeless, and you may lose interest or pleasure in most activities. When your mood becomes manic or hypomanic (less extreme than manic), you may feel elated, energetic, or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.
Episodes of mood swings can occur infrequently or several times a year. Although most people experience some emotional symptoms between episodes, some may not.
Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medication and psychological counseling (psychotherapy).
Bipolar disorder treatment at Mayo Clinic
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symptoms
There are different types of bipolar and related disorders. They can include mania or hypomania and depression. The symptoms can cause unpredictable changes in mood and behavior, leading to significant stress and difficulties in life.
- bipolar I disorderHas had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania can trigger a loss of reality (psychosis).
- Bipolar II Disorder.You have had at least one major depressive episode and at least one hypomanic episode, but you have never had a manic episode.
- cyclothymic disorder.They had many episodes of hypomanic symptoms and episodes of depressive symptoms (although less severe than major depression) for at least two years, or one year for children and adolescents.
- Other types.These include, for example, bipolar and related disorders caused by certain drugs or alcohol or due to a disease such as Cushing's disease, multiple sclerosis, or stroke.
Bipolar II disorder is not a milder form of bipolar I disorder, but a diagnosis in its own right. While the manic episodes of bipolar I disorder can be severe and dangerous, people with bipolar II disorder can be depressed for longer periods of time, which can cause significant disability.
Although bipolar disorder can occur at any age, it is usually diagnosed in the teens or early 20s. Symptoms can vary from person to person, and symptoms can vary over time.
mania or hypomania
Mania and hypomania are two different types of episodes, but they share the same symptoms. Mania is more severe than hypomania, causing more noticeable problems with work, school, and social activities, as well as relationship difficulties. Mania can also trigger a loss of reality (psychosis) and require hospitalization.
Both a manic episode and a hypomanic episode involve three or more of these symptoms:
- Exceptionally upbeat, nervous or connected
- Increased activity, energy, or restlessness
- Exaggerated well-being and self-confidence (euphoria)
- Disminution of necesity of sleep.
- unusual talkativeness
- daydreams
- distraction
- Poor decision making, for example, shopping, taking sexual risks, or making foolish investments.
major depressive episode
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulties with activities of daily living, such as work, school, social activities, or relationships. An episode includes five or more of these symptoms:
- depressed mood, such as B. sadness, emptiness, hopelessness, or crying (in children and adolescents, depressed mood may manifest as irritability)
- Marked loss of interest or dislike in all or nearly all activities
- Significant weight loss without dieting, weight gain, or decreased or increased appetite (in children, unexpected weight gain may be a sign of depression)
- Insomnia or too much sleep
- Restlessness or slow behavior
- tiredness or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Suicidal thoughts, plans, or attempts
Other Features of Bipolar Disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features such as: B. anxiety, melancholy, psychosis, or others. Timing of symptoms may include diagnostic terms such as mixed cycling or rapid cycling. Also, bipolar symptoms can occur during pregnancy or change with the seasons.
Symptoms in children and adolescents
The symptoms of bipolar disorder can be difficult to recognize in children and adolescents. It's often hard to tell if these are normal ups and downs, the result of stress or trauma, or signs of a mental health problem other than bipolar disorder.
Children and adolescents can have varying degrees of depressive, manic, or hypomanic episodes, but the pattern may vary from that of adults with bipolar disorder. And moods can change rapidly during episodes. Some children may have periods without mood symptoms between episodes.
The most noticeable signs of bipolar disorder in children and adolescents can be severe mood swings that differ from usual mood swings.
when to the doctor
Despite extreme moods, people with bipolar disorder often don't realize how much their emotional instability interferes with their lives and the lives of their loved ones, and they don't get the treatment they need.
And if you're like some people with bipolar disorder, you may enjoy the euphoric feeling and the cycles of being more productive. However, this euphoria is always followed by an emotional crisis, which can leave you feeling depressed, exhausted, and perhaps embroiled in financial, legal, or relationship problems.
If you have symptoms of depression or mania, see your doctor or psychologist. Bipolar disorder does not get better on its own. Seeing treatment from a psychologist experienced in bipolar disorder can help you manage your symptoms.
When to get emergency help
Suicidal thoughts and behaviors are common in people with bipolar disorder. If you think you could be hurt, call 911 or your local emergency number right away, go to an emergency room, or entrust it to a trusted relative or friend. Or contact a suicide hotline. In the US, call or text 988 to speak to theCrisis and Suicide Lifeline 988, available 24 hours a day, seven days a week. Or use theLifeline-Chat. Services are free and confidential.
If you have a loved one who is suicidal or has attempted suicide, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think it's safe, take the person to the nearest hospital emergency room.
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causes
The exact cause of bipolar disorder is unknown, but a number of factors may be involved, such as:
- biological differences.People with bipolar disorder seem to have physical changes in the brain. The significance of these changes is not yet clear, but it may help to identify the causes.
- Genetic.Bipolar disorder is more common in people who have a first-degree relative, such as a B. They have siblings or parents with bipolar disorder. Researchers are trying to find genes that may be involved in causing bipolar disorder.
risk factor's
Factors that can increase your risk of developing bipolar disorder or triggering your first episode include:
- Having a first-degree relative, such as a parent or sibling, with bipolar disorder
- Periods of high stress, such as the death of a loved one or other traumatic events
- Drug or alcohol abuse
complications
If left untreated, bipolar disorder can lead to serious problems that affect all areas of your life, such as:
- Problems related to drug and alcohol use.
- Suicide or attempted suicide
- Legal or financial problems
- damaged relationships
- Poor performance at work or school
Conditions that occur simultaneously
If you have bipolar disorder, you may also have another medical condition that needs to be treated along with your bipolar disorder. Some medical conditions can make bipolar disorder symptoms worse or make treatment less effective. Examples include:
- anxiety disorders
- eating disorder
- Attention Deficit Hyperactivity Disorder (ADHD)
- problems with alcohol or drugs
- Physical health problems, such as heart disease, thyroid problems, headaches, or obesity
More information
- Bipolar disorder treatment at Mayo Clinic
- Bipolar disorder and alcoholism: are they related?
prevention
There is no sure way to prevent bipolar disorder. However, treatment at the first signs of a mental illness can help prevent bipolar disorder or other mental illnesses from getting worse.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from developing into full-blown episodes of mania or depression:
- Pay attention to warning signs.Early treatment of symptoms can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel like you are slipping into depression or mania. Involve family or friends in watching for warning signs.
- Avoid drugs and alcohol.The use of alcohol or recreational drugs can worsen symptoms and increase the chance of recurrence.
- Take your medication exactly as directed.You may be tempted to stop treatment, but don't. Stopping the medication or reducing the dose on your own may cause withdrawal symptoms, or your symptoms may worsen or come back.
By the staff of the Mayo Clinic
December 13, 2022