What is bipolar disorder?

Bipolar disorder is a mental illness that can be chronic (persistent or constantly recurring) or episodic (occurring occasionally and at irregular intervals).

Bipolar disorder used to be called other names, including manic-depressive or manic depression.

Bipolar disorder causes mood swings, changes in behavior, energy levels, and activity levels.

• Sometimes you may feel extremely “up,” elated, irritable, or energized. This is called a manic episode.
• Other times you may feel “down,” sad, indifferent, or hopeless. This is called a depressive episode.
• You may have both manic and depressive symptoms together. This is called a mixed episode.
• Some people have hypomanic episodes, which are like manic episodes but are less severe, and don’t interfere as much with daily life.

Most of the time, bipolar disorder symptoms start during late adolescence or early adulthood. Occasionally, children may experience bipolar disorder symptoms.

Although symptoms may come and go, bipolar disorder usually requires lifelong treatment and does not go away on its own.

Bipolar disorder can be an important factor in suicide, job loss, ability to function, and family discord. However, proper treatment can lead to better functioning and improved quality of life.

What are the types of bipolar disorder?

There are three main types of bipolar disorder:

• Bipolar I disorder involves manic episodes that last at least 7 days or manic symptoms so severe that you need immediate hospital care. Depressive episodes are also common. Those often last at least two weeks. This type of bipolar disorder can also involve mixed episodes.
• Bipolar II disorder involves depressive episodes. But instead of full-blown manic episodes, there are episodes of hypomania. Hypomania is a less severe version of mania.
• Cyclothymic disorder, or cyclothymia, also involves hypomanic and depressive symptoms. But they are not as intense or as long-lasting as hypomanic or depressive episodes. The symptoms usually last for at least two years in adults and for one year in children and teenagers.

With any of these types, having four or more episodes of mania or depression in a year is called “rapid cycling.”

What are the symptoms of bipolar disorder?

The symptoms of bipolar disorder can vary. But they involve mood swings known as mood episodes:

• The symptoms of a manic episode can include
  • Feeling very up, high, or elated
  • Feeling jumpy or wired, more active than usual
  • Having a very short temper or seeming extremely irritable
  • Having racing thoughts and talking very fast
  • Needing less sleep
  • Feeling like you are unusually important, talented, or powerful
  • Do risky things that show poor judgment, such as eating and drinking too much, spending or giving away a lot of money, or having reckless sex
• The symptoms of a depressive episode can include
  • Feeling very sad, hopeless, or worthless
  • Feeling lonely or isolating yourself from others
  • Talking very slowly, feeling like you have nothing to say, or forgetting a lot
  • Having little energy
  • Sleeping too much
  • Eating too much or too little
  • Lack of interest in your usual activities and being unable to do even simple things
  • Thinking about death or suicide
• The symptoms of a mixed episode include both manic and depressive symptoms together. For example, you may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.

Some people with bipolar disorder may have milder symptoms. For example, you may have hypomania instead of mania. With hypomania, you may feel very good and find that you can get a lot done. You may not feel like anything is wrong. But your family and friends may notice your mood swings and changes in activity levels. They may realize that your behavior is unusual for you. After the hypomania, you might have severe depression.

Your mood episodes may last a week or two or sometimes longer. During an episode, symptoms usually occur every day for most of the day.