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Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a mood disorder that can cause intense mood swings:

  • 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.

Along with the mood swings, bipolar disorder causes changes in behavior, energy levels, and activity levels.

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

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 causes bipolar disorder?

The exact cause of bipolar disorder is unknown. Several factors likely play a role in the disorder. They include genetics, brain structure and function, and your environment.

Who is at risk for bipolar disorder?

You are at higher risk for bipolar disorder if you have a close relative who has it. Going through trauma or stressful life events may raise this risk even more.

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.

How is bipolar disorder diagnosed?

To diagnose bipolar disorder, your health care provider may use many tools:

  • A physical exam
  • A medical history, which will include asking about your symptoms, lifetime history, experiences, and family history
  • Medical tests to rule out other conditions
  • A mental health evaluation. Your provider may do the evaluation or may refer you to a mental health specialist to get one.
What are the treatments for bipolar disorder?

Treatment can help many people, including those with the most severe forms of bipolar disorder. The main treatments for bipolar disorder include medicines, psychotherapy, or both:

  • Medicines can help control the symptoms of bipolar disorder. You may need to try several different medicines to find which one works best for you. Some people need to take more than one medicine. It's important to take your medicine consistently. Don't stop taking it without first talking with your provider. Contact your provider if you have any concerns about side effects from the medicines.
  • Psychotherapy (talk therapy) can help you recognize and change troubling emotions, thoughts, and behaviors. It can give you and your family support, education, skills, and coping strategies. There are several different types of psychotherapy that may help with bipolar disorder.
  • Other treatment options include
    • Electroconvulsive therapy (ECT), a brain stimulation procedure that can help relieve symptoms. ECT is most often used for severe bipolar disorder that is not getting better with other treatments. It may also be used when someone needs a treatment that will work more quickly than medicines. This might be when a person has a high risk of suicide or is catatonic (unresponsive).
    • Getting regular aerobic exercise may help with depression, anxiety, and trouble sleeping
    • Keeping a life chart can help you and your provider track and treat your bipolar disorder. A life chart is a record of your daily mood symptoms, treatments, sleep patterns, and life events.

Bipolar disorder is a lifelong illness. But long-term, ongoing treatment can help manage your symptoms and enable you to live a healthy, successful life.

NIH: National Institute of Mental Health

Mood Disorders

Most people feel sad or irritable from time to time. They may say they're in a bad mood. A mood disorder is different. It affects a person's everyday emotional state. Nearly one in ten people aged 18 and older have mood disorders. These include depression and bipolar disorder (also called manic depression).

Mood disorders can increase a person's risk for heart disease, diabetes, and other diseases. Treatments include medication, psychotherapy, or a combination of both. With treatment, most people with mood disorders can lead productive lives.

Teen Mental Health

Being a teenager is hard. You're under stress to be liked, do well in school, get along with your family, and make big decisions. You can't avoid most of these pressures, and worrying about them is normal. But feeling very sad, hopeless or worthless could be warning signs of a mental health problem.

Mental health problems are real, painful, and sometimes severe. You might need help if you have the signs mentioned above, or if you

  • Often feel very angry or very worried
  • Feel grief for a long time after a loss or death
  • Think your mind is controlled or out of control
  • Use alcohol or drugs
  • Exercise, diet and/or binge-eat obsessively
  • Hurt other people or destroy property
  • Do reckless things that could harm you or others
  • Feel depressed (sad and hopeless)

Mental health problems can be treated. To find help, talk to your parents, school counselor, or health care provider.

Child Mental Health

It's important to recognize and treat mental illnesses in children early on. Once mental illness develops, it becomes a regular part of your child's behavior. This makes it more difficult to treat.

But it's not always easy to know when your child has a serious problem. Everyday stresses can cause changes in your child's behavior. For example, getting a new brother or sister or going to a new school may cause a child to temporarily act out. Warning signs that it might be a more serious problem include

  • Problems in more than one setting (at school, at home, with peers)
  • Changes in appetite or sleep
  • Social withdrawal or fear of things he or she did not used to be not afraid of
  • Returning to behaviors more common in younger children, such as bedwetting
  • Signs of being upset, such as sadness or tearfulness
  • Signs of self-destructive behavior, such as head-banging or suddenly getting hurt often
  • Repeated thoughts of death

To diagnose mental health problems, the doctor or mental health specialist looks at your child's signs and symptoms, medical history, and family history. Treatments include medicines and talk therapy.

NIH: National Institute of Mental Health

Psychotic Disorders

Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you or that the TV is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there.

Schizophrenia is one type of psychotic disorder. People with bipolar disorder may also have psychotic symptoms. Other problems that can cause psychosis include alcohol and some drugs, brain tumors, brain infections, and stroke.

Treatment depends on the cause of the psychosis. It might involve drugs to control symptoms and talk therapy. Hospitalization is an option for serious cases where a person might be dangerous to himself or others.

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