What is Bipolar Disorder?
Bipolar Disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are different than the normal ups and downs that everyone goes through from time to time, and can be severe. Patients can have manic episodes, in which they feel greatly energized, need little sleep, are more impulsive, think and behave differently, or experience depressed episodes, in which they are unable to participate in daily activities, feel profoundly sad, think of death, suicide or even attempt suicide. Some patients can have a mixture of these symptoms. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. However, bipolar disorder is treatable, most often through a combination of medications and psychotherapy.
Bipolar disorder often develops in a person’s late teens and early 20s. At least half of all cases start before age 25. Some people first develop symptoms in childhood, while a small percentage develop symptoms later in life.
Symptoms of Bipolar Disorder
People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.
Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.
A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.
Symptoms of Mania
- A long period of feeling “high,” or an overly happy or outgoing mood
- Extremely irritable mood, agitation, feeling “jumpy” or “wired.”
Talking very fast, jumping from one idea to another, having racing thoughts
Being easily distracted
Increasing goal-directed activities, such as taking on new projects
- Having an unrealistic belief in one’s abilities
- Behaving impulsively and taking part in a lot of pleasurable, high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.
Symptoms of Depression
- A long period of feeling sad, worried or empty
- Loss of interest in activities once enjoyed, including sex.
- Feeling tired or “slowed down”
- Having problems concentrating, remembering, and making decisions
- Being restless or irritable
- Changing eating, sleeping, or other habits
- Thinking of death or suicide, or attempting suicide.
Types of Bipolar Disorder
A more modern conceptualization of mood disorders is that they exist along a spectrum, as illustrated in the figure below. While patients can have symptoms consistent with Bipolar I or Bipolar II disorder, a number of patients have symptoms that fall in between, that are referred to as Bipolar Spectrum Illnesses, or Other Specified Bipolar Disorder. And while patients can have clear symptoms of mania or depression, many patients can suffer with mixtures of symptoms from mania and depression. So a patient who is depressed can also have symptoms of mania or hypomania, and a patient who has mania or hypomania can also have depressive symptoms. pole, and vice-versa. This mixing of symptoms has been more formally recognized in DSM-5, which allows for the co-occurrence of subthreshold mood symptoms from opposite poles. Irritability can occur in either depressive or manic states.
Bipolar I Disorder is mainly defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, the person also has depressive episodes, typically lasting at least two weeks, though a person does not need to have depressive episodes to have bipolar I disorder. The symptoms of mania or depression must be a major change from the person’s normal behavior.
Bipolar II Disorder
Bipolar II Disorder is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes. Bipolar II disorder is not a less severe form of bipolar disorder, as the episodes of depression, which can be frequent, can be serious and disabling for many patients.