Bipolar disorder, sometimes called manic depression, causes extreme shifts in mood. People who have it may spend weeks feeling like they’re on top of the world before plunging into a deep depression. The length of each high and low varies greatly from person to person.
Without treatment, a person with bipolar disorder may have intense episodes of depression. Symptoms include sadness, anxiety, loss of energy, hopelessness, and trouble concentrating. They may lose interest in activities that they used to enjoy. It’s also common to gain or lose weight, sleep too much or too little, and even think about suicide.
Bipolar Disorder: The Manic Phase
During this phase, people feel super-charged and think they can do anything. Their self-esteem soars out of control and it’s hard for them to sit still. They talk more, are easily distracted, their thoughts race, and they don’t sleep enough. It often leads to reckless behavior, such as spending sprees, cheating, fast driving, and substance abuse. Three or more of these symptoms nearly every day for a week accompanied by feelings of intense excitement may signal a manic episode.
Bipolar Disorder: I Versus II
People with bipolar I disorder have manic phases for at least a week. Many also have separate depression phases, too.
Those with bipolar ll have bouts of major depression, but instead of full manic episodes, they have low-grade hypomanic swings that are less intense and may last less than a week. They may seem fine, even like the “life of the party,” though family and friends notice their mood changes.
Bipolar Disorder: What Is a “Mixed Episode”?
When people with bipolar disorder have depression and manic symptoms at the same time, or very close together, this is called a manic or depressive episode with mixed features. This can lead to unpredictable behavior, such as taking dangerous risks when feeling hopeless and suicidal but energized and agitated. Mood episodes involving mixed features may be somewhat more common in women and in people who develop bipolar disorder at a young age.
Bipolar Disorder: Causes
Doctors don’t know exactly what causes bipolar disorder. Current theories hold that the disorder may result from a combination of genetic, biological, and environmental factors. Scientists think that brain circuits involved in the regulation of mood, energy, thinking, and biological rhythms may function abnormally in people with bipolar disorder, resulting in the mood and other changes associated with the illness.
Men and women both get bipolar disorder. In most cases, symptoms usually start in people who are 15-30 years old. More rarely, it can begin in childhood. The condition can sometimes run in families, but not everyone in a family may have it.
Bipolar Disorder: Risk Behavior Is Increased
Many people with bipolar disorder have trouble with drugs or alcohol. They may drink or abuse drugs to ease the uncomfortable symptoms of their mood swings. Substance misuse also may be prone to occur as part of the recklessness and pleasure-seeking associated with mania.
Bipolar Disorder: Suicide
People with bipolar disorder are 10-20 times more likely to commit suicide than others. Warning signs include talking about suicide, putting their affairs in order, and doing very risky things. If you know someone who may be at risk, call one of these hotlines: 800-SUICIDE (800-784-2433) and 800-273-TALK (800-273-8255). If the person has a plan to commit suicide, call 911 or help them get to an emergency room immediately.
Bipolar Disorder: Medications
There are several types of prescription drugs for bipolar disorder. They include mood stabilizers that prevent episodes of ups and downs, as well as antidepressants and antipsychotic drugs. When they aren’t in a manic or depressive phase, people usually take maintenance medications to avoid a relapse.
Bipolar Disorder: Talk Therapy
Counseling can help people stay on medication and manage their lives. Cognitive behavioral therapy focuses on changing thoughts and behaviors that accompany mood swings. Interpersonal therapy aims to ease the strain bipolar disorder puts on personal relationships. Social rhythm therapy helps people develop and maintain daily routines.
Bipolar Disorder: Electroconvulsive Therapy (ECT)
This treatment, done while you are “asleep” under general anesthesia, can rapidly improve mood symptoms of bipolar disorder. It uses an electric current to cause a seizure in the brain. It’s one of the fastest ways to ease severe symptoms. ECT is often a safe and effective treatment option for severe mood episodes when medications have not led to meaningful symptom improvement. It’s a safe and highly effective treatment.