What is bipolar disorder?
Bipolar disorder is a mental illness marked by extreme shifts in mood. Symptoms can include an extremely elevated mood called mania. They can also include episodes of depression. Bipolar disorder is also known as bipolar disease or manic depression.
People with bipolar disorder may have trouble managing everyday life tasks at school or work, or maintaining relationships. There’s no cure, but there are many treatment options available that can help to manage the symptoms. Learn the signs of bipolar disorder to watch for.
Types of bipolar disorder
The person may receive a diagnosis of one of three broad types of bipolar disorder.
Bipolar I disorder
For a diagnosis of bipolar I disorder:
- There must have been at least one manic episode
- The person must also have had a previous major depressive episode
- The doctor must rule out disorders that are not associated with bipolar disorder, such as schizophrenia, delusional disorder, and other psychotic disorders.
Bipolar II Disorder
For a diagnosis of bipolar II disorder, the patient must have experienced one or more episodes of depression and at least one hypomanic episode.
A hypomanic state is less severe than a manic one.
Features of a hypomanic episode include sleeping less than normal and being competitive, outgoing, and full of energy.
However, the person is fully functioning, which may not be the case with manic episodes.
Bipolar II disorder can also involve mixed episodes, and there may be symptoms of mood-congruent or mood-incongruent psychotic features.
A mood-congruent psychosis would involve features that match the mood. For example, if a person is experiencing depression, mood-congruent psychosis could have a theme of sadness.
Cyclothymia
Cyclothymia involves episodes of low-level depression that alternate with periods of hypomania.
The DSM-V classifies it separately from bipolar disorder, because the mood changes are less dramatic.
A person who receives a diagnosis of bipolar disorder has a lifelong diagnosis. They may enter a period of stability, but they will always have the diagnosis.
Bipolar symptoms
There are three main symptoms that can occur with bipolar disorder: mania, hypomania, and depression.
While experiencing mania, a person with bipolar disorder may feel an emotional high. They can feel excited, impulsive, euphoric, and full of energy. During manic episodes, they may also engage in behavior such as:
- spending sprees
- unprotected sex
- drug use
Hypomania is generally associated with bipolar II disorder. It’s similar to mania, but it’s not as severe. Unlike mania, hypomania may not result in any trouble at work, school, or in social relationships. However, people with hypomania still notice changes in their mood.
During an episode of depression you may experience:
- deep sadness
- hopelessness
- loss of energy
- lack of interest in activities they once enjoyed
- periods of too little or too much sleep
- suicidal thoughts
Although it’s not a rare condition, bipolar disorder can be hard to diagnose because of its varied symptoms. Find out about the symptoms that often occur during high and low periods.
Causes of bipolar disorder
Bipolar disorder is a common mental health disorder, but it’s a bit of a mystery to doctors and researchers. It’s not yet clear what causes some people to develop the condition and not others.
Possible causes of bipolar disorder include:
Genetics
If your parent or sibling has bipolar disorder, you’re more likely than other people to develop the condition (see below). However, it’s important to keep in mind that most people who have bipolar disorder in their family history don’t develop it.
Your brain
Your brain structure may impact your risk for the disease. Abnormalities in the structure or functions of your brain may increase your risk.
Environmental factors
It’s not just what’s in your body that can make you more likely to develop bipolar disorder. Outside factors may contribute, too. These factors can include:
- extreme stress
- traumatic experiences
- physical illness
Each of these factors may influence who develops bipolar disorder. What’s more likely, however, is that a combination of factors contributes to the development of the disease. Here’s what you need to know about the potential causes of bipolar disorder.
Is bipolar hereditary?
Bipolar disorder can be passed from parent to child. Research has identified a strong genetic link in people with the disorder. If you have a relative with the disorder, your chances of also developing it are four to six times higher than people without a family history of the condition.
However, this doesn’t mean that everyone with relatives who have the disorder will develop it. In addition, not everyone with bipolar disorder has a family history of the disease.
Still, genetics seem to play a considerable role in the incidence of bipolar disorder. If you have a family member with bipolar disorder, find out whether screening might be a good idea for you.
Bipolar diagnosis
A diagnosis of bipolar disorder I involves either one or more manic episodes, or mixed (manic and depressive) episodes. It may also include a major depressive episode, but it may not. A diagnosis of bipolar II involves one or more major depressive episodes and at least one episode of hypomania.
To be diagnosed with a manic episode, you must experience symptoms that last for at least one week or that cause you to be hospitalized. You must experience symptoms almost all day every day during this time. Major depressive episodes, on the other hand, must last for at least two weeks.
Bipolar disorder can be difficult to diagnose because mood swings can vary. It’s even harder to diagnose in children and adolescents. This age group often has greater changes in mood, behavior, and energy levels.
Bipolar disorder often gets worse if it’s left untreated. Episodes may happen more often or become more extreme. But if you receive treatment for your bipolar disorder, it’s possible for you to lead a healthy and productive life. Therefore, diagnosis is very important. See how bipolar disorder is diagnosed.
Risk factors
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the 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 event
- Drug or alcohol abuse
Complications
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
- Problems related to drug and alcohol use
- Suicide or suicide attempts
- Legal or financial problems
- Damaged relationships
- Poor work or school performance
Co-occurring conditions
If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:
- Anxiety disorders
- Eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug problems
- Physical health problems, such as heart disease, thyroid problems, headaches or obesity
Prevention
There’s no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
If you’ve been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:
- Pay attention to warning signs. Addressing symptoms early on 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 you’re falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.
- Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
- Take your medications exactly as directed. You may be tempted to stop treatment — but don’t. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.
Bipolar disorder treatment
Several treatments are available that can help you manage your bipolar disorder. These include medications, counseling, and lifestyle changes. Some natural remedies may also be helpful.
Medications
Recommended medications may include:
- mood stabilizers, such as lithium (Lithobid)
- antipsychotics, such as olanzapine (Zyprexa)
- antidepressant-antipsychotics, such as fluoxetine-olanzapine (Symbyax)
- benzodiazepines, a type of anti-anxiety medication such as alprazolam (Xanax) that may be used for short-term treatment
Psychotherapy
Recommended psychotherapy treatments may include:
Cognitive behavioral therapy
Cognitive behavioral therapy is a type of talk therapy. You and a therapist talk about ways to manage your bipolar disorder. They will help you understand your thinking patterns. They can also help you come up with positive coping strategies.
Psychoeducation
Psychoeducation is a kind of counseling that helps you and your loved ones understand the disorder. Knowing more about bipolar disorder will help you and others in your life manage it.
Interpersonal and social rhythm therapy
Interpersonal and social rhythm therapy (IPSRT) focuses on regulating daily habits, such as sleeping, eating, and exercising. Balancing these everyday basics can help you manage your disorder.
Other treatment options
Other treatment options may include:
- electroconvulsive therapy (ECT)
- sleep medications
- supplements
- acupuncture
Lifestyle changes
There are also some simple steps you can take right now to help manage your bipolar disorder:
- keep a routine for eating and sleeping
- learn to recognize mood swings
- ask a friend or relative to support your treatment plans
- talk to a doctor or licensed healthcare provider
Other lifestyle changes can also help relieve depressive symptoms caused by bipolar disorder. Check out these seven ways to help manage a depressive episode.
Some natural remedies may be helpful for bipolar disorder. However, it’s important not to use these remedies without first talking with your doctor. These treatments could interfere with medications you’re taking.
The following herbs and supplements may help stabilize your mood and relieve symptoms of bipolar disorder:
- Fish oil. A 2013 studyTrusted Source shows that people who consume a lot of fish and fish oil are less likely to develop bipolar disease. You can eat more fish to get the oil naturally, or you can take an over-the-counter (OTC) supplement.
- Rhodiola rosea. This researchTrusted Source also shows that this plant may be a helpful treatment for moderate depression. It may help treat depressive symptoms of bipolar disorder.
- S-adenosylmethionine (SAMe). SAMe is an amino acid supplement. The researchTrusted Source shows it can ease symptoms of major depression and other mood disorders.
Several other minerals and vitamins may also reduce symptoms of bipolar disorder. Here’s 10 alternative treatments for bipolar disorder.
If you or someone you know has bipolar disorder, you’re not alone. Bipolar disorder affects about 60 million peopleTrusted Source around the world.
One of the best things you can do is to educate yourself and those around you. There are many resources available. For instance, SAMHSA’s behavioral health treatment services locator provides treatment information by ZIP code. You can also find additional resources at the site for the National Institute of Mental Health.
If you think you’re experiencing symptoms of bipolar disorder, make an appointment with your doctor. If you think a friend, relative, or loved one may have bipolar disorder, your support and understanding is crucial. Encourage them to see a doctor about any symptoms they’re having. And read how to help someone living with bipolar disorder.
People who are experiencing a depressive episode may have suicidal thoughts. You should always take any talk of suicide seriously.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
Frequently Asked Questions
What is bipolar disorder?
Bipolar disorder is in a class of mood disorders that is marked by dramatic changes in mood, energy and behaviour. The key characteristic of people with bipolar disorder is alternating between episodes of mania (extreme elevated mood) and depression (extreme sadness). These episodes can last from hours to months. The mood disturbances are severe enough to affect the person’s ability to function. The experience of mania can be very frightening and lead to impulsive behaviour that has serious consequences for the person and the family. A depressive episode makes it difficult or impossible for a person to function in his or her daily life
Bipolar disorder is a medical condition that can be treated.
How prevalent is bipolar disorder?
Bipolar disorder affects approximately 3 to 5% of the adult population and is equally distributed between men and women.
Who is at risk of developing bipolar disorder?
If you have a family member with bipolar disorder, you may be slightly more likely to develop it yourself.
What are the risk factors/triggers for bipolar disorder?
Bipolar disorder has no single proven cause, but research suggests that the condition is due to abnormalities in the way some nerve cells in the brain function or communicate. The disorder makes people more vulnerable to emotional and physical stress. As a result, stresses, such as upsetting experiences, substance use or lack of sleep, can trigger episodes, even though they do not actually cause the disorder.
Is there a test to tell me if I have, or may inherit, bipolar disorder?
Currently, no test can tell a person if he is at risk of developing bipolar disorder. It is unlikely that a single gene will be discovered that is responsible for the illness in all people with bipolar disorder.
If I am diagnosed with bipolar disorder, will I be on medication for the rest of my life?
Not necessarily. However, patients are encouraged to stay on medication indefinitely if an episode was very frightening or associated with great risk to their health, finances, or family relationships.
Is there anything I can do to help my disorder?
Yes. First, learn all you can about your illness by reading books, going to lectures and talking to your doctor. Get support from others who also have the illness. Mental Health America is a good place to look for a support group in your area. In these groups, you can hear how others face the challenges of life and manage their mood and treatment medications.
What do I need to tell my doctor?
- Write down any symptoms you’ve had
- Write down key personal information
- Make a list of all medications you are taking
- Write down questions to ask your doctor
- Take a family member or friend along
Describe to the doctor what people think your “normal” personality is like. Describe how things are different now. Discuss all of your symptoms with your doctor and describe how they are affecting your life (e.g. racing thoughts that cause you to lose focus and not get things done). Your doctor can suggest or provide appropriate therapy based on your symptoms. Make sure to discuss all of the available treatments and medications and their benefits and side effects before making any decisions.
What are the treatment options for bipolar disorder?
The most common forms of treatment for bipolar depression and mania are medication (mainly mood stabilizers such as Lithium or Epival) and psychotherapy, used alone or in combination with other treatments. The use of atypical anti-psychotic medication such as Zyprexa, Risperidal or Seroquel has become more common, as they demonstrate fewer side effects than the older drugs, and serve to stabilize mood as well.
Some of the factors that determine the type of treatment are the nature of the symptoms, the severity and duration of the condition, possible precipitating causes and previous response to treatment. Approximately one in three people with bipolar disorder will remain completely symptom free by taking mood stabilizers.
Complementary treatments, such as peer group support and other support programs, may also be helpful.
Additional treatments, such as massage, mindfulness meditation, shiatsu, therapeutic touch, aromatherapy, tai chi, Pilates and yoga, can also help improve wellness.
What are the things I need to do to get well?
There are a number of medications available to effectively treat bipolar disorder. Often, the most effective treatment is a combination of medication and psychotherapy. There are also certain lifestyle choices that can supplement treatments:
- Stick to your treatment plan. Don’t skip psychotherapy sessions. Even if you’re feeling well, continue to take medication as prescribed.
- Learn about bipolar disorder. Empower yourself by learning about your condition.
- Pay attention to the warning signs. Find out what triggers episodes. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes. Ask friends or family to watch out for warning signs.
- Get exercise. Physical activity reduces symptoms of depression. Consider walking, jogging, swimming,
gardening, or any other physical activity. - Avoid alcohol and illicit drugs. It may seem like they lessen symptoms, but in the long run, the symptoms generally get worse and may make your condition harder to treat.
- Get plenty of sleep. This is especially important. If you’re having trouble sleeping, talk to your doctor about what you can do.