Bipolar disorder, formerly called manic depression, is a mental illness that brings severe high and low moods and changes in sleep, energy, thinking, and behavior.
People who have bipolar disorder can have periods in which they feel overly happy and energized and other periods of feeling very sad, hopeless, and sluggish. In between those periods, they usually feel normal. You can think of the highs and the lows as two "poles" of mood, which is why it's called "bipolar" disorder.
People with bipolar disorder often have cycles of elevated and depressed mood that fit the description of "manic depression." When a person's illness follows this classic pattern, diagnosing bipolar disorder is relatively easy.
But bipolar disorder can be sneaky. Symptoms can defy the expected manic-depressive sequence. Infrequent episodes of mild mania or hypomania can go undetected. Depression can overshadow other aspects of the illness. And substance abuse can cloud the picture.
The word "manic" describes the times when someone with bipolar disorder feels overly excited and confident. These feelings can also involve irritability and impulsive or reckless decision-making. About half of people during mania can also have delusions (believing things that aren't true and that they can't be talked out of) or hallucinations (seeing or hearing things that aren't there).
"Hypomania" describes milder symptoms of mania, in which someone does not have delusions or hallucinations, and their high symptoms do not interfere with their everyday life.
The word "depressive" describes the times when the person feels very sad or depressed. Those symptoms are similar to depression, a condition in which someone never has manic or hypomanic episodes.
Most people with bipolar disorder spend more time in depressed phases than in manic phases.
What Are the Symptoms of Bipolar Disorder?
In bipolar disorder, the dramatic episodes of high and low moods do not follow a set pattern. Someone may feel the same mood state (depressed or manic) several times before switching to the opposite mood. These episodes can happen over a period of weeks, months, and sometimes even years.
How severe it gets differs from person to person and can also change over time, becoming more or less severe.
Symptoms of mania ("the highs"):
Excessive happiness, hopefulness, and excitement
Sudden changes from being joyful to being irritable, angry, and hostile
Rapid speech and poor concentration
Increased energy and less need for sleep
High sex drive
Making grand and unrealistic plans
Showing poor judgment
Drug and alcohol abuse
Becoming more impulsive
During depressive periods ("the lows"), a person with bipolar disorder may have:
Loss of energy
Feelings of hopelessness or worthlessness
Not enjoying things they once liked
Trouble making decisions
Needing more sleep
Appetite changes that make them lose or gain weight
Thoughts of death or suicide
Who Gets Bipolar Disorder?
When someone gets bipolar disorder, it usually starts when they're a young adult. It can happen earlier, often along with ADHD. Bipolar disorder can run in families.
Men and women are equally likely to get it. Women are somewhat more likely than men to go through "rapid cycling," which is having several distinct mood episodes within a year. Women also tend to spend more time depressed than men with bipolar disorder.