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Bipolar Disorder

Bipolar disorder was formerly called manic depression. It is a form of major affective disorder, or mood disorder, defined by manic or hypomanic episodes (changes from one's normal mood accompanied by high energy states).  Bipolar disorder is a serious condition, for instance, mania can cause sleeplessness, sometimes for days, along with hallucinations, psychosis, grandiose delusions, or paranoid rage.  In addition, depressive episodes can be more devastating and harder to treat than for people who never have manias or hypomanias.

What Is Bipolar Disorder?

Bipolar disorder is a complex disorder that likely stems from a combination of genetic and non-genetic factors. The mood episodes associated with it involve clinical depression or mania (extreme elation and high energy) with periods of normal mood and energy in between episodes. The severity of mood episodes can range from very mild to extreme, and they can happen gradually or suddenly within a timeframe of days to weeks. When discrete mood episodes happen four or more times per year, the process is called rapid cycling.  Rapid cycling should not be confused with very frequent moment-to-moment changes in mood, which can sometimes occur in people with bipolar disorder or other conditions such as borderline personality disorder.

Along with manic or depressive episodes, patients with bipolar disorder may have disturbances in thinking. They may also have distortions of perception and impairment in social functioning.

 

What Causes Bipolar Disorder?

Like with other mood disorders, what causes bipolar disorder is not known. What is known is that bipolar disorder sometimes has a genetic component and can run in families.

At What Age Is Bipolar Disorder Usually Diagnosed?

Bipolar disorder usually appears between ages 15 and 24 and persists throughout a lifetime. It's rare that newly diagnosed mania is seen in children or in adults over age 65.

Severity of symptoms varies with individuals who have bipolar disorder. While some people have a few symptoms, others have many that impair their ability to work and live a normal life.

Marked by relapses and remissions, bipolar disorder has a high rate of recurrence if untreated. Patients with severe mania usually require hospitalization to keep them from risky behaviors. Those who are severely depressed also might need hospitalization to keep them from acting on suicidal thoughts or psychotic symptoms (delusions, hallucinations, disorganized thinking).

About 90% of individuals with bipolar I disorder, which is the more serious form, have at least one psychiatric hospitalization. Two out of three will have two or more hospitalizations in their lifetime.

What Are the Depression Symptoms of Bipolar Disorder?

The clinical depression symptoms seen with bipolar disorder include:

  • Decreased appetite and/or weight loss, or overeating and weight gain
  • Difficulty concentrating, remembering, and making decisions
  • Fatigue, decreased energy, being "slowed down"
  • Feelings of guilt, worthlessness, helplessness
  • Feelings of hopelessness, pessimism
  • Insomnia, early-morning awakening, or oversleeping
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
  • Persistently sad, anxious, or "empty" moods
  • Restlessness, irritability
  • Thoughts of death or suicide, suicide attempts
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