Bipolar Disorder (Manic-Depressive Illness)

What is bipolar disorder?

Bipolar disorder is a chronic mental health condition that causes extreme mood swings that include mania or hypomania (emotional highs) and bipolar depression (lows). Mania is characterized by a euphoric, energetic, or irritable mood which may manifest in an exaggerated assessment of self-importance or grandiosity, sleeplessness, racing thoughts, pressured speech, and the tendency to engage in activities which appear pleasurable, but have a high potential for adverse consequences. When mood shifts to depression, one may feel sad, hopeless and lose interest or pleasure in most activities. The disturbance of mood is episodic and recurrent, affecting sleep, energy, activity, judgement, and behavior. When people experience symptoms of both a manic and a depressive episode at the same time, they're said to be experiencing a mixed state (or mixed mania). People with bipolar disorder can lead healthy and productive lives when the illness is properly treated and managed.
The two most common types are:
  • Bipolar I disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
  • Bipolar II disorder— defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above. 
Risk factors
  • Genetics. People with certain genes are more likely to develop bipolar disorder than others
  • Family History. Bipolar disorder tends to run in families. 
  • Traumatic Event. Death of a loved one or other periods of high stress. 
Risk of relapse or recurrence
  • Not taking maintenance medication
  • Abrupt discontinuation or rapid tapering of mood-stabilizing medication
  • Postpartum period
  • Season
  • Abnormal levels of psychosocial stress
  • Serious medical illness (depression, myocardial infarction)
  • Endogenous hormone fluctuations (thyroid dysfunction, menstrual cycle, menopause)
Diagnosis of bipolar disorder is done by a trained mental health professional, such as a psychiatrist. Your evaluation may include:
  • Physical exam and lab tests to identify any medical problems that could be causing your symptoms.
  • Psychiatric assessment to talk about your thoughts, feelings and behavior patterns. With your permission, family members or close friends may be asked to provide information about your symptoms.
  • Mood charting to keep a daily record of your moods, sleep patterns or other factors that could help with diagnosis and finding the right treatment.
  • Criteria for bipolar disorder. Your psychiatrist may compare your symptoms with the criteria for bipolar and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Children with bipolar disorder are frequently also diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems.
Treatment of bipolar disorder, like depression, may include: 
  • Support groups
  • Medication
  • Psychotherapy (psychological counseling)
  • Other strategies a healthcare provider may suggest
Although patients with depression can be treated with antidepressants, it can cause manic episodes in bipolar patients.
  • Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year.
  • The disorder results in 9.2 years reduction in expected life span.
  • Up to 1 in 5 bipolar patients completes suicide.
  • An equal number of men and women develop bipolar illness and it is found in all ages, races, ethnic groups and social classes.
  • Bipolar disorder is the 6th leading cause of disability in the world.
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  • "Bipolar Disorder." Mayo Clinic. Mayo Foundation for Medical Education and Research, 15 Feb. 2017. Web. 18 Apr. 2017.
  • "Bipolar Disorder." National Institutes of Health. U.S. Department of Health and Human Services, Apr. 2016. Web. 18 Apr. 2017.
  • "Bipolar Disorder." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 04 Oct. 2013. Web. 18 Apr. 2017
  • "Hotline Information." About Bipolar Disorder. Depression and Bipolar Support Alliance, n.d. Web. 18 Apr. 2017.
  • "Bipolar Disorder." Bipolar Disorder | ADAA. Anxiety and Depression Association of America, ADAA, n.d. Web. 18 Apr. 2017.
  • "Bipolar Disorder." Bipolar Disorder | Johns Hopkins Medicine Health Library. Johns Hopkins Medicine Health Library, n.d. Web. 18 Apr. 2017


Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. Mental health also helps determine how we handle stress, relate to others, and make choices.
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