Bipolar Disorder: Symptoms, Causes, Diagnosis, Treatment

Get the facts from WebMD about bipolar disorder, also known as manic depression, including symptoms, causes, diagnosis, and treatments. MenuNews&FeaturesReferenceSlideshowsVideosMedicationsFindaPsychiatristOverviewSymptoms&TypesTreatment&PreventionLiving&SupportADHDAnxiety&PanicDisordersCrisisAssistanceDepressionMentalHealthPillIdentifierSchizophreniaSubstanceAbuseandAddictionMoreRelatedTopicsBipolarDisorderReferenceMenuMedicallyReviewedbySmithaBhandari, MDonAugust12,2022InthisArticleWhatIsBipolarDisorder?AreThereDifferentTypesofBipolarDisorder?WhatAretheSymptomsofBipolarDisorder?WhatAretheCausesofBipolarDisorder?WhatAreBipolarDisorderRiskFactors?HowIsBipolarDisorderDiagnosed?WhatAretheTreatmentsforBipolarDisorder?BipolarDisorderOutlookBipolarDisorderandSuicideWhatIsBipolarDisorder?Bipolardisorder,alsoknownasmanicdepression,isamentalillnessthatbringsseverehighandlowmoodsandchangesinsleep,energy,thinking,andbehavior.Peoplewhohavebipolardisordercanhaveperiodsinwhichtheyfeeloverlyhappyandenergizedandotherperiodsoffeelingverysad,hopeless,andsluggish.Inbetweenthoseperiods,theyusuallyfeelnormal.Youcanthinkofthehighsandthelowsastwo"poles"ofmood,whichiswhyit'scalled"bipolar"disorder.Theword"manic"describesthetimeswhensomeonewithbipolardisorderfeelsoverlyexcitedandconfident.Thesefeelingscanalsoinvolveirritabilityandimpulsiveorrecklessdecision-making.Abouthalfofpeopleduringmaniacanalsohavedelusions(believingthingsthataren'ttrueandthattheycan'tbetalkedoutof)orhallucinations(seeingorhearingthingsthataren'tthere)."Hypomania"describesmildersymptomsofmania,inwhichsomeonedoesnothavedelusionsorhallucinations,andtheirhighsymptomsdonotinterferewiththeireverydaylife.Theword"depressive"describesthetimeswhenthepersonfeelsverysadordepressed.Thosesymptomsarethesameasthosedescribedinmajordepressivedisorderor"clinicaldepression,"aconditioninwhichsomeoneneverhasmanicorhypomanicepisodes.Mostpeoplewithbipolardisorderspendmoretimewithdepressivesymptomsthanmanicorhypomanicsymptoms.AreThereDifferentTypesofBipolarDisorder?Thereareafewtypesofbipolardisorder,including:BipolarIdisorder:Withthistype,youhaveextremeerraticbehavior,withmanic“up”periodsthatlastatleastaweekoraresoseverethatyouneedmedicalcare.Therearealsousuallyextreme“down”periodsthatlastatleast2weeks. BipolarIIdisorder:Withthistype,youalsohaveerratichighsandlows,butitisn’tasextremeasbipolarI.Cyclothymicdisorder:Thistypeinvolvesperiodsofmanicanddepressivebehaviorthatlastatleast2yearsinadultsor1yearinchildrenandteens.Thesymptomsaren’tasintenseasbipolardisorderIorbipolardisorderII."Unspecified"or"otherspecified"bipolardisorder(formerlycalled"bipolardisordernototherwisespecified")isnowusedtodescribeconditionsinwhichapersonhasonlyafewofthemoodandenergysymptomsthatdefineamanicorhypomanicepisode,orthesymptomsmaynotlastlongenoughtobeconsideredasclear-cut"episodes."Rapidcyclingisnotatypeofbipolardisorder,butatermusedtodescribethecourseofillnessinpeoplewithbipolarIorIIdisorder.Itapplieswhenmoodepisodesoccurfourormoretimesovera1-yearperiod.Womenaremorelikelytohavethistypeofillnesscoursethanmen,anditcancomeandgoatanytimeinthecourseofbipolardisorder.Rapidcyclingisdrivenlargelybydepressionandcarriesanincreasedriskforsuicidalthoughtsorbehaviors.Withanytypeofbipolardisorder,misuseofdrugsandalcoholusecanleadtomoreepisodes.Havingbipolardisorderandalcoholusedisorder,knownas“dualdiagnosis,”requireshelpfromaspecialistwhocanaddressbothissues. WhatAretheSymptomsofBipolarDisorder?Inbipolardisorder,thedramaticepisodesofhighandlowmoodsdonotfollowasetpattern.Someonemayfeelthesamemoodstate(depressedormanic)severaltimesbeforeswitchingtotheoppositemood.Theseepisodescanhappenoveraperiodofweeks,months,andsometimesevenyears.Howsevereitgetsdiffersfrompersontopersonandcanalsochangeovertime,becomingmoreorlesssevere.Symptomsofmania("thehighs"):Excessivehappiness,hopefulness,andexcitementSuddenchangesfrombeingjoyfultobeingirritable,angry,andhostileRestlessnessRapidspeechandpoorconcentrationIncreasedenergyandlessneedforsleepUnusuallyhighsexdriveMakinggrandandunrealisticplansShowingpoorjudgmentDrugandalcoholabuseBecomingmoreimpulsiveLessneedforsleepLessofanappetiteLargersenseofself-confidenceandwell-beingBeingeasilydistractedDuringdepressiveperiods("thelows"),apersonwithbipolardisordermayhave:SadnessLossofenergyFeelingsofhopelessnessorworthlessnessNotenjoyingthingstheyoncelikedTroubleconcentratingForgetfulnessTalkingslowlyLessofasexdriveInabilitytofeelpleasureUncontrollablecryingTroublemakingdecisionsIrritabilityNeedingmoresleepInsomniaAppetitechangesthatmakeyouloseorgainweightThoughtsofdeathorsuicideAttemptingsuicide WhatAretheCausesofBipolarDisorder?Thereisnosinglecauseofbipolardisorder.Researchersarestudyinghowafewfactorsmayleadtoitinsomepeople.Forexample,sometimesitcansimplybeamatterofgenetics,meaningyouhaveitbecauseitrunsinyourfamily.Thewayyourbraindevelopsmayalsoplayarole,butscientistsaren’texactlysurehoworwhy.WhatAreBipolarDisorderRiskFactors?Whensomeonedevelopsbipolardisorder,itusuallystartswhenthey'reinlateadolescenceoryoungadulthood.Rarely,itcanhappenearlierinchildhood.Bipolardisordercanruninfamilies.Menandwomenareequallylikelytogetit.Womenaresomewhatmorelikelythanmentogothrough"rapidcycling,"whichishavingfourormoredistinctmoodepisodeswithinayear.Womenalsotendtospendmoretimedepressedthanmenwithbipolardisorder.Bipolardisorderusuallydevelopslaterinlifeforwomen,andthey’remorelikelytohavebipolardisorderIIandbeaffectedbyseasonalmoodchanges. Acombinationofmedicalandmentalissuesisalsomorecommoninwomen.Thosemedicalissuescanincludethyroiddisease,migraine,andanxietydisorders. Somethingsthatmakeyoumorelikelytohavebipolardisorderinclude:HavingafamilymemberwithbipolardisorderGoingthroughatimeofhighstressortraumaDrugoralcoholabuseCertainhealthconditionsManypeoplewiththeconditionabusealcoholorotherdrugswhenmanicordepressed.Peoplewithbipolardisorderaremorelikelytohaveseasonaldepression,co-existinganxietydisorders,posttraumaticstressdisorder,andobsessive-compulsivedisorder.HowIsBipolarDisorderDiagnosed?Ifyouorsomeoneyouknowhassymptomsofbipolardisorder,talktoyourfamilydoctororapsychiatrist.Theywillaskquestionsaboutmentalillnessesthatyou,orthepersonyou'reconcernedabout,havehad,andanymentalillnessesthatruninthefamily.Thepersonwillalsogetacompletepsychiatricevaluationtotelliftheyhavelikelybipolardisorderoranothermentalhealthcondition.Diagnosingbipolardisorderisallabouttheperson'ssymptomsanddeterminingwhethertheymaybetheresultofanothercause(suchaslowthyroidormoodsymptomscausedbydrugoralcoholabuse).Howseverearethey?Howlonghavetheylasted?Howoftendotheyhappen?Themosttellingsymptomsarethosethatinvolvehighsorlowsinmood,alongwithchangesinsleep,energy,thinking,andbehavior.Talkingtoclosefriendsandfamilyofthepersoncanoftenhelpthedoctordistinguishbipolardisorderfrommajordepressivedisorderorotherpsychiatricdisordersthatcaninvolvechangesinmood,thinking,andbehavior.Ifyouhavejustbeendiagnosedwithbipolardisorder,youmightfeelfrightened.Thefuturemayseemterriblyuncertain.Whatwillthismeanforyourlife,yourfamily,andyourjob?Butgettinganaccuratediagnosisisactuallygoodnews.Itmeansyoucanfinallygetthetreatmentyouneed.Peoplewithbipolardisorderusuallygoabout10yearsbeforebeingaccuratelydiagnosed.Diagnosingbipolardisordercanbetrickierforchildrenandteenagers.Theirsymptomsmaybethesameasadultsbutmightbeconfusedforattentiondeficithyperactivitydisorder(ADHD)orevenjustbadbehavior.Ifyouthinkyourchildmighthavebipolardisorder,askyourdoctorforareferraltoachildpsychologistwho’sfamiliarwithbipolardisorder.WhatAretheTreatmentsforBipolarDisorder?Bipolardisordercanbetreated.It'salong-termconditionthatneedsongoingcare.Peoplewhohavefourormoremoodepisodesinayear,orwhoalsohavedrugoralcoholproblems,canhaveformsoftheillnessthataremuchhardertotreat.Treatmentcanmakeahugedifference.Withacombinationofthings--goodmedicalcare,medication,talktherapy,lifestylechanges,andthesupportoffriendsandfamily--youcanfeelbetter.Bipolardisorder--ormanicdepression,asitisalsostillsometimescalled--hasnoknown cure.Itisachronichealthconditionthatrequireslifetimemanagement. Plentyofpeoplewiththisconditiondowell;theyhavefamiliesandjobsandlivenormallives.MedicationMedicationisthemaintreatment,usuallyinvolvingthefollowing: Moodstabilizers,suchascarbamazepine(Tegretol),lamotrigine(Lamictal),lithium,orvalproate(Depakote)Antipsychoticdrugs,suchascariprazine(Vraylar), lumateperone(Caplyta), lurasidone(Latuda),olanzapine(Zyprexa),andquetiapine(Seroquel)Antidepressants Antidepressant-antipsychoticdrugs,acombinationofanantidepressantandamoodstabilizerAnti-anxietymedicationsorsleepmedicines,suchassedativeslikebenzodiazepinesItcantakeawhiletofindtherightcombinationforyou.Youmayneedtotryafewthingsbeforeyouandyourdoctorfigureoutwhatworksbest.Onceyoudo,it’simportanttostayonyourmedicationandtalkwithyourdoctorbeforestoppingorchanginganything.Womenwhoarepregnantorbreastfeedingshouldtalkwiththeirdoctorsaboutmedicationsthataresafetotake. Psychotherapy,or"talktherapy,"isoftenrecommended,too.Thereareseveraldifferenttypes.Optionscaninclude:Interpersonalandsocialrhythmtherapy(IPSRT).Thisisbasedontheideathathavingadailyroutineforeverything,fromsleepingtoeating,canhelpkeepyourmoodstable.Cognitivebehavioraltherapy(CBT).Thishelpsyoureplacebadhabitsandactionswithmorepositivealternatives.Italsocanhelpyoulearntomanagestressandothernegativetriggers.Psychoeducation.Learningmoreandteachingfamilymembersaboutbipolardisordercanhelpgiveyousupportwhenepisodeshappen.Family-focusedtherapy.Thissetsupasupportsystemtohelpwithtreatmentandhelpsyourlovedonesrecognizethebeginningofanepisode.Othertreatmentoptionsforbipolardisordercaninclude:Electroconvulsivetherapy(ECT).Smalldosesofelectricityshockthebrainandsetoffasmallseizuretokindofrebootitandchangethebalanceofcertainchemicals.Whileit’sstillalast-resorttreatmentwhenmedicationsandtherapyhaven’tworked,itismuchbettercontrolledandsafer,withfewerrisksandsideeffects,thanintheearlydaysofthisprocedure.Acupuncture.There’ssomeevidencethat thiscomplementarytherapymayhelpwiththedepressioncausedbybipolardisorder.Supplements.Whilesomepeopletakecertainvitaminsupplementstohelpwiththesymptomsofbipolardisorder,therearemanypossibleissueswithusingthem.Forexample, theiringredientsaren’tregulated,theycanhavesideeffects,andsomecanaffecthowprescribedmedicationswork.Besuretotellyourdoctoraboutanysupplementsyoutake.Lifestylechangesmayalsohelp:Getregularexercise.Stayonascheduleforeatingandsleeping.Learntorecognizeyourmoodswings.Getsupportfromfriendsorgroups.Keepasymptomjournalorchart.Learntomanagestress.Findhealthyhobbiesorsports.Don’tdrinkalcoholoruserecreationaldrugs.BipolarDisorderOutlookBipolardisordercanmakeyoufeelutterlyalone.Butthatreallyisn'tthecase.Morethan2millionadultsintheU.S.arecopingwithbipolardisorderrightnow.It'simportantnottoblameyourselfforyourcondition.Bipolardisorderisaphysicalillness,notasignofpersonalweakness.It'slikediabetes,heartdisease,oranyotherhealthcondition.Nobodyknowswhatcausesbipolardisorder,butformanypeople,itisaverymanageablecondition.Theimportantthingistofocusonthefuture.Livingwithbipolardisordercanbetough.Butdon'tletithijackyourlife.Instead,takeactionandregaincontrolofyourhealth.Withdedicationandthehelpofyourhealthcareproviders,youcanfeelbetteragain.Formostpeople,agoodtreatmentprogramcanstabilizetheirmoodsandhelpeasesymptoms.Thosewhoalsohaveasubstanceabuseproblemmayneedmorespecializedtreatment.Ongoingtreatmentismoreeffectivethandealingwithproblemsastheycomeup. Themoreyouknowaboutyourcondition,thebetteryoucanmanageyourepisodes.Andsupportgroups,whereyoucantalkwithpeoplewhoaregoingthroughthesamethingsyouare,canalsohelp.BipolarDisorderandSuicideSomepeoplewhohavebipolardisordermaybecomesuicidal.Learnthewarningsignsandseekimmediatemedicalhelpforthem:Depression(changesineating,sleeping,activities)IsolatingyourselfTalkingaboutsuicide,hopelessness,orhelplessnessActingrecklesslyTakingmorerisksHavingmoreaccidentsAbusingalcoholorotherdrugsFocusingonmorbidandnegativethemesTalkingaboutdeathanddyingCryingmore,orbecominglessemotionallyexpressiveGivingawaypossessionsWhenaLovedOneHasBipolarDisorderIsBipolarDisorderorADHD?MoodDisorders:HowtoRecognizeandTreatThemWarningSignsofBipolarDisorderHowIsBipolarDisorderDiagnosed?BipolarDisorder:AnOverviewBipolarDisorderOverviewFamousPeopleWithBipolarDisorderDealingWithUpsandDownsofBipolarDisorder?UnderstandingBipolarDisorderFindBalanceWithBipolarDisorderBalancingBipolarDisorderWhatDoesBipolarManiaLookandFeelLike?BipolarIDisorderTopicsMoodSwings?ItCouldBeBipolarDisorderSignsofmaniaanddepression.CelebritiesWithBipolarDisorderFamouspeoplewhohavethiscondition.DealingWiththeUpsandDownsofBipolar?Assessyoursymptoms.5TypesofBipolarDisorderHowiseachonedifferent?ASSESSMENTCouldYouHaveBipolarDisorder?ArticleWhatTriggersBipolarMoodSwings?ArticleBipolarDisorder:FoodstoAvoidArticleWho'sAtRiskforBipolarDisorder?SlideshowUnderstandingBipolarDisorderArticleBipolarSymptoms:DoYouKnowThem?ArticleWomenandBipolarDisorderArticleHowtoTreatBipolarDisorderBipolarDisorderAssessmentPregnancyandBipolarDisorderWhat'sCausingMyMoodSwings?CanECTTreatBipolarDisorder?5TypesofBipolarDisorderSignsofaBipolarManicEpisodeHealthSolutionsPenisCurvedWhenErect?CouldIhaveCAD?TreatBentFingersTreatHR+,HER2-MBCTiredofDandruff?BenefitsofCBDRethinkMSTreatmentAFib-RelatedStrokesRiskofaFutureDVT/PEIsMyPenisNormal?RelapsingMSOptionsLiverTransplantsSaveLivesFinancePlasticSurgeryBentFingerCausesLivingWithPsoriasis?MissingTeeth?MorefromWebMD5TipstoHelpWithRelapsingMSHowtoThriveWithNarcolepsyReliefforBlockedHairFolliclesPsoriaticArthritisandYourSleepWhatPsoriasisFeelsLikeFirstPsoriaticArthritisFlareTalkingtoYourDoctorAboutRACrohn's:A'Full-Body'DiseaseAvoidingCrohn’sFlaresHealthBenefitsofHempSeedOilLiveBetterWithPsoriaticDiseaseTypesofB-CellTherapyforMS5HealthBenefitsofHempWhyProstateCancerSpreadsLivingwithAdvancedBreastCancerWhereBreastCancerSpreads