What Are Bipolar Disorders? - Psychiatry.org

These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally ... AsdescribedinthePrivacyPolicyoftheAmericanPsychiatricAssociation(APA),thiswebsiteutilizescookiesformultiplepurposesincludingtoprovideyouwithpersonalizedcontent,evaluateandanalyzetheuseofoursite,andtoidentifywhichadvertisementsbringuserstoAPA’swebsites.Byclosingthismessage,continuingthenavigation,orotherwisecontinuingtoviewtheAPA’swebsites&applications,youconfirmthatyouunderstandandacceptthetermsoftheAPA’sPrivacyPolicy,includingtheuseofcookies.ReadourfullPrivacyPolicyhere. Accept Skiptocontent Important!APA'sOnlineSystemsUpdated.Passwordresetrequired. Closealert Important!APA'sOnlineSystemsUpdated. Passwordresetwillberequired. Readmorehere> Closealert Youarehere: PatientsandFamilies BipolarDisorders WhatAreBipolarDisorders? Share Print SubNavigation BipolarDisorders TogglePageListing WhatAreBipolarDisorders? ExpertQ&A:BipolarDisorder OnThisPage WhatAreBipolarDisorders? Bipolardisorderisabraindisorderthatcauseschangesinaperson'smood,energy,andabilitytofunction.Peoplewithbipolardisorderexperienceintenseemotionalstatesthattypicallyoccurduringdistinctperiodsofdaystoweeks,calledmoodepisodes.Thesemoodepisodesarecategorizedasmanic/hypomanic(abnormallyhappyorirritablemood)ordepressive(sadmood).Peoplewithbipolardisordergenerallyhaveperiodsofneutralmoodaswell.Whentreated,peoplewithbipolardisordercanleadfullandproductivelives. Peoplewithoutbipolardisorderexperiencemoodfluctuationsaswell.However,thesemoodchangestypicallylasthoursratherthandays.Also,thesechangesarenotusuallyaccompaniedbytheextremedegreeofbehaviorchangeordifficultywithdailyroutinesandsocialinteractionsthatpeoplewithbipolardisorderdemonstrateduringmoodepisodes.Bipolardisordercandisruptaperson’srelationshipswithlovedonesandcausedifficultyinworkingorgoingtoschool. Bipolardisorderisacategorythatincludesthreedifferentdiagnoses:bipolarI,bipolarII,andcyclothymicdisorder. Bipolardisordercommonlyrunsinfamilies:80to90percentofindividualswithbipolardisorderhavearelativewithbipolardisorderordepression.Environmentalfactorssuchasstress,sleepdisruption,anddrugsandalcoholmaytriggermoodepisodesinvulnerablepeople.Thoughthespecificcausesofbipolardisorderwithinthebrainareunclear,animbalanceofbrainchemicalsisbelievedtoleadtodysregulatedbrainactivity.Theaverageageofonsetis25yearsold. PeoplewithbipolarIdisorderfrequentlyhaveothermentaldisorderssuchasanxietydisorders,substanceusedisorders,and/orattention-deficit/hyperactivitydisorder(ADHD).TheriskofsuicideissignificantlyhigheramongpeoplewithbipolarIdisorderthanamongthegeneralpopulation. BipolarIDisorder BipolarIdisorderisdiagnosedwhenapersonexperiencesamanicepisode.Duringamanicepisode,peoplewithbipolarIdisorderexperienceanextremeincreaseinenergyandmayfeelontopoftheworldoruncomfortablyirritableinmood.SomepeoplewithbipolarIdisorderalsoexperiencedepressiveorhypomanicepisodes,andmostpeoplewithbipolarIdisorderalsohaveperiodsofneutralmood. SymptomsofBipolarIDisorder ManicEpisode Amanicepisodeisaperiodofatleastoneweekwhenapersonisextremelyhigh-spiritedorirritablemostofthedayformostdays,possessesmoreenergythanusual,andexperiencesatleastthreeofthefollowingchangesinbehavior: Decreasedneedforsleep(e.g.,feelingenergeticdespitesignificantlylesssleepthanusual Increasedorfasterspeech Uncontrollableracingthoughtsorquicklychangingideasortopicswhenspeaking Distractibility Increasedactivity(e.g.,restlessness,workingonseveralprojectsatonce) Increasedriskybehavior(e.g.,recklessdriving,spendingsprees) Thesebehaviorsmustrepresentachangefromtheperson’susualbehaviorandbecleartofriendsandfamily.Symptomsmustbesevereenoughtocausedysfunctioninwork,family,orsocialactivitiesandresponsibilities.Symptomsofamanicepisodecommonlyrequireapersontoreceivehospitalcaretostaysafe. Somepeopleexperiencingmanicepisodesalsoexperiencedisorganizedthinking,falsebeliefs,and/orhallucinations,knownaspsychoticfeatures. HypomanicEpisode Ahypomanicepisodeischaracterizedbylessseveremanicsymptomsthatneedtolastonlyfourdaysinarowratherthanaweek.Hypomanicsymptomsdonotleadtothemajorproblemsindailyfunctioningthatmanicsymptomscommonlycause. MajorDepressiveEpisode Amajordepressiveepisodeisaperiodofatleasttwoweeksinwhichapersonhasatleastfiveofthefollowingsymptoms(includingatleastoneofthefirsttwosymptoms): Intensesadnessordespair Lossofinterestinactivitiesthepersononceenjoyed Feelingsofworthlessnessorguilt Fatigue Increasedordecreasedsleep Increasedordecreasedappetite Restlessness(e.g.,pacing)orslowedspeechormovement Difficultyconcentrating Frequentthoughtsofdeathorsuicide TreatmentandManagement Bipolardisordersymptomscommonlyimprovewithtreatment.Medicationisthecornerstoneofbipolardisordertreatment,thoughtalktherapy(psychotherapy)canhelpmanypatientslearnabouttheirillnessandadheretomedications,preventingfuturemoodepisodes. Medicationsknownas“moodstabilizers”(e.g.,lithium)arethemostcommonlyprescribedtypeofmedicationsforbipolardisorder.Thesemedicationsarebelievedtocorrectimbalancedbrainsignaling.Becausebipolardisorderisachronicillnessinwhichmoodepisodestypicallyrecur,ongoingpreventivetreatmentisrecommended.Bipolardisordertreatmentisindividualized;peoplewithbipolardisordermayneedtotrydifferentmedicationsbeforefindingwhatworksbestforthem. Insomecases,whenmedicationandpsychotherapyhavenothelped,aneffectivetreatmentknownaselectroconvulsivetherapy(ECT)maybeused.ECTinvolvesseveralroundsofabriefelectricalcurrentappliedtothescalpwhilethepatientisunderanesthesia,leadingtoashort,controlledseizure.ECT-inducedseizuresarebelievedtoremodelbrainsignalingpathways. Sincebipolardisordercancauseseriousdisruptionsinaperson’sdailylifeandcreateastressfulfamilysituation,familymembersmayalsobenefitfromprofessionalresources,particularlymentalhealthadvocacyandsupportgroups.Fromthesesources,familiescanlearnstrategiesforcoping,participatingactivelyinthetreatment,andobtainingsupport. BipolarIIDisorder AdiagnosisofbipolarIIdisorderrequiressomeonetohaveatleastonemajordepressiveepisodeandatleastonehypomanicepisode(seeabove).Peoplereturntotheirusualfunctioningbetweenepisodes.PeoplewithbipolarIIdisorderoftenfirstseektreatmentasaresultoftheirfirstdepressiveepisode,sincehypomanicepisodesoftenfeelpleasurableandcanevenincreaseperformanceatworkorschool. PeoplewithbipolarIIdisorderfrequentlyhaveothermentalillnessessuchasananxietydisorderorsubstanceusedisorder,thelatterofwhichcanexacerbatesymptomsofdepressionorhypomania. Treatment TreatmentsforbipolarIIaresimilartothoseforbipolarI:medicationandpsychotherapy.Themostcommonlyusedmedicationsaremoodstabilizersandantidepressants,dependingonthespecificsymptoms.Ifdepressivesymptomsaresevereandmedicationisnoteffective,ECT(seeabove)maybeused.Eachperson'streatmentisindividualized. CyclothymicDisorder Cyclothymicdisorderisamilderformofbipolardisorderinvolvingmany"moodswings,"withhypomaniaanddepressivesymptomsthatoccurfrequently.PeoplewithcyclothymiaexperienceemotionalupsanddownsbutwithlessseveresymptomsthanbipolarIorIIdisorder. Cyclothymicdisordersymptomsincludethefollowing: Foratleasttwoyears,manyperiodsofhypomanicanddepressivesymptoms,butthesymptomsdonotmeetthecriteriaforhypomanicordepressiveepisode. Duringthetwo-yearperiod,thesymptoms(moodswings)havelastedforatleasthalfthetimeandhaveneverstoppedformorethantwomonths. Treatment Treatmentforcyclothymicdisordercaninvolvemedicationandtalktherapy.Formanypeople,talktherapycanhelpwiththestressesofmoodswings.Keepingamoodjournalcanbeaneffectivewaytoobservepatternsinmoodfluctuation.Peoplewithcyclothymiamaystartandstoptreatmentovertime. PhysicianReview MollyHowland,M.D. AlexElSehamy,M.D. January2021 MoreResources DepressionandBipolarSupportAlliance Overviewofbipolardisorder ThrivingwithBipolar SMIAdviser Answerstocommonquestionsaboutseriousmentalilnness Familystories InternationalBipolarFoundation:GettingHelp InternationalSocietyforBipolarDisordersVideo:Patients'andPhysicians'PerspectivesonDiagnosisandCoping MentalHealthAmerica Overviewofbipolardisorder GuidetoBipolarDisorderforAfricanAmericans TrastornoBipolar:LoQueUstedNecesitaSaber(GuidetoBipolarDisorderinSpanish) NationalAllianceonMentalIllness Overviewofbipolardisorder Guidetolivingwithamentalhealthcondition InformationHelpline:800-950-6264 Medicalleadershipformind,brainandbody. 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