>> Bipolar Disorder
We all have our ups and downs, our "off"
days and our "on" days, but if you're suffering
from bipolar disorder, these peaks and valleys are
more severe. The extreme highs and lows of bipolar
disorder can disrupt daily activities and damage relationships.
And although it’s treatable, many people don’t
recognize the warning signs and get the help they
need. Since bipolar disorder tends to worsen without
treatment, it’s important to learn what the
symptoms look like. Recognizing the problem is the
first step to getting it under control.
WHAT IS BIPOLAR DISORDER?
Bipolar disorder—also known as manic depression
or manic-depressive illness—involves dramatic
shifts in mood from the highs of mania to the lows
of major depression. More than just a fleeting good
or bad mood, the cycles of bipolar disorder last for
days, weeks, or months.
Unlike ordinary mood swings, bipolar disorder is much
more intense and disruptive to everyday functioning,
affecting energy, activity levels, judgment, and behavior.
During a manic episode, a person might impulsively
quit a job, charge up huge amounts of debt, or feel
rested after sleeping two hours.
During a depressive episode, the same person might
be too tired to get out of bed and full of self-loathing
and hopelessness over his or her unemployment status
and credit card bills.
Bipolar disorder is more common than many think affecting
nearly 3 out of every 100 adults in the U.S according
to the National Institutes of Mental
Health. Its causes aren’t completely understood,
but bipolar disorder often runs in families.
The first manic or depressive episode of bipolar disorder
usually occurs in the teenage years or early adulthood.
SIGNS AND SYMPTOMS OF BIPOLAR
Bipolar disorder involves periods of elevated mood,
or mania. Usually—but not always—the disorder
also involves periods of depression. In a typical
case, a person with bipolar disorder cycles between
these two extremes—experiencing recurrent episodes
of both elevated and depressed mood, often with symptom-free
stretches in between.
SIGNS AND SYMPTOMS OF MANIA
||There are four types of mood
episodes that can occur in bipolar disorder,
each with a unique pattern of symptoms:
- Mixed episode
In the manic phase of bipolar disorder, feelings of
heightened energy, creativity, and euphoria are common.
People experiencing a manic episode often talk a mile
a minute, sleep very little, and are hyperactive.
They may also feel like they’re all-powerful,
invincible, or destined for greatness.
But while mania feels good at first, it has a tendency
to spiral out of control. People often behave recklessly
during a manic episode—gambling away savings,
engaging in inappropriate sexual activity, or making
foolish business investments, for example. They may
also become angry, irritable, and aggressive, picking
fights, lashing out when others don’t go along
with their plans, and blaming anyone who criticizes
Common signs and symptoms of mania include:
SIGNS AND SYMPTOMS OF HYPOMANIA
- Feeling unusually “high”
and optimistic OR extremely irritable
- Unrealistic, grandiose beliefs about
one’s abilities or powers
- Sleeping very little, but feeling extremely
- Talking so rapidly that others can’t
- Racing thoughts; jumping quickly from
one idea to the next
- Highly distractible, unable to concentrate
- Impaired judgment and impulsiveness
- Acting recklessly without thinking about
- Delusions and hallucinations (in severe
Hypomania is a less severe form of mania. People in
a hypomanic state feel euphoric, energetic, and productive,
but their symptoms are milder than those of mania
and much less disruptive. Unlike manics, people with
hypomania never suffer from delusions and hallucinations.
They are able to carry on with their day-to-day lives.
To others, it may seem as if the hypomanic individual
is merely in an unusually good mood. But unfortunately,
hypomania often escalates to full-blown mania or is
followed by a major depressive episode.
SIGNS AND SYMPTOMS OF BIPOLAR
The depressive phase of bipolar disorder is very similar
to that of major depression. However, there are some
notable differences. When compared to major depression,
bipolar depression is more likely to include symptoms
of low energy. People with bipolar depression tend
to move and speak slowly and sleep a lot. They are
also more likely to have psychotic depression, a condition
in which they’ve lost contact with reality.
Common symptoms of bipolar depression include:
SIGNS AND SYMPTOMS OF A MIXED
- Feeling hopeless, sad, or empty.
- Loss of interest in things you used to
- Fatigue or loss of energy
- Physical and mental sluggishness
- Appetite or weight changes
- Sleeping too much or too little
- Concentration and memory problems
- Feelings of self-loathing, shame, or
- Thoughts of death or suicide
A mixed episode of bipolar disorder features symptoms
of both mania and depression. Common signs of a mixed
episode include agitation, irritability, insomnia,
appetite changes, loss of contact with reality, and
suicidal thoughts. This combination of high energy
and low mood makes for a particularly high risk of
SYMPTOMS OF BIPOLAR DISORDER
IN CHILDREN AND TEENS
Unlike many adults with bipolar disorder, whose episodes
tend to be more clearly defined, children and young
adolescents with the illness often experience very
fast mood swings between depression and mania many
times within a day. Children with mania are more likely
to be irritable and prone to destructive tantrums
than to be overly happy and elated. Mixed symptoms
also are common in youths with bipolar disorder. Older
adolescents who develop the illness may have more
classic, adult-type episodes and symptoms.
TYPES OF BIPOLAR DISORDER
The course of bipolar disorder varies widely from
person to person, with unpredictable differences in
the pattern and frequency of the manic and depressive
episodes. Some people are more prone to either mania
or depression, while others alternate equally between
the two types of episodes. Some have frequent mood
disruptions, while others experience only a few over
a lifetime. The duration and severity of each episode
Each of the four types of bipolar disorder have a
unique pattern of symptoms:
DISORDER AND SUICIDE
- Bipolar I Disorder – Mania
Bipolar I Disorder is the classic manic-depressive
form of the illness, as well as the most
severe type of bipolar disorder. It is characterized
by at least one manic episode or mixed episode.
Although a previous episode of major depression
is not required for diagnosis, the vast
majority of people with Bipolar I Disorder
have experienced one. The typical course
of Bipolar I Disorder involves recurring
cycles between mania and depression.
- Bipolar II Disorder – Hypomania
In Bipolar II disorder, the person doesn’t
experience full-blown manic episodes. Instead,
the illness involves episodes of hypomania
and severe depression. In order to be diagnosed
with Bipolar II Disorder, you must have
experienced at least one hypomanic episode
and one major depressive episode in your
lifetime. If you ever have a manic episode,
your diagnosis would be changed to Bipolar
- Cyclothymia – Hypomania
and mild depression
Cyclothymia, also known as cyclothymic disorder,
is a milder form of bipolar disorder. Like
bipolar disorder, cyclothymia consists of
cyclical mood swings. However, the highs
and lows are not severe enough to qualify
as either mania or major depression. To
be diagnosed with cyclothymia, you must
experience numerous periods of hypomania
and mild depression over at least a two-year
time span. Because people with cyclothymia
are at an increased risk of developing full-blown
bipolar disorder, it is a condition that
should be monitored and treated.
- Rapid Cycling – Frequent
episodes of mania, hypomania, or depression
Rapid cycling is a subtype of bipolar disorder
characterized by four or more episodes of
mania, hypomania, or depression within one
year. The shifts from low to high can occur
over a matter of days or hours. Rapid cycling
can occur within any type of bipolar disorder.
It usually develops later in the course
of bipolar disorder, but it is sometimes
just a temporary condition.
The depressive phase of bipolar disorder is often
very severe, and suicide is a major risk factor. In
fact, people suffering from bipolar disorder are more
likely to attempt suicide than those suffering from
regular depression. Furthermore, their suicide attempts
tend to be more lethal.
The risk of suicide is even higher in people with
bipolar disorder who have a high number of depressive
episodes, mixed episodes, a history of alcohol or
drug abuse, a family history of suicide, or an early
onset of the disease.
The warning signs of suicide include:
If you or someone you know is having suicidal
thoughts, seek help immediately.
- Talking about death, self-harm, or suicide
- Feeling hopeless or helpless
- Feeling worthless or like a burden to
- Putting affairs in order or saying goodbye
- Acting recklessly, as if one has a “death
- Seeking out weapons or pills that could
be used to commit suicide
call a doctor, a suicide hotline, or your local hospital.
If you believe that a suicide attempt is imminent,
call 911 immediately and stay with the person until
TRIGGERS AND RISK FACTORS
FOR BIPOLAR DISORDER
It’s very important to take any thoughts
or talk of suicide seriously. If you or someone
you care about is suicidal, call the National
Suicide Prevention Lifeline at 1-800-273-TALK.
IN A LIFE-THREATENING EMERGENCY, CALL 911.
Research indicates that some people are genetically
predisposed to bipolar disorder. But not everyone
with an inherited vulnerability develops the illness,
indicating that external factors also play a role.
These external risk factors are called triggers. Triggers
can set off a bipolar disorder or prolong an existing
mood episode. Many episode of mania or depression
occur, however, without an obvious trigger.
SEEKING HELP FOR BIPOLAR
- Stress - Severe stress or
emotional trauma can trigger either depression
or mania in someone with a genetic vulnerability
to bipolar disorder. Stress can also worsen a
bipolar mood episode or extend its duration.
- Major Life Event - Major life
events both good and bad can trigger an episode
of bipolar disorder. These events tend to involve
drastic or sudden changes, such as getting married,
going away to college, starting a new job, or
- Substance Abuse - While substance
abuse doesn’t cause bipolar disorder, it
can bring on an episode and worsen the course
of the disease. Drugs such as cocaine, ecstasy,
and amphetamines can trigger mania, while alcohol
and tranquilizers can trigger depression.
- Medication - Certain medications,
most notably antidepressant drugs, can trigger
mania. Other drugs that may induce mania include
over-the-counter cold medicine, appetite suppressants,
caffeine, corticosteroids, and thyroid medication.
- Seasonal Changes - Episodes
of mania and depression often follow a seasonal
pattern. Manic episodes are more common during
the summer, and depressive episodes more common
during the fall, winter, and spring.
- Sleep Deprivation –
Loss of sleep—even as little as skipping
a few hours of rest—can trigger an episode
Living with untreated bipolar disorder can cause problems
in everything from your career to your relationships
to your outlook on life. Diagnosing the problem as
early as possible and starting a comprehensive treatment
plan can help prevent these complications. While dealing
with bipolar disorder isn’t always easy, it
doesn’t have to run your life. But in order
to successfully manage bipolar disorder, it is essential
to fully understand the condition and its challenges.
Melinda Smith, M.A., Jeanne Segal, Ph.D., and Robert
Segal, M.A., contributed to this article. Last modified
Jaelline Jaffe, Ph.D., and Jeanne Segal, Ph.D., contributed
to this article. Last modified on: 2/02/07.
Reprinted with permission from http://www.helpguide.org/.
C 2008 Helpguide.org. All rights reserved.
You can find the original article at
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