Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a mood disorder. It causes you to have cycles of extreme mood changes that go beyond normal ups and downs. You will have periods of feeling joyful, energized, and excited (called mania). These are followed by periods of feeling sad and depressed. For this reason, it’s also called manic depression.

Depression affects your body, mood, and thoughts. It also affects how you eat and sleep, think about things, and feel about yourself. It’s not the same as being unhappy or in a blue mood. It’s not a sign of weakness or a condition that can be willed away. Treatment is often needed and is key to recovery.

Bipolar disorder affects equal numbers of men and women. But women tend to have more symptoms of depression than of mania. This disorder often starts in the teens or early adulthood.

What causes bipolar disorder?

Experts don't know what causes bipolar disorder. They agree that many factors seem to play a role. This includes environmental, mental health, and genetic factors.

Bipolar disorder tends to run in families. Researchers are still trying to find genes that may be linked to it.

What are the symptoms of bipolar disorder?

Symptoms may occur a bit differently in each person. The following are the most common symptoms:

Depressive symptoms may include:

• Constant sad, anxious, or empty mood

• Loss of interest in things that you once enjoyed, including sex

• Feeling restless or irritable

• Inability to focus, think, or make decisions

• Low energy, tiredness (fatigue), or being slowed down

• Having thoughts of death or suicide, wishing to die, or attempting suicide (People with this symptom should get treatment right away.)

• Feeling worthless or hopeless

• Feeling undue guilt

• Changes in eating habits, or eating too much or not enough

• Changes in sleep patterns, such as fitful sleep, inability to sleep, waking up very early, or sleeping too much

• Headaches, digestive problems, or chronic pain

Manic symptoms may include:

• Very inflated self-esteem

• Need for less rest and sleep

• Easily distracted or irritable

• Racing thoughts

• Physical agitation

• Risky, aggressive, or destructive behavior

• Talking a lot and talking fast

• Very high or euphoric feelings (feeling overly happy)

• Increased sex drive

• Increased energy

• Unusual poor judgment. For instance, buying sprees, drug or alcohol abuse, or risky sexual behavior.

• Increased denial

Cultural background influences how people understand and react to the symptoms and diagnosis of bipolar disorder. It’s important to remember that when interacting with people and families who are managing this serious mental illness.

How is bipolar disorder diagnosed?

To diagnose bipolar disorder, your healthcare provider will ask about your health history, your symptom history, and your current symptoms. You may have both depressive and manic symptoms to a varying degree.

A diagnosis is made after a careful medical evaluation (to make certain there are no physical problems) and a mental health exam by an experienced mental health provider.

The symptoms of bipolar disorder may look like other mental health conditions.

Always see a healthcare provider for a diagnosis.

How is bipolar disorder treated?

There is no cure for bipolar disorder, but treatment works well for many people. Treatment may include 1 or a combination of the following:

• Medicine. Many different medicines are available for bipolar disorder. But it often takes 4 to 6 weeks for antidepressants to work their best. So it’s important to keep taking the medicine even if it doesn’t seem to be working at first. It’s also important to talk with your healthcare provider before stopping or changing the medicine dose. Some people have to switch medicines or add medicines to get results.

• Therapy. This treatment is most often cognitive-behavioral or interpersonal therapy. It focuses on changing the distorted views you have of yourself and your environment. It works to improve your interpersonal relationship skills. It also helps you find out what your stressors are and how to manage them.

• Electroconvulsive therapy (ECT). This treatment may be used in people with severe, life-threatening depression that has not responded to medicines. A brief electrical current is passed through the brain, triggering a mild seizure. For unknown reasons, this treatment helps restore the normal balance of chemicals in the brain and ease symptoms.

In most cases, you will need consistent, long-term treatment to stabilize the mood swings and provide the support needed to manage bipolar disorder. Life charts can be very helpful to manage the condition. In a life chart, you record daily mood, symptoms, treatments, sleep patterns, and life events. You can share this life chart information with your healthcare provider. The chart can help your healthcare provider see patterns and figure out the best treatment. Family therapy can also be very helpful.

Self-care

You can also take steps to help yourself. During periods of depression, consider the following:

• Get help. If you think you may be depressed, see a healthcare provider right away.

• Set realistic goals and don’t take on too much at a time.

• Break large tasks into small ones. Set priorities and do what you can as you can.

• Try to be with other people and confide in someone. It's usually better than being alone and secretive.

• Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.

• Get regular exercise.

• Expect your mood to get better slowly, not right away. Feeling better takes time.

• Eat healthy, well-balanced meals.

• Don't drink alcohol or use illegal drugs. These can make depression worse.

• It’s best to postpone big decisions until the depression has lifted. Before making big decisions, such as changing jobs or getting married or divorced, discuss it with others who know you well and have a more objective view of your situation.

• People don’t snap out of a depression. But with treatment they can feel a little better day by day.

• Try to be patient and focus on the positives. It may help replace the negative thinking that is part of the depression, and the negative thoughts will disappear as your depression responds to treatment.

• As difficult as it may be, tell your family and friends that you are not feeling well and let them help you.

When to call 988

• If you have suicidal thoughts, seek help right away. Call or text the 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (8255). You will be connected to trained mental health crisis services. An online chat choice is also available. This service is free and available 24/7.

Key points about bipolar disorder

• Bipolar disorder causes cycles of extreme mood changes that go beyond life's regular ups and downs. Treatment is key to recovery.

• There is no clear cause of bipolar disorder. Mental health experts think it’s a result of chemical imbalances in the brain. It seems to run in families, but no genes have yet been linked to it.

• It causes unusual mood swings. A person will have periods of extreme joy, elevated mood, or irritability (called mania). This switches with periods of depression.

• Bipolar disorder may be diagnosed after a careful mental health exam by a mental health provider.

• It's most often treated with medicine, therapy, or a combination of both.

• You can lead a productive life with ongoing medical care, medicine management, psychological support, family and social support, and a plan for self-care.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.