Bipolar Disorder

Bipolar disorder results in extreme swings in mood, energy, and ability to function. The mood changes of bipolar disorder are more dramatic than normal ups and downs. They can hurt relationships and cause poor job or school performance. Bipolar disorder can be treated. Contact your doctor if you think you may have this condition.

The two mood extremes of bipolar disorder are mania and depression. In mania, one of the defining symptoms is an increase in energy and a decreased need for sleep. The mood may be overly happy or irritable. In depression , a down mood with fatigue takes over, and it is often accompanied with irritability.

There are two forms of this condition:

• Bipolar I disorder—involves recurrent episodes of mania often immediately followed by depression
• Bipolar II disorder—involves milder episodes of mania (called hypomania) that alternate with episodes of depression

The cause of bipolar disorder is not known. This condition tends to run in families. Specific genes may play a role. It is most likely many different genes that act together.

A family history of the disorder increases your chance of developing it. Tell your doctor if you have a family member with bipolar disorder.

Symptoms include:

• Dramatic mood swings—This can range from elated excitability, unrealistic goal setting, and an exaggerated sense of self to hopeless despondency.
• Extreme changes in energy and behavior
• Periods of normal mood in between ups and downs

Signs and symptoms of mania include:

• Decreased need for sleep
• Increased energy and effort toward goal-directed activities
• Overconfidence or inflated self-esteem
• Persistent and inexplicable elevation in mood
• Poor judgment, often involving spending sprees and sexual indiscretions
• Racing thoughts, jumping from one idea to another
• Rapid speech or pressure to keep talking
• Restlessness and agitation
• Trouble concentrating

Signs and symptoms of depression include:

• Agitation
• Decreased energy or fatigue
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Prolonged sad, hopeless, or empty mood
• Restlessness or diminished movements
• Sleeping too much or too little
• Thoughts of death or suicide with or without suicide attempts
• Trouble concentrating, remembering, and/or making decisions
• Unintended weight loss or gain

Severe episodes of mania or depression may sometimes be associated with psychotic symptoms such as:

• Delusions
• Disorders of thought
• Hallucinations

Your doctor will ask about your symptoms and medical history. A physical exam may be done. In some cases, lab tests are ordered. They will help to rule out other causes of mood and behavior symptoms. You may be referred to a mental health specialist. Diagnosis of bipolar disorder is based on:

• Absence of other causes, such as some medicines and certain conditions
• Family history of bipolar disorder
• Presence of certain symptoms over time

Mania is diagnosed if:

• Mood is elevated and there are three or more manic symptoms (listed above)
  • If the mood is irritable, not elevated, four symptoms must be present for a diagnosis of mania
• Symptoms last during most of the day, nearly every day, for one week or longer

A depressive episode is diagnosed if:

• Symptoms last for most of the day, nearly every day, for a period of two weeks or longer
• There are five or more of the depressive symptoms (listed above)

Some medicines, illicit drugs, and conditions may show similar features, such as:

• Cocaine or methamphetamines
• Corticosteroids
• Multiple sclerosis
• Thyroid disease

The diagnosis is made only when none of these causes are present.

Talk with your doctor about the best plan for you.

There are no guidelines for preventing bipolar disorder. Taking your daily medicine and following your treatment plan can help prevent future mood episodes from recurring.