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What is Bipolar?

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Definition

By Mayo Clinic staff

Bipolar disorder — sometimes called manic-depressive disorder — causes mood swings that range from of the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may only occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time.

Although bipolar disorder is a disruptive, long-term condition, you can keep your moods in check by following a treatment plan. In most cases, bipolar disorder can be controlled with medications and psychological counseling (psychotherapy).

Symptoms

By Mayo Clinic staff

Bipolar disorder is divided into several subtypes. Each has a different pattern of symptoms. Types of bipolar disorder include:

* Bipolar I disorder.

Mood swings with bipolar I cause significant difficulty in your job, school or relationships. Manic episodes can be severe and dangerous.

* Bipolar II disorder.

Bipolar II is less severe than bipolar I. You may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine. Instead of full-blown mania, you have hypomania — a less severe form of mania. In bipolar II, periods of depression typically last longer than periods of hypomania.

* Cyclothymia.

Cyclothymia is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disruptive, but the highs and lows are not as severe as they are with other types of bipolar disorder.

Bipolar disorder symptoms reflect a range of moods.Bipolar disorder symptoms reflect a range of moods.

The exact symptoms of bipolar disorder vary from person to person. For some people, depression causes the most problems; for other people manic symptoms are the main concern. Symptoms of depression and symptoms of mania or hypomania may also occur together. This is known as a mixed episode.

Manic phase of bipolar disorder

Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:

* Euphoria

* Extreme optimism

* Inflated self-esteem

* Poor judgment

* Rapid speech

* Racing thoughts

* Aggressive behavior

* Agitation or irritation

* Increased physical activity

* Risky behavior

* Spending sprees or unwise financial choices

* Increased drive to perform or achieve goals

* Increased sex drive

* Decreased need for sleep

* Inability to concentrate

* Careless or dangerous use of drugs or alcohol

* Frequent absences from work or school

* Delusions or a break from reality (psychosis)

* Poor performance at work or school

Depressive phase of bipolar disorder

Signs and symptoms of the depressive phase of bipolar disorder can include:

* Sadness

* Hopelessness

* Suicidal thoughts or behavior

* Anxiety

* Guilt

* Sleep problems

* Low appetite or increased appetite

* Fatigue

* Loss of interest in daily activities

* Problems concentrating

* Irritability

* Chronic pain without a known cause

* Frequent absences from work or school

* Poor performance at work or school

Other signs and symptoms bipolar disorder

Signs and symptoms of bipolar disorder can also include:

* Seasonal changes in mood. As with seasonal affective disorder (SAD), some people with bipolar disorder have moods that change with the seasons. Some people become manic or hypomanic in the spring or summer and then become depressed in the fall or winter. For other people, this cycle is reversed — they become depressed in the spring or summer and manic or hypomanic in the fall or winter.

* Rapid cycling bipolar disorder. Some people with bipolar disorder have rapid mood shifts. This is defined as having four or more mood swings within a single year. However, in some people moods shifts occur much more quickly, sometimes within just hours.

* Psychosis. Severe episodes of either mania or depression may result in psychosis, a detachment from reality. Symptoms of psychosis may include false but strongly held beliefs (delusions) and hearing or seeing things that aren't there (hallucinations). In some people, sudden psychosis (a psychotic break) is the first sign of bipolar disorder.

Symptoms in children and adolescents

Instead of clear-cut depression and mania or hypomania, the most prominent signs of bipolar disorder in children and adolescents can include explosive temper, rapid mood shifts, reckless behavior and aggression. In some cases, these shifts occur within hours or less — for example, a child may have intense periods of giddiness and silliness, long bouts of crying and outbursts of explosive anger all in one day. Changing sleep patterns are also a common indicator of childhood bipolar disorder.

When to see a doctor

If you have any symptoms of depression or mania, see your doctor or mental health provider. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health provider with experience in bipolar disorder can help you get your symptoms under control.

Many people with bipolar disorder don't get the treatment they need. Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones. And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.

If you're reluctant to seek treatment, confide in a friend or loved one, a health care professional, a faith leader or someone else you trust. They can help you take the first steps to successful treatment.

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