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by McCoy K
(Manic-Depressive Illness; Manic Depression; Manic Disorder; Manic Affective Disorder)

Definition

Bipolar disorder is a mental health condition. It is extreme swings in mood and energy. The mood changes of bipolar disorder are more severe than normal ups and downs. They can hurt relationships and make it hard to succeed at work or school.

Bipolar disorder swings between mania and depression. Mania is an increase in energy and a decreased need for sleep. The mood may be overly happy or irritable. Depression is a down mood with heavy fatigue. Irritability is common with depression too.

There are 4 forms of bipolar disorder:

  • Bipolar I disorder—Mania often immediately followed by depression. This cycle repeats. It can be severe.
  • Bipolar II disorder—Less severe mania (called hypomania) that rotate with major depression.
  • Bipolar disorder not otherwise specified (BP-NOS)—does not fit the description of bipolar I or bipolar II disorder.
  • Cyclothymia—Hypomania that alternate with episodes of mild depression that lasts for at least 2 years.

Causes

The exact cause of bipolar disorder is unknown. Changes in genes may change how the brain works.

The Brain
Color coded brain
Copyright © Nucleus Medical Media, Inc.

Risk Factors

The risk of bipolar disease is higher if another family member has it.

Symptoms

Symptoms include:

  • Dramatic mood swings—may be very excitable or sad and hopeless. May lead to unrealistic goal setting or exaggerated sense of self-importance.
  • Periods of normal mood in between ups and downs.
  • Extreme changes in energy and behavior.

Mania may cause:

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

Depression may cause:

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

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

  • Hallucinations
  • Delusions
  • Disorders of thought

Diagnosis

The doctor will ask about your symptoms and past health. A physical exam will be done. Lab tests may be done to rule out other possible causes of symptoms. A mental health specialist will help to diagnosis bipolar disorder. It will be based on the history of symptoms.

Episodes of mania or depression will also be diagnosed as they occur. Symptoms will need to last a period of time and be severe enough to interfere with day to day life.

Treatment

Treatment may help to ease mood swings . It can help to decrease effect on day to day life and avoid major complications.

Medicine

Medicine called mood stabilizers is the main treatment for bipolar disorder. Some may be used during a crisis such as severe depression. Others may help with long term control. The exact plan will be based on individual needs. A medical team will work to find the medicines that have the most benefits and smallest risks. Bipolar disorder medicine may include:

  • Mood stabilizers
  • Antipsychotics
  • Antidepressants—only during depressive episodes
  • Antiseizure medicines

Treatment should prevent major mood swings. It may take some time to find the best treatment plan.

Psychotherapy

Psychotherapy can give patients and their families support and help with treatment plan. Therapy may include:

It can help people stay on track with their treatment plan.

Other Therapy

Some manic or depressive episodes can be severe. Some may also have frequent bipolar cycles. Medicine and therapy may not be effective for this. Electroconvulsive therapy (ECT) uses controlled electrical currents to reset the brain. It may be a treatment option for those with severe problems.

Prevention

The cause of bipolar disorder is not clear so there are no steps to prevent it.

RESOURCES

Depression and Bipolar Support Alliance  http://www.dbsalliance.org 

Mental Health America  http://www.mentalhealthamerica.net 

CANADIAN RESOURCES

Canadian Mental Health Association  https://cmha.ca 

Canadian Psychiatric Association  http://www.cpa-apc.org 

References

Bipolar disorder. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/bipolar-disorder . Accessed August 14, 2020.

Bipolar disorder. National Alliance on Mental Illness website. Available at: https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder. Accessed August 14, 2020.

Bipolar disorder in adults. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml. Accessed August 14, 2020.

4/29/2011 DynaMed Systematic Literature Surveillance  https://www.dynamed.com/condition/bipolar-disorder : Nivoli AM, Colom F, Murru A, et al. New treatment guidelines for acute bipolar depression: a systematic review. J Affect Disord. 2011;129(1-3):14-26.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrian Preda, MD
  • Review Date: 04/2020
  • Update Date: 08/14/2020