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What is Bipolar Disorder?

Bipolar disorder is a medical condition caused by chemical imbalances in the brain and marked by significant changes in mood, thought, energy and behavior. A person's mood can alternate between the "poles" of mania (highs) and depression (lows). This change in mood or "mood swing" can last for hours, days, weeks, or months and can result in significant problems in areas such as relationships, work, and finances.  Although the direct cause of the illness is unclear, it has long been understood/accepted that genetic, biochemical and environmental factors play a role.

There are two main forms of the illness. Bipolar I, the most severe, is referred to as the classic form of the illness. It typically involves recurrent episodes of mania and depression. People diagnosed with bipolar II disorder do not experience manias but have milder episodes called hypomanias.  In addition, they also experience alternating depressive episodes, experience milder episodes of hypomania with alternating depression. Manic and depressive symptoms can also occur at the same time which is called a mixed episode. Rapid cycling bipolar disorder is when a person experiences four or more episodes of manias, hypomanias, or depressive episodes over the course of a year.

Bipolar disorder affects more than 5.7 million adult Americans. An equal number of men and women develop this illness; and it is found among all ages, races, ethnic groups and social classes. The illness tends to run in families and appears to have a genetic link.

Bipolar disorder differs significantly from clinical depression, although the symptoms for the depressive phase of the illness are similar. Mood swings between "high" and "low" can be severe, ranging from extreme energy to deep despair.

Symptoms of mania - the "highs" of bipolar disorder include:

  • Increased physical and mental activity and energy
  • Heightened mood, exaggerated optimism and self-confidence
  • Excessive irritability, aggressive behavior
  • Decreased need for sleep without experiencing fatigue
  • Grandiose delusions, inflated sense of self-importance
  • Racing speech, racing thoughts, flight of ideas
  • Impulsiveness, poor judgment, distractibility (which may lead to "spending sprees", sexual promiscuity, high-risk business ventures)
  • Reckless behavior (driving, etc.)
  • In the most severe cases, delusions and hallucinations

Symptoms of mania:

  • Feelings of elation, hyper, “high”
  • Increase in activity
  • Increased energy
  • Excessive irritability
  • Aggressive behavior
  • Decreased need for sleep without fatigue
  • Grandiose beliefs, Inflated sense of powers and abilities
  • Pressured/rapid speech
  • Racing thoughts
  • Poor concentration, distractibility
  • Impulsiveness
  • Poor judgment
  • Increased sexual drive
  • Spending sprees
  • Reckless behavior (driving)
  • Delusions and/or hallucinations

Common symptoms of depression - the "lows" of bipolar disorder

  • Prolonged sadness or unexplained crying spells
  • Significant changes in appetite and sleep patterns
  • Irritability, anger, worry, agitation, anxiety
  • Pessimism, indifference
  • Loss of energy, persistent lethargy
  • Feelings of guilt, worthlessness
  • Inability to concentrate, indecisiveness
  • Inability to enjoy former interests, social withdrawal
  • Unexplained aches and pains
  • Complete inability to function in society
  • Recurring thoughts of death or suicide

Common  symptoms of depression:

  • Prolonged sadness
  • Pessimism, indifference
  • Irritability
  • Loss of energy
  • Decrease interest in typically pleasurable activities including sex
  • Tearfulness
  • Change in appetite, unintentional weight gain/loss
  • Sleeping too much or too little
  • Restlessness or moving slowly
  • Anxiety
  • Feelings of guilt, worthlessness
  • Poor concentration
  • Unexplained physical pain
  • Thoughts of death or suicide, suicide attempts

Many people do not seek medical attention during periods of mania because they feel manic symptoms (increased energy, heightened mood, increased sexual drive, etc.) have a positive impact on them. However, left unchecked, these behaviors can have harmful results. When symptoms of mania are left untreated, they can lead to illegal or life-threatening situations, because mania often involves impaired judgment and reckless behavior.

Several therapies exist for bipolar disorder, and promising new treatments are currently under investigation. Treatment may include psychopharmacologic medications and/or psychotherapy/counseling.