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Bipolar disorder is a mental health condition in which a person has periods of depression and periods of being extremely happy or being cross or irritable. In addition to these mood swings, the person also has extreme changes in activity and energy levels.
Manic depression; Bipolar affective disorder
Bipolar disorder affects men and women equally. It usually starts between ages 15 and 25. The exact cause is not known. But it occurs more often in relatives of people with bipolar disorder.
In most people with bipolar disorder, there is no clear cause for the periods (episodes) of extreme happiness and high activity or energy (mania) or depression and low activity or energy (depression). The following may trigger a manic episode:
The manic phase may last from days to months. It may include these symptoms:
The depressive episode may include these symptoms:
Episodes of depression are more common than episodes of mania. The pattern is not the same in all people with bipolar disorder:
To diagnose bipolar disorder, the health care provider may do some or all of the following:
The main goal of treatment is to:
Medicines are a key part of treating bipolar disorder. Most often, the first medicines used are called mood stabilizers. They help you avoid mood swings and extreme changes in activity and energy levels.
With medicines, you may begin to feel better. For some, symptoms of mania may feel good. Or side effects from the medicines may occur. As a result, you may be tempted to stop taking your medicine or change the way you are taking them. But stopping your medicines or taking them in the wrong way can cause symptoms to come back or become much worse.
Ask family members or friends to help you take medicines the right way. This means taking the right dose at the right time. They can also help make sure that episodes of mania and depression are treated as soon as possible.
You may try other medicines, such as antipsychotics or antidepressants.
You will need regular visits with a psychiatrist to talk about your medicines and their possible side effects. Blood tests are often needed too.
Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase if it does not respond to medication.
People who are in the middle of a severe manic or depressive episode may need to stay in a hospital until they are stable and their behavior is under control.
SUPPORT PROGRAMS AND TALK THERAPY
Many people with bipolar disorder do not recognize when they are becoming more depressed or more manic. Joining a support group may help you and your loved ones. Involving family members and caregivers in your treatment may help reduce the chance of symptoms returning.
Important skills you may learn at such programs include how to:
Talk therapy with a mental health provider may be helpful for people with bipolar disorder.
Periods of depression or mania return in most people, even with treatment. People may also have issues with alcohol or drug use. They may also have problems with relationships, school, work, and finances.
Suicide is a very real risk during both mania and depression. People with bipolar disorder who think or talk about suicide need emergency attention right away.
Seek help right way if you:
Call the treating health care provider if:
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013;381:1672-82. PMID: 23663953 www.ncbi.nlm.nih.gov/pubmed/23663953.
Perlis RH, Ostacher MJ. Bipolar disorder. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier Mosby; 2016:chap 30.
Perlis RH. Bipolar disorder. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Elsevier Mosby; 2008:chap 30.
Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.