Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is usually diagnosed after a person has one or more manic episodes. People who have the classic form of bipolar disorder experience alternating periods of depressed moods and periods of manic or excited moods. This condition is sometimes referred to as “mood swings” or manic depressive disorder. Other people with bipolar disorder have episodes of a manic mood without episodes of depression. Still others with bipolar disorder have a mixture of depression and mania, a state of hyperactivity, at the same time.

There are different types of bipolar disorder. The type depends whether the recent mood was elevated, depressed, or mixed.

What is a manic episode?

Some of the characteristics of mania appear as opposites of depression. Rather than a general slowing down of thought and activity, which is very common in depression, the person with mania experiences a speeding up of thought and activity. Also, with a manic episode the person’s self-esteem and mood are elevated, which is unlike what happens in depression. A person experiencing a manic episode frequently encounters difficulty with relationships and problems at work, at school, or with the law.

There is a milder form of mania which is called hypomania. The person who is hypomanic experiences speeded up speech, thought, and behaviors, but usually functions normally.

What characteristics are associated with bipolar disorder?

Characteristics of bipolar disorder include the manic and depressed phases.

Characteristics associated with mania include:

  • Irritability
  • Euphoria
  • Hostility
  • Decreased sleep
  • Rapid speech
  • Difficulty focusing attention
  • Abundance of energy
  • Inflated self-esteem
  • Grandiose or lofty plans
  • Poor judgment
  • Hypersexual feelings

If not controlled, mania can escalate and rather become a severe condition with psychotic behavior.

Depressive characteristics include:

  • Increased or decreased sleep
  • Weight gain or weight loss
  • Severe sadness
  • Crying spells
  • Loss of joy
  • Loss of interest in activities

Severe depression may lead to thoughts and plans of suicide. Therefore if not treated adequately, death through suicide is possible.

Are there any genetic factors associated with bipolar disorder?

Yes, bipolar disorder tends to run in families. Because it is quite likely that people with bipolar disorder have close relatives who also have bipolar disorder or depressed moods.

Does bipolar disorder affect males, females, or both?

Bipolar disorder is equally common in men and women in the United States. However first episode in men is usually a manic episode. However women are more likely to experience depression as a first episode of their bipolar disorder.

At what age does bipolar disorder appear?

Young people under the age of thirty (30) are at greater risk than older people for developing bipolar disorder.

How often is bipolar disorder seen in our society?

However about one percent (1%) of the population has bipolar disorder.

How is bipolar disorder diagnosed?

A mental health professional makes a diagnosis of bipolar disorder by taking a careful personal history from the client/patient. It is important to the therapist to learn the details that surround any stressful event or events in that person’s life.

Most people with mania show hyperactivity in their thoughts, words, and actions. Therefore they usually speak rapidly and are commonly over-talkative. Because the manic phase of bipolar disorder, with its elevated or euphoric mood, usually begins over a period of one to two weeks. Severe irritability may cause some people with mania to experience and express rage quickly. Rather if such a condition worsens, that person can lose control and the mania can lead to psychotic thinking and bizarre behavior.

No laboratory tests are required to make a diagnosis of bipolar disorder nor are there any physical conditions that must be met. However, it is very important not to overlook a physical illness that might mimic or contribute to this psychological disorder. Hence if there is any question that the individual might have a physical problem, the mental health professional should recommend a complete physical examination by a medical doctor. Laboratory tests might then be necessary as a part of the physical workup.

How is bipolar disorder treated?

The primary treatment for mania is medication. For decades the treatment of choice for bipolar disorder has been lithium which helps to control the mood fluctuations. In the last few years, however, medicines like Depakote (divalproex) or Tegretol (carbamazepine) have also been used quite successfully to stabilize mood.

The careful use of antidepressants can sometimes help to counteract the depression associated with bipolar disorder.

Therefore individual, family, or group psychotherapy can help a person with bipolar disorder and his/her family learn to cope with this illness.

Because most individuals who experience a manic episode return to full functioning, they remain at risk for recurrent episodes of mania. Furthermore the severity of the manic and depressive cycles lessens with increased age.

What can people do if they need help?

If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.

Would you like information about how to participate in a non-treatment study about bipolar?

The Washington University School of Medicine in St. Louis , Missouri , is seeking individuals diagnosed with Bipolar 1 Disorder to participate in a non-treatment study. You will find information about the study at

Developed by John L. Miller, MD
Reviewed 7/2001

Page last modified on September 28, 2005

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