Depression (manic)
Bipolar disorder (previously called manic-depressive illness or manic depression) is a mental disorder that causes unusual changes in mood, energy, activity level, concentration, and the ability to perform daily tasks.
There are three types of bipolar disorder. In all three types there are marked changes in mood, energy and activity level. These moods range from periods of extremely "up," elated, irritable, or energetic behavior (known as manic episodes) to very "down," sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic episodes are known as hypomanic episodes.
- Bipolar I Disorder - defined by manic episodes lasting at least 7 days, or by manic symptoms so severe that the person requires immediate hospital care. Depressive episodes usually also occur, usually lasting at least 2 weeks. Episodes of depression with mixed features (with simultaneously depressive symptoms and manic symptoms) are also possible.
- Bipolar II Disorder - Defined by a pattern of depressive and hypomanic episodes, but not the full-blown manic episodes typical of Bipolar I Disorder.
- Cyclothymic disorder (also called cyclothymia) - defined by periods of hypomanic symptoms and periods of depressive symptoms that last for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
Sometimes a person may experience symptoms of bipolar disorder that do not match the three categories listed above, referred to as 'other specified and unspecified bipolar and related disorders'.
Bipolar disorder is usually diagnosed during late adolescence (teenage years) or early adulthood. Occasionally, bipolar symptoms can occur in children. Bipolar disorder can also first appear during a woman's pregnancy or after giving birth. While symptoms can vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.
Signs and Symptoms
People with bipolar disorder experience periods of unusually intense emotions, changes in sleep patterns and activity levels, and unusual behavior - often without realizing the likely harmful or unwanted effects. These different periods are called 'states of mind'. Mood episodes are very different from the moods and behaviors typical of the person. During an episode, symptoms last for most of the day every day. Episodes can also take longer, such as several days or weeks.
People with a manic episode can: | People with a depressive episode can: |
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Feel very "up", "high", elated, or irritable or touchy | Feel very sad, "down", empty, worried or hopeless |
Feel "jumpy" or "wired" | Feel delayed or restless |
Have a reduced need for sleep | Having trouble falling asleep, waking up too early, or sleeping too much |
Loss of appetite | Experience increased appetite and weight gain |
Talk about many different things very quickly | Talk very slowly, feel like they have nothing to say, forget a lot |
Feel like their thoughts are racing | Have trouble concentrating or making decisions |
Think they livestockl can do things at the same time | Don't feel able to do even simple things |
Do risky things that show poor judgment, such as eating and drinking excessively, spending or giving away a lot of money, or having reckless sex | Having little interest in almost all activities, a decreased or absent sex drive, or an inability to experience pleasure ("anhedonia") |
Feeling that they are extremely important, talented or powerful | Feel hopeless or worthless, think of death or suicide |
Sometimes people experience both manic and depressive symptoms in the same episode. This type of episode is called a mixed-feature episode. People who experience an episode with mixed characteristics may feel very sad, empty, or hopeless, while at the same time feeling extremely energetic.
A person can have bipolar disorder, even if the symptoms are less extreme. For example, some people with bipolar disorder (Bipolar II) experience hypomania, a less severe form of mania. During a hypomanic episode, a person can feel very good, get things done, and keep up with daily life. The person may not feel like something is wrong, but family and friends may recognize the changes in mood or activity level as a possible bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression.
Diagnosis
Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking to a doctor or other licensed healthcare provider is the first step. The health care provider can take a physical exam and order necessary medical tests to rule out other conditions. The healthcare provider can then perform a mental health assessment or refer you to a trained mental health professional, such as a psychiatrist, psychologist, or clinical social worker experienced in diagnosing and treating bipolar disorder.
GGZ health care providers usually diagnose bipolar disorder based on a person's symptoms, life history, experiences, and, in some cases, family history. Accurate diagnosis in young people is particularly important. You can find tips for talking to your health care provider in the NIMH Fact sheet About Mental Health Control: Tips for Talking With Your Health Care Provider .
Note to health care providers: People with bipolar disorder are more likely to seek help when they are depressed than when they experience mania or hypomania. Taking a careful medical history is essential to ensure that bipolar disorder is not mistaken for major depression . This is especially important when treating a first episode of depression, as antidepressants can cause a manic episode in people who are more likely to have bipolar disorder.
Bipolar Disorder and Other Conditions
Some of the symptoms of bipolar disorder are similar to those of other illnesses, which can make it challenging for a health care provider to diagnose. In addition, many people can have bipolar disorder along with another mental disorder or condition, such as an anxiety disorder , substance use disorder , or an eating disorder . People with bipolar disorder have an increased risk of thyroid disease, migraines, heart disease, diabetes, obesity, and other physical conditions.
Psychosis: Sometimes a person with severe episodes of mania or depression may experience psychotic symptoms & nb
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