What is bipolar disorder?

Bipolar Disorder

Bipolar disorder: Overview

Bipolar disorder is a mental health condition that causes extreme mood changes. You can go from times of very high energy (manic episodes) to times of depression. These moods may cause problems with your work, school, family life, friendships, and how well you function.

This condition is also called manic-depression.

There is no cure for bipolar disorder, but it can be helped with medicines. Counseling may also help. It is important to take your medicines exactly as prescribed, even when you feel well. You may need lifelong treatment.

Bipolar disorder

Bipolar disorder causes extreme mood swings, from very high energy (mania) to depression. Your mood may return to normal between these swings. Bipolar disorder is also called manic-depressive disorder. It often begins in the teen or early adult years, and it may run in families.

This condition can cause behavior so extreme that it's hard to work or have successful relationships. Medicines and counseling may help control the symptoms.

What happens when you have bipolar disorder?

When you have bipolar disorder, you go back and forth between highs and lows of mania and depression. In between, you may return completely to normal. Without treatment, your bipolar disorder may get worse. This can cause you to move more often between mania and depression.

What are the symptoms of bipolar disorder?

The symptoms depend on your mood swings, or "highs" and "lows." During a manic high, you may feel:

  • Very happy, energetic, or on edge.
  • Like you need very little sleep.
  • Overly self-confident.

Some people spend a lot of money or get involved in dangerous activities when they are manic. After a manic episode, you may return to normal. Or your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness.

During a depressive episode, or low, you may have:

  • Trouble thinking and making decisions.
  • Memory problems.
  • Less interest in things you have enjoyed in the past.
  • Thoughts about killing yourself.

The mood swings of bipolar disorder can be mild or extreme. They may come on slowly over several days or weeks or suddenly over a few minutes or hours. These mood swings may last for a few hours or for several months.

What are the types of bipolar disorder?

The different types of bipolar disorder are based on things like how often a person has symptoms and how severe the symptoms are.

Bipolar I.

This form includes having at least one episode of mania. It also may include episodes of depression. Depression is common with this form, but you can still be diagnosed even if you haven't had depression.

Bipolar II.

With this form, the manic highs are less severe. These are called hypomanic episodes. People with bipolar II have both hypomanic and depressive episodes.


The high and low mood swings aren't as severe as in bipolar I or bipolar II.

Other types.
There are a few other types of bipolar disorder. For example, bipolar disorder caused by taking a medication or using a substance is one type. Bipolar disorder caused by another medical condition is another example.

How is bipolar disorder treated?

Bipolar disorder is treatable. A treatment plan can make you feel better.

You may need to try several medicines to find the best combination.

  • Most people with bipolar disorder need to take a medicine called a mood stabilizer every day.
  • Antipsychotic medicine can help get a manic phase under control.
  • Antidepressants are used carefully for episodes of depression. They cause some people to move into a manic phase.

Counseling is also an important part of treatment. It can help you cope with some of the work and relationship issues that the condition may cause.

You can do a few things on your own. These include getting enough sleep and learning to recognize the early signs of highs and lows. Exercise may also help with depressive symptoms.

People often stop taking their medicines during a manic phase because they feel good. But this is a mistake. Take your medicines regularly, even if you're feeling better.

How is bipolar disorder diagnosed?

To find out if you have bipolar disorder, your doctor will ask how long your symptoms last and how often you have them. The doctor will also ask about your family history and may do a mental health assessment. You may have other tests to make sure another problem isn't causing your symptoms.

How are medicines used to treat bipolar disorder?

Medicines can help control bipolar mood swings. Your doctor will vary the amounts and combinations of your medicines based on:

  • Your symptoms.
  • Which type of bipolar disorder you have.
  • How you respond to the medicines.

Medicine choices

Several medicines are used to treat bipolar disorder. The most common ones used are:

  • Mood stabilizers, such as lithium. A mood stabilizer and an antipsychotic are recommended as the first medicines for acute manic episodes.
  • Anticonvulsants. These include carbamazepine, divalproex, and valproate.
  • Antipsychotics. These include aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone. They improve manic episodes.
  • Benzodiazepines. An example is diazepam.

Monitoring medicines

You'll need to check in with your doctor regularly when taking medicines for bipolar disorder. You may need regular blood tests to watch the amount of medicine in your blood.

The use of antidepressants alone has been linked to an increase in manic episodes. Antidepressant treatment needs to be monitored closely to avoid causing a manic episode.

Who can diagnose and treat bipolar disorder?

Though other health professionals can diagnose bipolar disorder, you may be referred to a psychiatrist who specializes in treating such disorders. They can prescribe medicines and provide counseling. Other health professionals who can diagnose bipolar disorder include:

  • Family medicine physicians.
  • General practitioners.
  • Internists.
  • Psychiatric nurse practitioner.

Counseling can help you deal with mood changes and the impact bipolar disorder can have on your work and family relationships. In addition to psychiatrists, others can provide counseling. They include:

  • Psychologists.
  • Social workers.
  • Licensed mental health counselors.

Bipolar disorder: Preventing a manic episode

Here are some steps you can take to help prevent a manic episode.

  • Learn the early warning signs of a manic episode.

    These signs may include:

    • Needing less sleep or being more active than usual.
    • Feeling very happy or very grouchy.
    • Being easily distracted and having racing thoughts.
    • Talking more than usual.
  • Keep track of your mood every day.

    After you know your early warning signs, check your mood each day to see if you may be heading for a mood swing. Write down your symptoms in a journal. Or record them on a chart or a calendar. When you see a pattern or warning signs of a mood swing, seek treatment.

  • Keep a stable sleep pattern.

    Go to bed about the same time each night, and wake up around the same time each morning. Too much or too little sleep or changes in your normal sleep patterns can alter the chemicals in your body. And this can trigger mood changes or make your symptoms worse.

  • Stay on a daily routine.

    Plan your day around a good routine. For example, eat meals at regular times, and make exercise or other physical activity a part of your daily schedule. You might also practice meditation or another relaxation technique each night before bed.

  • Don't use alcohol or illegal drugs.

    It may be tempting to use alcohol or drugs to help you get through a manic episode. But this can make symptoms worse. Even one drink can interfere with sleep, mood, or medicines used to treat bipolar disorder.

  • Get help from family and friends.

    You may need help from your family or friends during a manic episode. This is even more important if you have trouble telling the difference between what's real and what isn't real (psychosis). Having a plan in place before any mood changes occur will help your support network help you make good decisions.

  • Reduce stress at home and at work.

    Try to keep regular hours at work or at school. Doing a good job is important, but avoiding a depressive or manic mood episode is more important. If stress at work, school, or home is a problem, counseling may help.

  • Keep getting treatment and counseling.

    It can be tempting to stop treatment during a manic episode because the symptoms feel good. But it's important to keep getting treatment as prescribed. It helps you to avoid taking risks or having to face problems caused by a manic episode. If you have concerns about treatment or the side effects of medicines, talk with your doctor. Don't adjust the medicines on your own.

What increases your risk of bipolar disorder?

If anyone in your family has been diagnosed with bipolar disorder, your risk of having it is higher. Bipolar disorder can be passed down through families.

How is counseling used to treat bipolar disorder?

Almost all people who have bipolar disorder need medicine. But counseling is also important. It helps you cope with work and relationship struggles related to the condition. Types of counseling include:

  • Cognitive behavioral therapy. It's aimed at teaching you how to become healthier by changing certain thought and behavior patterns.
  • Interpersonal therapy. This type of counseling focuses on social and personal relationships and related problems.
  • Problem solving. This focuses on specific problems and how you can solve them.
  • Family therapy. It lets each person express any concerns and fears about how the problem affects the person who has bipolar disorder and the family as a whole.

Try to form a long-term relationship with a counselor you like. They will help you recognize personality changes that show when you are moving into a mood swing. Getting early treatment can reduce the length of the high or low.

Helping someone during a manic episode

You may feel frustrated around a person with bipolar disorder who is having a manic episode. The high energy level can be tiring or even scary. The person may also actually enjoy the mania and may not take medicines, which can make the episode last longer. Also, the person may say and do unusual or hurtful things. Here are some ways you can help during a manic episode.

  • Spend time with the person.

    People who are manic often feel isolated from other people. Spending even short periods of time with them helps them feel less isolated. If the person has a lot of energy, walk together. This allows the person to keep on the move but share your company.

  • Answer questions honestly.

    But don't argue or debate with a person during a manic episode. Avoid intense conversation.

  • Don't take comments or behavior personally.

    During periods of high energy, a person often says and does things that they would not usually say or do. This can include focusing on negative aspects of others. If needed, stay away from the person and avoid arguments.

  • Prepare easy-to-eat foods and drinks.

    It may be difficult for the person to sit down to a meal during periods of high energy, so offer easy to eat foods. Examples are peanut butter and jelly sandwiches, apples, cheese and crackers, and juices.

  • Keep surroundings as quiet as possible.

    Help them avoid a lot of activity and stimulation.

  • Allow the person to sleep whenever possible.

    During periods of high energy, sleeping is difficult and short naps may be taken throughout the day. Sometimes the person feels rested after only 2 to 3 hours of sleep.

Call a health professional if you have questions or concerns about the behavior of a person who has bipolar disorder. Always call a health professional (or 911 or other emergency services) if you think they are in danger of causing any harm to themself or others.

What causes bipolar disorder?

The cause of bipolar disorder isn't completely understood. There are likely many factors involved. It tends to run in families. You are at greater risk of having bipolar disorder if a close family member has it.

What is bipolar disorder?

Bipolar disorder is a mental health condition that causes extreme mood changes, from times of very high energy (manic episodes) to times of depression. These moods can be so extreme that it's hard to function at work, in school, and with family and friends. There's no cure, but medicines and counseling can help.

How can you prevent a manic episode when you have bipolar disorder?

If you have bipolar disorder, there are some things you can do to help prevent a manic episode. These include:

  • Learning the early warning signs of a manic episode. Watch for signs like needing less sleep and feeling happier or grouchier than usual.
  • Keeping track of your moods in a daily journal or on a calendar.
  • Sticking with a daily routine. For example, eat meals at the same time each day.
  • Trying to reduce your stress.
  • Going to counseling.
  • Taking your medicines as prescribed.

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