Bipolar Disorder, formerly called manic depression, is a mental health condition that causes extreme

mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most
activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel
euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity,
judgment, behavior and the ability to think clearly.

Episodes of mood swings may occur rarely or multiple times a year. While most people will experience
some emotional symptoms between episodes, some may not experience any.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other
symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and
psychological counseling (psychotherapy).

Symptoms

There are several types of bipolar and related disorders. They may include mania or hypomania and
depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant
distress and difficulty in life.

Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by
hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality
(psychosis).

Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic
episode, but you've never had a manic episode.

Cyclothymic disorder. You've had at least two years — or one year in children and teenagers — of many
periods of hypomania symptoms and periods of depressive symptoms (though less severe than major
depression).

Other types. These include, for example, bipolar and related disorders induced by certain drugs or
alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.

Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic
episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be
depressed for longer periods, which can cause significant impairment.

Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s.
Symptoms can vary from person to person, and symptoms may vary over time.

Mania and hypomania

Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is
more severe than hypomania and causes more noticeable problems at work, school and social activities,
as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require
hospitalization.

Both a manic and a hypomanic episode include three or more of these symptoms:
Abnormally upbeat, jumpy or wired

Increased activity, energy or agitation

Exaggerated sense of well-being and self-confidence (euphoria)

Decreased need for sleep

Unusual talkativeness

Racing thoughts

Distractibility

Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish
investments

Major depressive episode

A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in
day-to-day activities, such as work, school, social activities or relationships. An episode includes five or
more of these symptoms:

Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood
can appear as irritability)

Marked loss of interest or feeling no pleasure in all — or almost all — activities

Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children,
failure to gain weight as expected can be a sign of depression)

Either insomnia or sleeping too much

Either restlessness or slowed behavior

Fatigue or loss of energy

Feelings of worthlessness or excessive or inappropriate guilt

Decreased ability to think or concentrate, or indecisiveness

Thinking about, planning or attempting suicide

Other features of bipolar disorder

Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious
distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as
mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the
seasons.

Symptoms in children and teens

Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern
can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some
children may have periods without mood symptoms between episodes.

The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings
that are different from their usual mood swings.

When to see a doctor

Despite the mood extremes, people with bipolar disorder often don't recognize how much their
emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment
they need.

And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles
of being more productive. However, this euphoria is always followed by an emotional crash that can
leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.

If you have any symptoms of depression or mania, see your doctor or mental health professional.
Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with
experience in bipolar disorder can help you get your symptoms under control.

When to get emergency help

Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts
of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or
confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the
National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone
stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can
do so safely, take the person to the nearest hospital emergency room.

Causes

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

Biological differences. People with bipolar disorder appear to have physical changes in their brains. The
significance of these changes is still uncertain but may eventually help pinpoint causes.

Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling
or parent, with the condition. Researchers are trying to find genes that may be involved in causing
bipolar disorder.

Risk factors
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode
include:

Having a first-degree relative, such as a parent or sibling, with bipolar disorder

Periods of high stress, such as the death of a loved one or other traumatic event

Drug or alcohol abuse

Complications

Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:

Problems related to drug and alcohol use

Suicide or suicide attempts

Legal or financial problems

Damaged relationships

Poor work or school performance

Co-occurring conditions

If you have bipolar disorder, you may also have another health condition that needs to be treated along
with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less
successful. Examples include:

Anxiety disorders

Eating disorders

Attention-deficit/hyperactivity disorder (ADHD)

Alcohol or drug problems

Physical health problems, such as heart disease, thyroid problems, headaches or obesity

Prevention

There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a
mental health disorder can help prevent bipolar disorder or other mental health conditions from
worsening.

If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from
becoming full-blown episodes of mania or depression:

Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse.
You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if
you feel you're falling into an episode of depression or mania. Involve family members or friends in
watching for warning signs.
Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them
more likely to come back.

Take your medications exactly as directed. You may be tempted to stop treatment — but don't.
Stopping your medication or reducing your dose on your own may cause withdrawal effects or your
symptoms may worsen or return.