Bipolar disorder, sometimes known as manic-depressive disorder, is a chronic mental illness that causes extreme shifts in mood and behavior.
According to the National Alliance on Mental Illness, bipolar disorder can develop at any point in life but is most commonly diagnosed in early adulthood. It affects about 2.9 percent of the United States population, and it is equally likely to occur in both men and women.
Bipolar disorder is generally characterized by periods of highly energized behavior and elated mood, known as manic episodes, offset by periods of sluggish physical energy and low emotions, known as depressive episodes. Less extreme or frenzied manic episodes are known as hypomania. These shifts are more exaggerated than the typical “highs” and “lows” that most people experience. They can sometimes happen simultaneously or in rapid succession, often without any warning or cause.
A manic episode is a period of elation, excitement, and high physical energy. A person in the middle of a manic episode may have increased activity levels, feel jumpy and irritable, or be unable to sit still, sleep, and relax.
Many people describe a manic episode as the feeling that their mind is moving very fast. They may think they can do several things at once and often will speak very quickly.
People experiencing manic bipolar symptoms sometimes feel as though they have special or superhuman abilities. These feelings of euphoria may cause a person to begin and quickly abandon new tasks or projects. They can also result in uncontrolled behavior, such as taking physical risks, spending lots of money, or having reckless sex.
Severe instances of mania may also include hallucinations or delusions. Hypomania, by contrast, does not include these psychotic episodes. People who experience hypomania can usually function normally at work or in social situations, though they will still feel elated, euphoric, and excessively energetic.
A depressive episode is characterized by extremely low energy, being unable to engage in physical activity, feeling hopeless, and disinterest in normal activities.
A person in the middle of a depressive episode may feel exhausted but be unable to sleep, or sleep too much and feel unable to wake up properly. These low feelings are usually accompanied by trouble concentrating, forgetfulness, feeling physically slow or stifled, and eating too much or too little.
Severe depressive bipolar symptoms may include feeling extremely worried, distrustful, or even suicidal. People in depressive episodes often feel overwhelmed by mundane decisions and guilty about their own behavior.
Depressive symptoms can sometimes occur on top of manic feelings. In these instances, a person has excessive energy while simultaneously feeling hopeless, empty, or incredibly sad. This is known as an episode with mixed features.
The National Institute of Mental Health recognizes four types of bipolar disorder, each varying slightly depending on how depressive and manic episodes happen.
Bipolar I disorder is often considered the most severe form. It is characterized by extreme manic episodes that last seven days or more, depressive episodes that can last up to two weeks, and occasional episodes with mixed features. These episodes are highly risky and can severely impair everyday functioning. People with bipolar I may need to be checked into a hospital in order to keep from hurting themselves or others.
Bipolar II disorder is usually characterized by hypomania, rather than full mania, as well as depression and mixed features. A person with bipolar II often can function normally during hypomanic episodes, but may be less able to go about their lives during depressive or mixed episodes.
When a person experiences many symptoms of hypomania and depression that do not meet the full diagnostic requirements for hypomanic or depressive episodes, it is usually a sign of cyclothymic disorder, or cyclothymia. In order to be diagnosed, adults must experience these symptoms for two years. For children or adolescents, the symptoms may occur over one year.
Symptoms of mania, depression, and hypomania that do not meet any of the other three definitions are considered unspecified or related bipolar disorders. People with this level of bipolar symptoms may find that it regularly interferes with their everyday life, or they may find that it only occasionally leaves them unable to function normally.
Recognizing these variations in symptoms is critical to properly diagnosing and treating bipolar disorder. If you think you or a loved one shows signs of manic or depressive behavior, talk to a trusted medical provider to get help and support.
August 10, 2016
Janet O’Dell, RN