Bipolar disorder (also known as manic depression) is a treatable illness marked by extreme changes in mood, thought, energy and behavior. It is not a character flaw or a sign of personal weakness. Bipolar disorder is also known as manic depression because a person's mood can alternate between the "poles" mania (highs) and depression (lows). This change in mood or "mood swing" can last for hours, days weeks or months.

Bipolar disorder affects more than two million adult Americans. It usually begins in late adolescence (often appearing as depression during teen years) although it can start in early childhood or later in life. An equal number of men and women develop this illness (men tend to begin with a manic episode, women with a depressive episode) and it is found among all ages, races, ethnic groups and social classes. The illness tends to run in families and appears to have a genetic link. Like depression and other serious illnesses, bipolar disorder can also negatively affect spouses and partners, family members, friends and coworkers.

Symptoms of Bipolar Disorder

Bipolar disorder differs significantly from clinical depression, although the symptoms for the depressive phase of the illness are similar. Most people who have bipolar disorder talk about experiencing "highs" and "lows" - the highs are periods of mania, the lows periods of depression. These swings can be severe, ranging from extreme energy to deep despair. The severity of the mood swings and the way they disrupt normal life activities distinguish bipolar mood episodes from ordinary mood changes.

Symptoms of mania - the "highs" of bipolar disorder

• Increased physical and mental activity and energy
• Heightened mood, exaggerated optimism and self-confidence
• Excessive irritability, aggressive behavior
• Decreased need for sleep without experiencing fatigue
• Grandiose delusions, inflated sense of self-importance
• Racing speech, racing thoughts, flight of ideas
• Impulsiveness, poor judgment, distractibility
• Reckless behavior
• In the most severe cases, delusions and hallucinations

Symptoms of depression - the "lows" of bipolar disorder

• Prolonged sadness or unexplained crying spells
• Significant changes in appetite and sleep patterns
• Irritability, anger, worry, agitation, anxiety
• Pessimism, indifference
• Loss of energy, persistent lethargy
• Feelings of guilt, worthlessness
• Inability to concentrate, indecisiveness
• Inability to take pleasure in former interests, social withdrawal
• Unexplained aches and pains

If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or hospital emergency room or call 911 immediately.

You cannot diagnose yourself. Only a properly trained health professional can determine if you have bipolar disorder. Our online self-assessment can help you communicate your symptoms to your health care professional.

Many people do not seek medical attention during periods of mania because they feel manic symptoms (increased energy, heightened mood, increased sexual drive, etc.) have a positive impact on them. However, left unchecked, these behaviors can have harmful results.

When symptoms of mania are left untreated, they can lead to illegal or life-threatening situations because mania often involves impaired judgment and reckless behavior. Manic behaviors vary from person to person. All symptoms should be discussed with your doctor.

Treatments for Bipolar Disorder

Several therapies exist for bipolar disorder and promising new treatments are currently under investigation. Because bipolar disorder can be difficult treat, it is highly recommended that you consult a psychiatrist or a general practitioner with experience in treating this illness. Your treatment may include medications and talk therapy.

Bipolar Disorder in Children

Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is estimated to be 15-30%. When both parents have bipolar disorder, the risk increases to 50-75%.

Symptoms of bipolar disorder may be difficult to recognize in children, as they can be mistaken for age-appropriate emotions and behaviors of children and adolescents. Symptoms of mania and depression may appear in a variety of behaviors. When manic, children and adolescents, in contrast to adults, are more likely to be irritable and prone to destructive outbursts than to be elated or euphoric. When depressed, there may be complaints of headaches, stomach aches, tiredness, poor performance in school, poor communication and extreme sensitivity to rejection or failure.

The treatment of bipolar disorder in children is based on experience in treating adults with the illness, since very few studies have been done of the effectiveness and safety of the medications in children and adolescents. It is important to find a doctor that is well-versed in treating this illness in children and one that you work closely with throughout the course of treatment.

According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder.

Helping a Friend

One of the most important thing family and friends can do for a person with bipolar disorder is learn about the illness. Often people who are depressed or experiencing mania or mood swings do not recognize the symptoms in themselves. If you are concerned about a friend or family member, help him or her get an appropriate diagnosis and treatment. This may involve helping the person to find a doctor or therapist and make their first appointment. You may also want to offer to go with the person to their first appointment for support. Encourage the individual to stay with treatment. Keep reassuring the person that, with time and help, he or she will feel better.

It is also important to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the person in conversation and listen carefully. Resist the urge to function as a therapist or try to come up with answers to the person's concerns. Often times we just want someone to listen. Do not put down feelings expressed, but point out realities and offer hope. Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your first invitation is refused.

It is often a good idea for the person with bipolar disorder to develop a plan should he or she experience severe manic or depressive symptoms. Such a plan might include contacting the person's doctor, taking control of credit cards and car keys or increasing contact with the person until the severe episode has passed. Your plan should be shared with a trusted family member and/or friend. Keep in mind, however, that people with bipolar disorder, like all people, have good and bad days. Being in a bad mood one day is not necessarily a sign of an upcoming severe episode.

Never ignore remarks about suicide. Report them to the person's therapist. Do not promise confidentiality if you believe someone is close to suicide. If you think immediate self-harm is possible, contact their doctor or dial 911 immediately. Make sure the person discusses these feelings with his or her doctor.

Source: National Institute of Mental Health

Relevant Links

Addiction Technology Transfer Center
Advocacy Unlimited
Advocacy Unlimited - Warm Line
PAmerican Association of Suicidology
American Foundation for Suicide Prevention
Child & Adolescent Bipolar Foundation
Depression and Bipolar Support Alliance
Emotions Anonymous
Mental Health Association of Connecticut
National Alliance for the Mentally Ill (NAMI)
National Alliance for the Mentally Ill - Connecticut
National Institute of Mental Health
National Mental Health Association
National Mental Health Consumers' Self-Help Clearinghouse
National Resource Center on Homelessness and Mental Illness
Online Depression Screening Test (New York University School of Medicine)
SAMHSA Mental Health Services Locator
SAMHSA's National Mental Health Information Center - Center for Mental Health Services