BIPOLAR (BP) DISORDER

Description

Bipolar disorder is a chronic mental illness that causes extreme shifts in mood, energy, and activity levels. These shifts can make it difficult to perform daily tasks and are more severe than normal ups and downs. Complex brain-based illness with a primary characteristic of disturbance in mood, often of both polarities: Depressive and Expansive or manic. Bipolar disorder affects approximately 5.7 million adult Americans or about 2.6% of the U.S. population.

Diagnostic criteria

Period of abnormally or persistently elevated, expansive, or irritable mood, lasting for at least 1 week

Persistence of symptoms:

  • Being much more active, energetic or agitated than usual.
  • Feeling a distorted sense of well-being, too self-confident or Inflated self-esteem, Grandiosity; feeling like you’re unusually important, talented or powerful.
  • Needing much less sleep than usual.
  • Being unusually talkative and talking fast and racing thoughts.
  • Having racing thoughts or jumping quickly from one topic to another.
  • Being easy to distract.
  • Increased impulsivity and making poor decisions. For example, you may go on buying sprees, having unsafe or unprotected sex or make foolish investments, excessive substance use or abuse, suddenly quitting your job.
  • Excessive happiness, hopefulness and excitement.
  • Sudden and severe changes in mood, such as going from being joyful to being angry and hostile.
  • Restlessness.
  • Making grand and unattainable plans.
  • Psychosis — experiencing hallucinations and delusions (in the most severe manic episodes).

Types of bipolar disorder:

Bipolar I disorder: You’ve had at least one manic episode that may come before or after hypomanic or major depressive episodes. In some cases, mania may cause a break from reality. This is called 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.

Cyclothymia: 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. These symptoms are less severe than major depression.

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

Complications

Left untreated, bipolar disorder can lead to serious problems that affect every area of your life, including:

Problems related to drug and alcohol misuse.

Suicide or suicide attempts.

Legal or financial problems.

Trouble getting along with others.

Poor work or school performance.

Management and Treatment

Psychotherapy (talk therapy).

Medications healthcare providers generally prescribe to treat bipolar disorder include:

  • Mood stabilizers.
  • Second-generation (“atypical”) neuroleptics (also called antipsychotics).
  • Antidepressants.

Self-management strategies, like education and identifying the early symptoms of an episode or possible triggers of episodes.

Helpful lifestyle habits, such as exercise, yoga and meditation. Quit drinking alcohol and/or using recreational drugs and tobacco. Keep a daily diary or mood chart. Maintain a healthy sleep schedule. Manage stress and maintain healthy relationships. These can support, but not replace, treatment.

When should I go to the emergency room (ER) for bipolar disorder?

If you’re experiencing any of these situations, it’s essential to call 911 or get to the nearest emergency room:

  • Thoughts of death or suicide.
  • Thoughts or plans of hurting yourself or others.
  • Experiencing hallucinations and delusions.
  • Symptoms of lithium toxicity (overdose), such as severe nausea and vomiting, severe hand tremors, confusion and vision changes.