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Bipolar Disorder

What is Bipolar Disorder?

Everyone has feelings of happiness and sadness once in a while. Feeling high and feeling low are part of life.

But for someone with bipolar disorder (sometimes called manic depression), these feelings can be extreme:

These ups and downs can be too much for a person to cope with.
They can interfere with daily life.
Sometimes they can even be dangerous.
The ups and downs

One day you may feel so depressed that you can't get out of bed. Work may seem impossible.

On another day you may feel great and full of endless energy. You may feel like you’re getting a lot done. But other people might think that what you are doing is dangerous and out of control.

Bipolar disorder is a lifelong condition. It can be hard for healthcare providers to diagnose. But it's nothing to be embarrassed about. Learning more about how to manage the condition can help.
About Bipolar Disorder

Bipolar disorder is a serious illness. It can make a person’s normal moods seem extreme. It used to be called manic depression.

People with bipolar disorder have mood swings. Their moods can swing from very low (depression) to very high (mania). Bipolar disorder sometimes is confused with other types of depression.

Bipolar disorder is a lifelong illness. But today there are many treatments. People with bipolar disorder should ask their healthcare provider about the best way to keep their moods from swinging too far one way or the other.
Types of mood episodes

In bipolar disorder, or manic depression, each mood swing is called an “episode.” There are 4 main types of mood episodes that people with bipolar disorder can have:

Depression — Depression is when people with bipolar disorder feel very sad. Sometimes this can go on for a long period of time. They may not even want to get out of bed or eat. They don’t enjoy doing things they used to do.
Mania — Mania is the other side of bipolar disorder. Mania may start with a good feeling, almost like a “high.” Or it may make a person feel very irritable and angry. People with mania may do very risky things.
Hypomania — Hypomania is a milder form of mania. It can make people feel good. They may think they are getting more things done. But the “feel good” stage can change into mania or depression. Hypomania is different from mania because it doesn’t get in the way of things like work or family. It sometimes is not even noticed as a problem.
Mixed mood — This is when feelings of mania and depression go back and forth quickly, sometimes even in the same day.
With all types of extreme mood episodes, people are at risk for suicide.
Recognizing Bipolar Disorder

Bipolar disorder, sometimes called manic depression, can be hard to detect because the symptoms can be similar to other mood disorders. Some people have the condition for 10 years or more before a healthcare provider diagnoses it.

The reason for this might have to do with the symptoms. When people are feeling manic or hypomanic, they are full of energy. They usually feel good. They feel "high on life" and don’t always seek help.

On the other hand, people are more likely to seek help when they fall into depression. When people feel depressed, they are likely to describe only depression symptoms to their healthcare provider. They may not mention the times when they are feeling “high on life,” since depression is what they are feeling at the time. Therefore, it’s common for a person to be incorrectly diagnosed with major depression instead of bipolar disorder.

In fact, nearly half of all patients who have bipolar disorder, sometimes called manic depression, will first be diagnosed with major depression. That’s why it’s important for people to say how they’ve been feeling weeks and even months before the day they talk to their healthcare provider in order to make it easier for the right diagnosis.

Many of the signs and symptoms of bipolar disorder can also be associated with other illnesses, such as anxiety disorders and schizophrenia. This can make it even harder for a healthcare provider to make a correct diagnosis.
Signs and Symptoms

The signs and symptoms of bipolar disorder can be different in each person.

Symptoms of depression include:

Feeling sad or blue, or “down in the dumps”
Loss of interest in things the person used to enjoy, including sex
Feeling worthless, hopeless, or guilty Sleeping too little or too much
Changes in weight or appetite
Feeling tired or having little or no energy
Feeling restless
Problems concentrating or making decisions
Thoughts of death or suicide

One person describes depression this way:
"I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless. [I am] haunt[ed]…with the total, the desperate hopelessness of it all…Others say, 'It's only temporary, it will pass, you will get over it.' But of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think, or care, then what on earth is the point?"

Symptoms of mania include:

    * Increased energy level
      Less need for sleep
      Racing thoughts or mind jumps around
      Easily distracted
      More talkative than usual or feeling pressure to keep talking
      More self-confident than usual
      Focused on getting things done, but often completing little
      Risky or unusual activities to the extreme, even if it’s likely bad things will happen
      One person describes mania this way:
      "The fast ideas become too fast and there are far too many…overwhelming confusion replaces clarity… Your              friends become frightened…everything is now against the grain…you are irritable, angry, frightened,                          uncontrollable, and trapped."

Hypomania is a milder form of mania that has similar but less severe symptoms.

Keeping track of your symptoms

Everyone has mood swings. But if you have bipolar disorder, you may have times of mania and depression that make your life unbearable for yourself or others around you. But with treatment, bipolar disorder can be managed and you can live a normal life.

One important way to manage bipolar disorder is to keep track of how you're feeling. Tracking your symptoms using a Mood Chart can provide a sense of how things are going and show how your treatment is working.

“I think that, all along the way I wanted people to help me, but I just wouldn’t let them. There was a fear of loss somehow, I think… I was just absolutely afraid to reach out to people, and to tell them what was going on, how I could use their help, how they could affect my life.”
— Stuart

Read more comments from people with bipolar disorder

Why early diagnosis and treatment are important
It’s important to get treatment for bipolar disorder, sometimes called manic depression, as early as possible.

Many people with bipolar disorder don’t know they have it. Some don’t seek treatment because they are ashamed of what they feel. Others are incorrectly diagnosed with other illnesses, such as depression, anxiety, or schizophrenia.

The right treatment can make bipolar disorder easier to manage. Also, controlling symptoms can help people live more normal lives.

Learning how to recognize bipolar disorder may help you get the right diagnosis. Healthcare providers need to hear exactly how you are feeling in order to make the right diagnosis. That way, you can get the right treatment sooner.

If you have bipolar disorder, as you get older your mood episodes can happen more often. If someone has 4 or more episodes a year, bipolar disorder can be even harder to treat. So it’s important to get treatment as early in life as possible.

Are there any other illnesses linked to bipolar disorder?
Some people have symptoms of bipolar disorder when they're fairly young but don’t get diagnosed right away. These people are more likely to also develop alcohol problems and other substance-abuse problems. These problems can make their bipolar disorder harder to manage. They also can increase the number of times they have to go to the hospital.

Other problems linked to bipolar disorder include:

Eating disorders such as anorexia and bulimia
Attention-deficit/hyperactivity disorder (ADHD)
Panic disorder
Social phobia
These disorders can be dangerous and may need medical treatment
There are 4 main types of bipolar disorder:

Bipolar I Disorder — In this type, you have had at least one episode of mania or mixed mood and often experience depression too. In between, your mood may be normal. Sometimes your mood swings happen when the seasons change.
Bipolar II Disorder — In this type, you have had at least one episode of depression and at least one period of hypomania. Hypomania is a milder form of mania. In between, your mood may be normal. Sometimes your mood swings happen when the seasons change.
Cyclothymic Disorder — This is a milder form of bipolar disorder. You may go back and forth between mild depression and a slightly elevated mood. But your mood swings are shorter and less severe. Many people with cyclothymic disorder go on to have a stronger type of bipolar disorder. This doesn’t happen to everyone, though.
Bipolar Disorder Not Otherwise Specified — This type of bipolar disorder is when you do not fit into the types mentioned above. The feelings of bipolar disorder vary from person to person.
Some people have what is called “rapid-cycling bipolar disorder.” This means they have had 4 or more periods of mania and/or depression in a year.
Causes and Risk Factors

Scientists don’t really know what causes bipolar disorder, sometimes called manic depression. They do think that family history plays a role. Most people with bipolar disorder have a relative with the same condition or with some other mood disorder.

But family history alone does not cause someone to have bipolar disorder. We don’t yet know what those other things are.

This is what we DO know about bipolar disorder:
Bipolar disorder most often starts in teenagers and young adults. But it also can occur in children and older adults.
Bipolar disorder equally affects people of all races and backgrounds.
Special chemicals in the brain may be involved. If the levels of these chemicals are out of balance, it may be harder for brain cells to work as they should.
Bipolar disorder also could be connected to hormone levels. Hormones are chemicals in the body that do certain things. Experts have noticed a link between thyroid hormone levels and bipolar disorder.
Also, certain parts of the brain may have a different size or shape in people with bipolar disorder. The changes could be a cause or symptom of the illness.
In some cases, other illnesses may play a role in bipolar disorder.
You can watch a short movie to learn more about bipolar disorder. Please click here to see the movie.

The following questions may help you start a conversation with your healthcare provider about symptoms you may be experiencing. He or she will have additional questions about your symptoms and medical history to help make an accurate diagnosis.

Do you experience mood swings?
Has there ever been a period of time when thoughts raced through your mind or you couldn't slow your mind down?
Has there ever been a period of time when you got much less sleep than usual and found you didn't really miss it?
Do any of your close relatives suffer from depression or bipolar illness (manic-depression)?

Talk to your healthcare provider and explain that you still feel depressed. Be sure to ask if you could have bipolar disorder. He or she may reconsider your treatment options.