Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.
There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, irritable, or energized behavior (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.
- Bipolar I disorder is defined by manic episodes that last at least 7 days (most of the day, nearly every day) or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible. The experience of four or more episodes of mania or depression within a year is termed “rapid cycling.”
- Bipolar II disorder is defined by a pattern of depressive episodes and hypomanic episodes, but the episodes are less severe than the manic episodes in bipolar I disorder.
- Cyclothymic disorder (also called cyclothymia) is defined by recurrent hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.
Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, and this is referred to as “other specified and unspecified bipolar and related disorders.”
Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.
Signs and Symptoms:
People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviors—often without recognizing their likely harmful or undesirable effects. These distinct periods are called “mood episodes.” Mood episodes are very different from the moods and behaviors that are typical for the person. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks.
| Symptoms of a Manic Episode |
Symptoms of a Depressive Episode |
| Feeling very up, high, elated, or extremely irritable or touchy |
Feeling very down or sad, or anxious |
| Feeling jumpy or wired, more active than usual |
Feeling slowed down or restless |
| Decreased need for sleep |
Trouble falling asleep, waking up too early, or sleeping too much |
| Talking fast about a lot of different things (“flight of ideas”) |
Talking very slowly, feeling unable to find anything to say, or forgetting a lot |
| Racing thoughts |
Trouble concentrating or making decisions |
| Feeling able to do many things at once without getting tired |
Feeling unable to do even simple things |
| Excessive appetite for food, drinking, sex, or other pleasurable activities |
Lack of interest in almost all activities |
| Feeling unusually important, talented, or powerful |
Feeling hopeless or worthless, or thinking about death or suicide |
Sometimes people experience both manic and depressive symptoms in the same episode, and this is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless while at the same time feeling extremely energized.
A person may have bipolar disorder even if their symptoms are less extreme. For example, some people with bipolar II disorder experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done and keep up with day-to-day life. The person may not feel that anything is wrong, but family and friends may recognize the changes in mood or activity levels as possible bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression.