Outline of bipolar disorder

Overview of and topical guide to bipolar disorder

Bipolar disorder, also known as manic-depressive illness, is a mental disorder characterized by periods of depression and periods of elevated mood. The elevated mood is significant and is known as mania or hypomania, depending on its severity or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy, or irritable. Individuals often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced during manic phases. During periods of depression, there may be crying, a negative outlook on life, and poor eye contact with others. The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self-harm occurs in 30–40%. Other mental health issues, such as anxiety disorders and substance use disorder, are commonly associated.

Classification

Bipolar disorder is classified into several types:

• Bipolar I disorder: Characterized by at least one manic episode, with or without depressive episodes.
• Bipolar II disorder: Involves at least one hypomanic episode and one major depressive episode.
• Cyclothymic disorder: A chronic state of cycling between hypomanic and depressive states that do not reach the diagnostic standard for bipolar I or II.
• Bipolar disorder not otherwise specified (BP-NOS): Symptoms of bipolar disorder that do not fit into the above categories.

Symptoms

Bipolar mood shifts

The symptoms of bipolar disorder can vary widely in their presentation and severity. They are generally divided into two categories: manic/hypomanic symptoms and depressive symptoms.

Manic symptoms

• Elevated or irritable mood
• Increased energy and activity
• Decreased need for sleep
• Grandiosity or inflated self-esteem
• Talkativeness
• Racing thoughts
• Distractibility
• Increased goal-directed activity
• Risky behavior

Depressive symptoms

• Depressed mood
• Loss of interest or pleasure in activities
• Changes in appetite or weight
• Sleep disturbances
• Fatigue or loss of energy
• Feelings of worthlessness or guilt
• Difficulty concentrating
• Suicidal thoughts or behaviors

Causes

The exact cause of bipolar disorder is unknown, but several factors are thought to contribute to its development:

• Genetic factors: Bipolar disorder is more common in people who have a family history of the condition.
• Biological differences: People with bipolar disorder appear to have physical changes in their brains.
• Neurotransmitter imbalances: Abnormalities in the balance of neurotransmitters may play a role.
• Environmental factors: Stress, abuse, significant loss, or other traumatic experiences may trigger or exacerbate the condition.

Diagnosis

Diagnosis of bipolar disorder is based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A thorough psychiatric evaluation, medical history, and mood charting are often used to aid in diagnosis.

Treatment

Treatment of bipolar disorder

Treatment for bipolar disorder typically involves a combination of medication and psychotherapy.

Medications

• Mood stabilizers: Such as lithium, valproate, and carbamazepine.
• Antipsychotics: Such as olanzapine, risperidone, and quetiapine.
• Antidepressants: Often used in conjunction with mood stabilizers to treat depressive episodes.

Psychotherapy

• Cognitive behavioral therapy (CBT): Helps patients identify and change negative thought patterns and behaviors.
• Psychoeducation: Educates patients and families about the disorder and its treatment.
• Family therapy: Involves family members in treatment to improve communication and support.

Prognosis

Bipolar disorder is a chronic condition that requires lifelong management. With appropriate treatment, many individuals with bipolar disorder can lead fulfilling lives. However, the disorder can be challenging to manage, and relapses are common.

Related pages

• Mood disorder
• Major depressive disorder
• Schizoaffective disorder
• Psychotherapy
• Lithium (medication)