Bipolar disorder is a type of mood disorder characterized by alternating periods of depression and mania. Bipolar disorder was previously called manic depression or bipolar depression because of the characteristic swings back and forth from lows (depression) to highs (mania). Bipolar disorder is also associated with problems in day-to-day functioning, changes in the immune system, and other aspects beyond mood.
In short, bipolar disorder is a complex disease that has a profound impact on the people who live with it.
Bipolar disorder is a mental illness that falls under the category of mood disorders. It is similar to disorders of depression (such as major depressive disorder) in that people who are bipolar often experience intense periods of depressed mood. However, episodes of manic symptoms are also a key feature of bipolar disorder.
The term “mania” refers to periods of elevated moods, increased energy, talkativeness, and feeling excited. Mania may also involve acting out of control, spending excessively, having racing thoughts, making impulsive decisions, and experiencing delusions or hallucinations.
The term “hypomania” refers to a less intense version of mania. Delusions and hallucinations do not feature in hypomanic episodes.
The term “depression” refers to periods of depressed mood, sadness, and decreased energy. Someone who is experiencing an episode of depression might also feel suicidal. Depressive behaviors in bipolar disorder look very much like the behaviors seen in major depressive disorder (sometimes referred to as “clinical depression”).
Bipolar disorder can look slightly different for each person with the diagnosis. Sometimes people think that being manic means being extremely happy. While this may be the case for some individuals, it isn’t the case for everyone experiencing mania. Mania can also mean being irritable, angry, distressed, or anxious.
Bipolar disorder is fairly uncommon. According to one large, multicountry study, the lifetime prevalence of bipolar spectrum disorders is about 2.4 percent of the general population. However, some studies have reported the prevalence rates of bipolar disorder as high as 5 percent.
One systematic review of the available data suggests there are no significant differences between ethnicities or genders regarding bipolar disorder diagnosis.
The biggest risk factor for bipolar disorder is having family members with the disease. The importance of family history suggests that bipolar disorder has a strong hereditary component. In other words, bipolar disorder can run in families.
One genetic variant in the section of DNA that codes for brain-derived neurotrophic factor (BDNF) has been repeatedly shown to have a strong association with bipolar disorder. BDNF is important to cell survival, nerve growth, communication, and memory. BDNF levels have even been shown to rise and fall as a person transitions in and out of depressive or manic states.
Genes alone don’t explain why some people get bipolar disorder and others don’t. Environment can also play a big role. For instance, early life stress has also been shown to contribute to the development of bipolar disorder. Some researchers believe that stress makes it easier for a depressive episode to be triggered.
Genes and environment also interact in complicated ways. One study found that there is a combined effect of childhood sexual abuse and a mutation in a gene that codes for toll-like receptors, an important component of the immune system. Specifically, the study demonstrated that this combination was more likely to result in an early onset of bipolar disorder. A similar relationship has been observed between the BDNF gene mutation, childhood sexual abuse, and the onset of bipolar disorder.
Symptoms of bipolar disorder range from the lows of depressive symptoms to the highs of manic symptoms. These symptoms differ from person to person and episode to episode.
Symptoms associated with the depression side of bipolar disorder include:
Symptoms associated with the manic side of bipolar disorder include:
The type of bipolar disorder a person has is defined by the symptoms they experience.
There are three types of bipolar disorder:
Read more about types of bipolar disorder.
Bipolar disorder is diagnosed based on the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. According to some experts, the current edition of the DSM does a better job than previous editions in recognizing cases of bipolar disorder. However, bipolar disorder remains underdiagnosed in the general population. It is often confused with major depression.
Remember, a diagnosis can only be made by a psychiatrist or clinical psychologist through a mental health assessment. A doctor may perform a physical examination to rule out other potential causes (such as thyroid disorder), but a referral to psychiatric services is usually required for a proper diagnosis.
Although bipolar disorder can’t yet be cured, treatments for bipolar disorder can help manage symptoms of the disorder. Many people with bipolar disorder take a combination of medications to help manage lows and highs. These medications may include:
In addition to prescription drugs, psychotherapy is often a helpful treatment option for learning to manage symptoms. For instance, cognitive behavioral therapy has been shown to be helpful for symptoms associated with bipolar disorder.
Read more about treatments for bipolar disorder.
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