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Straight Talk About Bipolar Disorder

Bipolar disorder — sometimes called manic-depressive disorder — causes mood swings that range from of the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may only occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time. Although bipolar disorder is a disruptive, long-term condition, you can keep your moods in check by following a treatment plan. The good news is that in most cases, bipolar disorder can be controlled with medications and psychological counseling (psychotherapy).

Several factors seem to be involved in causing and triggering bipolar episodes:

  • Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.

  • Neurotransmitters. An imbalance in naturally occurring brain chemicals called neurotransmitters seems to play a significant role in bipolar disorder and other mood disorders.

  • Hormones. Imbalanced hormones may be involved in causing or triggering bipolar disorder.

  • Inherited traits. Bipolar disorder is more common in people who have a blood relative (such as a sibling or parent) with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

  • Environment. Stress, abuse, significant loss or other traumatic experiences may play a role in bipolar disorder.


Bipolar disorder is divided into several subtypes. Each has a different pattern of symptoms. Types of bipolar disorder include:

Bipolar I disorder. Mood swings with bipolar I cause significant difficulty in your job, school or relationships. Manic episodes can be severe and dangerous.

Bipolar II disorder. Bipolar II is less severe than bipolar I. You may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine. Instead of full-blown mania, you have hypomania — a less severe form of mania. In bipolar II, periods of depression typically last longer than periods of hypomania.

Cyclothymia. Cyclothymia is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disruptive, but the highs and lows are not as severe as they are with other types of bipolar disorder.

The exact symptoms of bipolar disorder vary from person to person. For some people, depression causes the most problems; for other people manic symptoms are the main concern. Symptoms of depression and symptoms of mania or hypomania may also occur together. This is known as a mixed episode.


Manic phase of bipolar disorder
Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:

  • Euphoria

  • Extreme optimism

  • Inflated self-esteem

  • Poor judgment

  • Rapid speech

  • Racing thoughts

  • Aggressive behavior

  • Agitation or irritation

  • Increased physical activity

  • Risky behavior

  • Spending sprees or unwise financial choices

  • Increased drive to perform or achieve goals

  • Increased sex drive

  • Decreased need for sleep

  • Inability to concentrate

  • Careless or dangerous use of drugs or alcohol

  • Frequent absences from work or school

  • Delusions or a break from reality (psychosis)

  • Poor performance at work or school

Depressive phase of bipolar disorder
Signs and symptoms of the depressive phase of bipolar disorder can include:

  • Sadness

  • Hopelessness

  • Suicidal thoughts or behavior

  • Anxiety

  • Guilt

  • Sleep problems

  • Low appetite or increased appetite

  • Fatigue

  • Loss of interest in daily activities

  • Problems concentrating

  • Irritability

  • Chronic pain without a known cause

  • Frequent absences from work or school

  • Poor performance at work or school

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