Manic depression; Bipolar affective disorder; Mood disorder - bipolar; Manic depressive disorder
Bipolar disorder is a mental condition in which a person has wide or extreme swings in their mood. Periods of feeling sad and depressed may alternate with periods of intense excitement and activity or being cross or irritable.
Bipolar disorder affects men and women equally. It most often starts between ages 15 and 25. The exact cause is not known, but it occurs more often in relatives of people with bipolar disorder.
In most people with bipolar disorder, there is no clear cause for the periods (episodes) of extreme happiness and high activity or energy (mania) or depression and low activity or energy (depression). The following may trigger a manic episode:
The manic phase may last from days to months. It may include these symptoms:
The depressive episode may include these symptoms:
People with bipolar disorder are at high risk for suicide. They may use alcohol or other substances. This can make the bipolar symptoms worse and increase the risk for suicide.
Episodes of depression are more common than episodes of mania. The pattern is not the same in all people with bipolar disorder:
To diagnose bipolar disorder, the health care provider may do some or all of the following:
The main goal of treatment is to:
Medicines are a key part of treating bipolar disorder. Most often, the first medicines used are called mood stabilizers. They help you avoid mood swings and extreme changes in activity and energy levels.
With medicines, you may begin to feel better. However, for some people, symptoms of mania may feel good. Some people have side effects from the medicines. As a result, you may be tempted to stop taking your medicines or change the way you are taking them. But stopping your medicines or taking them in the wrong way can cause symptoms to come back or become much worse. Do not stop taking or change the dosages of your medicines. Talk with your provider if you have questions about your medicines.
Ask family members or friends to help you take medicines the right way. This means taking the right dose at the right time. They can also help make sure that episodes of mania and depression are treated as soon as possible.
If mood stabilizers do not help, your provider may suggest other medicines, such as antipsychotics or antidepressants.
You will need regular visits with a psychiatrist to talk about your medicines and their possible side effects. Blood tests are often needed, too.
Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase if it does not respond to medicine.
People who are in the middle of a severe manic or depressive episode may need to stay in a hospital until they are stable and their behavior is under control.
SUPPORT PROGRAMS AND TALK THERAPY
Joining a support group may help you and your loved ones. Involving family members and caregivers in your treatment may help reduce the chance of symptoms returning.
Important skills you may learn at such programs include how to:
Talk therapy with a mental health provider may be helpful for people with bipolar disorder.
Periods of depression or mania return in most people, even with treatment. People may also have issues with alcohol or drug use. They may also have problems with relationships, school, work, and finances.
Suicide is a very real risk during both mania and depression. People with bipolar disorder who think or talk about suicide need emergency attention right away.
Seek help right way if you:
Call the treating provider if:
If you are thinking about hurting yourself or others, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
American Psychiatric Association. Bipolar and related disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:123-154.
McIntyre RS, Berk M, Brietzke E, et al. Bipolar disorders. Lancet. 2020;396(10265):1841-1856. PMID: 33278937 pubmed.ncbi.nlm.nih.gov/33278937/.
Perlis RH, Ostacher MJ. Bipolar disorder. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 30.BACK TO TOP
Review Date: 6/5/2022
Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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