Frequently Asked Questions about Bipolar Disorder

What is Bipolar Disorder?

Bipolar Disorder consists of extreme highs and lows in mood, and thus the two poles. These highs are referred to as mania or manic behavior and the lows are called depression. Bipolar disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression. Often, the first episode of mania or depression occurs during a person’s twenties, but it can occur as late as during the forties.

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

Bipolar Disorder differs from the common changes in mood that everyone experiences in their lives because of the severity and duration of bipolar symptoms. If left untreated, Bipolar Disorder can disrupt many aspects of daily life.

What are the symptoms of Bipolar Disorder?

• Signs and symptoms of mania (or a manic episode) include:
• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong
• Signs and symptoms of depression (or a depressive episode) include:
• Lasting sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or can't sleep
• Change in appetite and/or unintended weight loss or gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
• Thoughts of death or suicide, or suicide attempts

What is Bipolar II?

Bipolar II does not have the same level of mania that Bipolar Disorder has. Those with Bipolar II Disorder experience milder episodes of mania, called hypomania. Hypomanic individuals do not become openly delusional or require hospitalization. The hypomanic individual typically presents with increased energy, heightened or irritable mood, increased talkativeness, decreased need for sleep, increased social or sexual activity, and increased spending or work-related activities. Some people with Bipolar II get most of their creative work done in their hypomanic periods, knowing that they have only so much time before they return to depression. Bipolar II Disorder is associated with significant social and vocational disability and an increased risk of suicide.

How Is Bipolar Disorder Treated?

Proper treatment of Bipolar Disorder can help to alleviate the emotional highs and lows of the disorder. Because bipolar disorder is a recurrent illness, it is recommended that the treatment plan be a long term plan. A strategy that combines medication and cognitive behavioral therapy is optimal for managing the disorder over time.

Bipolar Disorder is often much better controlled through continuous treatment. Breaks in treatment can cause fluctuations in mood. Sometimes, even with continuous treatment, there can be episodes of mania and depression. It is important to report any emotional changes to a physician immediately. The doctor may be able to prevent a full-blown episode by making adjustments to the treatment plan. Working closely with the doctor and communicating openly about treatment concerns and options can make a difference in treatment effectiveness.

In addition, keeping a chart of daily mood symptoms, treatments, sleep patterns, and life events may help people with bipolar disorder and their families to better understand the illness. This chart also can help the doctor track and treat the illness most effectively.

Changes to the treatment plan may be needed at various times during the course of bipolar disorder to manage the illness most effectively. A psychiatrist should guide any changes in type or dose of medication.

Be sure to tell the psychiatrist about all other prescription drugs, over-the-counter medications, or natural supplements you may be taking. This is important because certain medications and supplements taken together may cause adverse reactions.

To reduce the chance of relapse or of developing a new episode, it is important to stick to the treatment plan. Talk to your doctor if you have any concerns about the medications.