These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are intense and happen along with changes in behavior, energy levels, or activity levels that are noticeable to others. Some people with bipolar disorder may have milder symptoms than others with the disorder. For example, hypomanic episodes may make the individual feel very good and be very productive; they may not feel like anything is wrong.
However, family and friends may notice the mood swings and changes in activity levels as behavior that is different from usual, and severe depression may follow mild hypomanic episodes.
There are three basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. People with bipolar disorder also may have a normal euthymic mood alternating with depression. Many people with bipolar disorder also may have other mental health disorders or conditions such as:.
Some bipolar disorder symptoms are like those of other illnesses, which can lead to misdiagnosis. For example, some people with bipolar disorder who also have psychotic symptoms can be misdiagnosed with schizophrenia. Some physical health conditions, such as thyroid disease, can mimic the moods and other symptoms of bipolar disorder.
Street drugs sometimes can mimic, provoke, or worsen mood symptoms. The exact cause of bipolar disorder is unknown. However, research suggests that there is no single cause. Instead, a combination of factors may contribute to bipolar disorder. Bipolar disorder often runs in families, and research suggests that this is mostly explained by heredity—people with certain genes are more likely to develop bipolar disorder than others. Many genes are involved, and no one gene can cause the disorder. But genes are not the only factor.
Some studies of identical twins have found that even when one twin develops bipolar disorder, the other twin may not. Although people with a parent or sibling with bipolar disorder are more likely to develop the disorder themselves, most people with a family history of bipolar disorder will not develop the illness. Researchers are learning that the brain structure and function of people with bipolar disorder may be different from the brain structure and function of people who do not have bipolar disorder or other psychiatric disorders.
Learning about the nature of these brain changes helps doctors better understand bipolar disorder and may in the future help predict which types of treatment will work best for a person with bipolar disorder. At this time, diagnosis is based on symptoms rather than brain imaging or other diagnostic tests. A psychiatrist or other mental health professional diagnoses bipolar disorder based on the symptoms, lifetime course, and experiences of the individual.
Some people have bipolar disorder for years before it is diagnosed. This may be because:. Treatment helps many people, even those with the most severe forms of bipolar disorder.
Doctors treat bipolar disorder with medications, psychotherapy, or a combination of treatments. Certain medications can help control the symptoms of bipolar disorder.
Some people may need to try several different medications and work with their doctor before finding the ones that work best. The most common types of medications that doctors prescribe include mood stabilizers and atypical antipsychotics. Mood stabilizers such as lithium can help prevent mood episodes or reduce their severity when they occur. Lithium also decreases the risk for suicide.
Additional medications that target sleep or anxiety are sometimes added to mood stabilizers as part of a treatment plan. Talk with your doctor or a pharmacist to understand the risks and benefits of each medication. Report any concerns about side effects to your doctor right away. Avoid stopping medication without talking to your doctor first. Psychotherapy can offer support, education, skills, and strategies to people with bipolar disorder and their families. Symptoms of psychosis can be:. Psychotic symptoms in bipolar disorder can reflect your mood.
For example, if you have a manic episode you may believe that you have special powers or are being monitored by the government. If you have depressive episode, you may feel very guilty about something you think you have done.
You may feel that you are worse than anybody else or feel that you don't exist. A diagnosis of bipolar I disorder means you will have had at least 1 episode of mania that lasts longer than 1 week. You may also have periods of depression. Manic episodes will generally last months if left untreated. Depressive episodes will generally last months without treatment.
A diagnosis of bipolar II disorder means it is common to have symptoms of depression. You will have had at least 1 period of major depression. And at least 1 period of hypomania instead of mania. You will experience symptoms of mania or hypomania and depression at the same time. You may feel very sad and hopeless at the same time as feeling restlessness and being overactive.
Rapid cycling means you have had 4 or more depressive, manic or hypomanic episodes in a month period. Seasonal pattern means that either your depression, mania or hypomania is regularly affected in the same way by the seasons.
There can be some similarities between bipolar I or II with seasonal pattern and another conditional called seasonal affective disorder. A diagnosis of cyclothymic disorder means you will have experienced regular episodes of hypomania and depression for at least 2 years. But they can last longer. Cyclothymia can develop into bipolar disorder. Research suggests that a combination of different things can make it more likely that you will develop bipolar disorder.
This risk is higher if both of your parents have the condition or if your twin has the condition. But different genes have been linked to the development of bipolar disorder. Different chemicals in your brain affect your mood and behaviour. Too much or too little of these chemicals could lead to you developing mania or depression. Stressful life events can trigger symptoms of bipolar disorder. Such as childhood abuse or the loss of a loved one.
They can increase your chances of developing depressive episodes. It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:.
Or there is a chance that you are a danger to yourself or someone else. Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at: www.
But they should have a good reason for not following them. Mania and hypomania You should be offered a mood stabiliser to help manage your mania or hypomania. You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:. Sodium valproate is an anticonvulsive medication. Your doctor will suggest different dosages and combinations to you depending on what works best for you.
Your personal preferences should be listened to. Depression Your doctor should offer you medication to treat depressive symptoms. You may be offered the following medication:.
If you would like to take medication, doctors will use different dosages and combinations depending on what works best for you. If you have an episode of depression you should be offered medication and a high intensity talking therapy, such as:. What is cognitive behavioural therapy CBT? CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. What is interpersonal therapy?
Interpersonal therapy is a talking therapy that focuses on you and your relationships with other people. Bipolar disorder is a life-long and often recurring illness. You may need long term support to help manage your condition. Your doctor will look at what medication worked for you during episodes of mania or depression. They should ask you whether you want to continue this treatment or if you want to change to lithium.
Lithium usually works better than other types of medication for long-term treatment. Your doctor should give you information about how to take lithium safely.
If lithium doesn't work well enough or causes you problems, you may be offered:. Your doctor should monitor your health. Physical health checks should be done at least once a year. These checks will include:. You should be offered a psychological therapy that is specially designed for bipolar disorder. You could have individual or group therapy. The aim of your therapy is to stop you from becoming unwell again. Family intervention is where you and your family work with mental health professionals to help to manage relationships.
This should be offered to people who you live with or who you are in close contact with. The support that you and your family are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions.
Your family should get support for 3 months to 1 year and should have at least 10 planned sessions. If you want to return to work, you should be offered support with that including training. You should get this support if your care is managed by your GP or by your community mental health team. You might not be able to work or to find any.
Your healthcare professionals should think about other activities that could help you back to employment in the future.
Your healthcare team should help you to make a recovery plan. The plan should help you to identify early warning signs and triggers that may make you unwell again and ways of coping. Your plan should also have people to call if you become very distressed.
CPA is a package of care that is used by secondary mental health services. You will have a care plan and someone to coordinate your care. All care plans should include a crisis plan. CPA should be available if you have a wide range of needs from different services or you are thought to be a high risk. Both you and your GP should be given a copy of your care plan. Your carers can be involved in your care plan and given a copy if you give your consent for this to happen.
You can speak to your doctor about your treatment. You could ask what other treatments you could try. Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. A second opinion means that you would like a different doctor to give their opinion about what treatment you should have.
You can also ask for a second opinion if you disagree with your diagnosis. But your doctor should listen to your reason for wanting a second opinion. An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard. There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns.
And help you to get the treatment that you would like. You can complain about your treatment or any other aspect of the NHS verbally or in writing. You can learn to manage your symptoms by looking after yourself. Selfcare is how you take care of your diet, sleep, exercise, daily routine, relationships and how you are feeling.
Routine helps many people with their mental wellbeing. It will help to give a structure to your day and may give you a sense of purpose. Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs mania or hypomania and lows depression. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities.
When your mood shifts to mania or hypomania less extreme than mania , you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. Episodes of mood swings may occur rarely or multiple times a year.
While most people will experience some emotional symptoms between episodes, some may not experience any. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling psychotherapy. Bipolar disorder care at Mayo Clinic. There are several types of bipolar and related disorders. They may include mania or hypomania and depression.
Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life. Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.
Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality psychosis and require hospitalization.
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:. Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others.
The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons. Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder. Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder.
And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes. The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.
Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need. And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive.
However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble. If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own.
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