Bipolar disorder

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 26, 2016
StartDiseasesBipolar disorder

Bipolar disorder which is also called manic depression often develops in the late teens and early adult years. An estimated three percent of American adults deal with its effects which can include dramatic moods swings and a feeling that life is out of control.


Definition & Facts

Bipolar disorder is characterized as a psychiatric illness that includes both manic episodes and depressive episodes. In some instances, a patient may experience only manic episodes. It's important to receive treatment for the disorder as it may lead to thoughts of suicide.

People who have bipolar disorder are at a greater risk of developing depression, isolating themselves, taking more risks and abusing drugs or abusing alcohol. It is important for those suffering from symptoms as well as those witnessing symptoms in a loved one to seek immediate help. Warning signs include thinking or talking about death and dying, crying frequently or conversely, becoming less emotionally expressive.

Symptoms & Complaints

Bipolar disorder is a dynamic condition that doesn't follow an easily identifiable pattern. People who have bipolar are generally thought to go through cycles on a regular basis, but this is not actually the case. An individual can have several manic or depressive episodes that last for weeks, months or years, and these episodes may be followed by what is considered normal functioning behavior. Many symptoms of bipolar disorder mimic other disorders, so it's important to receive a full evaluation by a psychiatrist or psychologist.

Manic individuals may experience excessive happiness, great hope and excitement that goes above and beyond what is considered normal. They may suddenly change demeanor and become openly hostile and angry or the inverse. These individuals often experience intense restlessness, and may have exceedingly fast speech patterns coupled with difficulty concentrating. Some individuals may demonstrate an increased sex drive and poor judgment. Unrealistic planning, impulsiveness and drug or alcohol abuse may be apparent as well.

During depressive episodes, an individual may feel lonely, sad and lack energy to participate in regular life. They typically withdraw from friends and family, and they often feel hopeless. This can lead to feelings of worthlessness, and they may begin to take less enjoyment in things they used to love. Difficulty concentrating, irritability and a need for more sleep may also occur.


Individuals who have bipolar disorder typically develop the disorder during adolescence. It can happen in childhood, but this is much rarer. It often runs in the family and many researchers believe there is a genetic component to the disorder. It doesn't discriminate by gender, and men and women are equally likely to develop the disorder. However, the symptoms are demonstrated in different ways. Men are less likely to demonstrate rapid cycling where four or more distinct mood episodes occur within a single year. Men also tend to have shorter periods of depressive episodes than women.

While it's difficult to determine a specific cause of the disorder, there are many contributing factors that can lead to the disorder. Genes may play a significant role in determining who gets the disorder. Brain changes can also bring about the disorder, and a traumatic brain injury could cause a person to develop the disorder. Large amounts of stress may also play a role in the development of the disorder.

Diagnosis & Tests

The first step is to talk with a psychologist or psychiatrist. Since the disorder can mimic other conditions, it's not a good idea to try to self-diagnose. The disorder is usually best diagnosed by a psychiatrist since they can prescribe any medications that may be necessary to treat the disorder. Bipolar may also be co-morbid with other issues, so it's important to get follow-up treatment. Often people who have bipolar disorder go off medications during a manic state as they feel there is nothing wrong with them and have an inflated view of themselves.

There are several possible other conditions that could explain the symptoms of bipolar disorder. It's important to rule out these conditions before making a diagnosis. Hypothyroidism is just one condition that could mimic the symptoms of bipolar disorder. It's also possible that a drug addiction or alcohol addiction could be to blame. A professional will evaluate the length of time and may prescribe certain personality tests to determine whether an individual has bipolar. Medical tests may also be necessary to rule out physical reasons for the symptoms.

Treatment & Therapy

While bipolar disorder can be treated with medication and therapy to treat issues resulting from living with the disorder. The main treatments for the disorder include mood stabilizers. Common mood stabilizers include carbamazepine, lamotrigine, lithium and valproate. Doctors may prescribe either generic or brand names for these medications.

In certain instances, doctors may recommend a treatment that uses antipsychotic drugs to help control symptoms. These include olanzapine, quetiapine, lurasidone, and cariprazine. For people who are experiencing depressive episodes, it may be necessary to include antidepressants in the treatment regimen.

Some people may require more intensive treatments. If an individual experiences extreme rapid cycling and has more than four episodes a year, it can be more difficult to treat the disorder. The issue is compounded if drug or alcohol addiction enters into the equation. Since individuals may self-medicate, it's important to get the disorder treated early on to avoid complications and difficulties with treatment.

Prevention & Prophylaxis

No treatment can guarantee the prevention of bipolar disorder. However, awareness of whether the disorder runs in the family can provide some clues and help detect the disorder early. Address warning signs with a psychologist or psychiatrist and avoid the use of alcohol and drugs for people at risk.

It's important to begin getting treatment at the earliest signs of bipolar disorder. This can often make the treatment of the disorder more effective and less invasive. Patients who are taking medication should get on a regular medication schedule and continue to take medications regardless of how they feel in the current moment.