During a manic episode, you might impulsively quit your job, charge up huge amounts on credit cards, or feel rested after sleeping two hours. During a depressive episode, you might be too tired to get out of bed, and full of self-loathing and hopelessness over being unemployed and in debt. The first manic or depressive episode of bipolar disorder usually occurs in the teenage years or early adulthood. The symptoms can be subtle and confusing; many people with bipolar disorder are overlooked or misdiagnosed—resulting in unnecessary suffering.
Recognizing the problem is the first step to feeling better and getting your life back on track. Fact: Many people with bipolar disorder have successful careers, happy family lives, and satisfying relationships. Living with bipolar disorder is challenging, but with treatment, healthy coping skills, and a solid support system, you can live fully while managing your symptoms.
Fact: Some people alternate between extreme episodes of mania and depression, but most are depressed more often than they are manic. Mania may also be so mild that it goes unrecognized. People with bipolar disorder can also go for long stretches without symptoms.
Fact: Bipolar disorder also affects your energy level, judgment, memory, concentration, appetite, sleep patterns, sex drive, and self-esteem. Additionally, bipolar disorder has been linked to anxiety, substance abuse, and health problems such as diabetes, heart disease, migraines, and high blood pressure.
Fact: While medication is the foundation of bipolar disorder treatment, therapy and self-help strategies also play important roles. You can help control your symptoms by exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding yourself with supportive people.
Bipolar disorder can look very different in different people. The symptoms vary widely in their pattern, severity, and frequency. Some people are more prone to either mania or depression, while others alternate equally between the two types of episodes.
Some have frequent mood disruptions, while others experience only a few over a lifetime. There are four types of mood episodes in bipolar disorder: mania, hypomania, depression, and mixed episodes. Each type of bipolar disorder mood episode has a unique set of symptoms. But while mania feels good at first, it has a tendency to spiral out of control. You may behave recklessly during a manic episode: gambling away your savings , engaging in inappropriate sexual activity, or making foolish business investments, for example.
Some people even become delusional or start hearing voices. Hypomania is a less severe form of mania. However, hypomania can result in bad decisions that harm your relationships, career, and reputation. In addition, hypomania often escalates to full-blown mania or is followed by a major depressive episode.
In the past, bipolar depression was lumped in with regular depression , but a growing body of research suggests that there are significant differences between the two, especially when it comes to recommended treatments.
Most people with bipolar depression are not helped by antidepressants. In fact, there is a risk that antidepressants can make bipolar disorder worse—triggering mania or hypomania, causing rapid cycling between mood states, or interfering with other mood stabilizing drugs.
Despite many similarities, certain symptoms are more common in bipolar depression than in regular depression. For example, bipolar depression is more likely to involve irritability, guilt, unpredictable mood swings, and feelings of restlessness. With bipolar depression, you may move and speak slowly, sleep a lot, and gain weight. A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression.
Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts.
This combination of high energy and low mood makes for a particularly high risk of suicide. Mood swings can occur very quickly, like a rollercoaster randomly moving from high to low and back again over a period of days or even hours. Rapid cycling can leave you feeling dangerously out of control and most commonly occurs if your bipolar disorder symptoms are not being adequately treated.
Bipolar I Disorder mania or a mixed episode — This is the classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Usually—but not always—Bipolar I Disorder also involves at least one episode of depression.
Instead, the illness involves episodes of hypomania and severe depression. Cyclothymia hypomania and mild depression — Cyclothymia is a milder form of bipolar disorder that consists of cyclical mood swings.
However, the symptoms are less severe than full-blown mania or depression. Living with untreated bipolar disorder can lead to problems in everything from your career to your relationships to your health. But bipolar disorder is highly treatable, so diagnosing the problem and starting treatment as early as possible can help prevent these complications. Mania and hypomania often turn destructive, hurting you and the people around you. Bipolar disorder requires long-term treatment. Most people with bipolar disorder need medication to prevent new episodes and stay symptom-free.
Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call or your local emergency number immediately.
Or, if you think you can do so safely, take the person to the nearest hospital emergency room. Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:. Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:. If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder.
Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:. There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview 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.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Reilly-Harrington NA et al. Journal of Affective Disorders. Bipolar and related disorders. Arlington, Va. Accessed Dec. Bipolar disorder. National Institute of Mental Health. Bipolar disorder in children and teens. National Alliance on Mental Illness. Rochester, Minn. Suppes T, et al. Bipolar disorder in adults: Clinical features. Axelson D, et al.
Pediatric bipolar disorder: Overview of choosing treatment. Birmaher B. 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. This could be a simple routine such as eating at the same time each day, going to bed at the same time each day and buying food once per week.
Your healthcare professionals should offer you a combined healthy eating, exercise and sleep programme. You can find more information about wellbeing any physical health at: www. You could join a support group. A support group is where people come together to share information, experiences and give each other support. You might be able to find a local group by searching online.
The charity Bipolar UK have an online support group. They also have face to face support groups in some areas of the country. Their contact details are in the Useful contacts at the bottom of this page. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area if you follow this link: www. Or you can contact our General Enquiries team on or info rethink.
Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your symptoms. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college. But the college may inform your care team. To see if there is a recovery college in your area you can use a search engine such as Google.
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