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Bipolar Disorder

  • Amy Scholten, MPH
Publication Type:


Bipolar Disorder

(Manic-Depressive Illness; Manic Depression; Manic Disorder; Manic Affective Disorder)


Bipolar disorder is a mental health problem. It is extreme swings in mood and energy. The mood changes are more severe than normal ups and downs. They can cause problems with relationships, work, and school.

Bipolar disorder swings between mania and depression. Mania is an increase in energy and a decreased need for sleep. The mood may be overly happy or irritable. Depression is a down mood with tiredness and irritability.

There are 4 forms of bipolar disorder:

  • Bipolar I disorder—There is at least one manic episode. Depression may occur before or after the mania. This cycle repeats. It can be severe.
  • Bipolar II disorder—Mania is less severe (called hypomania). There is at least one episode of severe depression.
  • Bipolar disorder not otherwise specified (BP-NOS)—Does not fit the description of bipolar I or bipolar II disorder.
  • Cyclothymia—Hypomania that alternates with episodes of mild depression. It lasts for at least 2 years.

Treatment can improve outcomes.


The exact cause of bipolar disorder is unknown. Changes in genes may change how the brain works.

The Brain.

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Risk Factors

The risk of bipolar disease is higher if another family member has it.


Symptoms include:

  • Dramatic mood swings—May be very excitable or sad and hopeless
  • Periods of normal mood in between ups and downs
  • Extreme changes in energy and behavior

Mania may cause:

  • A mood that is extremely high, overly good, or irritable
  • Increased energy and effort toward goal-directed activities
  • Restlessness and agitation
  • Racing thoughts, jumping from one idea to another
  • Talking fast—or pressure to keep talking
  • Problems focusing
  • Decreased need for sleep
  • Inflated self-esteem or confidence
  • Poor judgment, often involving sex or spending lots of money

Depression may cause:

  • A long-lasting sad, hopeless, or empty mood
  • Loss of interest or pleasure in activities once enjoyed, including sex
  • Feeling tired
  • Problems focusing, remembering, and/or making decisions
  • Feelings of guilt, worthlessness, or helplessness
  • Restlessness or fewer movements
  • Sleeping too much or too little
  • Weight loss or gain
  • Thoughts of death or suicide—with or without suicide attempts

Severe episodes of mania or depression may sometimes happen with psychotic symptoms, such as:

  • Hallucinations
  • Delusions
  • Disorders of thought


The doctor will ask about symptoms and past health. A physical exam will be done. Lab tests may be done to rule out other possible causes of symptoms. A mental health specialist will help to diagnosis bipolar disorder. It will be based on the history of symptoms.

Episodes of mania or depression will be diagnosed as they occur. Symptoms will need to last a period of time. They also need to be severe enough to interfere with day to day life.


Treatment may help to ease mood swings. It can help to decrease effect on day to day life and avoid major problems.


There are no guidelines to prevent bipolar disorder.





  • Bipolar disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/bipolar-disorder.
  • Bipolar disorder. National Alliance on Mental Illness website. Available at: https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder.
  • Bipolar disorder in adults. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/publications/bipolar-disorder.
  • Bonnín CDM, Reinares M, et al. Improving functioning, quality of life, and well-being in patients with bipolar disorder. Int J Neuropsychopharmacol. 2019;22(8):467-477.


  • Adrian Preda, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.