Bipolar disorder is a treatable medical illness marked by extreme changes in mood, thought, energy, and behavior. It is also known as manic-depression because a person's mood can alternate between symptoms of mania and depression.

These changes in mood or "mood swings" can last for hours, days, weeks, or even months. Unlike people with clinical depression (the "lows"), most people who have bipolar disorder talk about experiencing "highs" and "lows."

Abnormalities in brain biochemistry and in the structure and/or activity of certain brain circuits are responsible for the extreme shifts in mood, thought, energy, and functioning that characterize bipolar disorder.

A diagnosis of bipolar I disorder is made when a person has experienced at least one episode of severe mania; a diagnosis of bipolar II disorder is made when a person has experienced at least one hypomanic episode but has not met the criteria for a full manic episode. Cyclothymic disorder, a milder illness, is diagnosed when a person experiences, over the course of at least two years (one year for adolescents and children), numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that are not severe enough to meet criteria for major manic or depressive episodes.

Bipolar disorder with rapid cycling is defined as four or more episodes of illness within a 12-month period. This form of the illness tends to be more resistant to treatment than non-rapid-cycling bipolar disorder.

Symptoms of Mania

• Heightened mood, exaggerated optimism and self-confidence
• Decreased need for sleep (less than three hours) without fatigue
• Grandiose delusions, inflated sense of self-importance
• Excessive irritability, aggressive behavior
• Increased physical, mental activity
• Racing speech, flight of ideas, impulsiveness
• Poor judgement, easily distracted, difficulty concentrating
• Reckless behavior without concern for consequences, such as spending sprees, rash business decisions, erratic driving, sexual indiscretions
• In severe cases, auditory hallucinations (hearing voices) or delusions (strong convictions about things that aren't true)

Symptoms of Depression

If a person experiences five or more of the following symptoms each day during a two-week period or if these symptoms interfere with work or family activities, criteria for a major depressive episode are met:

• Prolonged sadness or unexplained crying spells
• Significant changes in appetite, sleep patterns
• Irritability, anger, worry, agitation, anxiety
• Pessimism, indifference
• Loss of energy, persistent tiredness
• Feelings of guilt, worthlessness
• Inability to concentrate, indecisiveness
• Inability to take pleasure in former interests, social withdraw
• Unexplained aches and pains
• Recurring thoughts of death and suicide

Who is Affected by Bipolar Disorder?

According to the National Institute of Mental Health, bipolar disorder affects more than 2.5 million adult Americans every year. Up to 90 percent of bipolar disorders start before age 20, although the illness can start in early childhood or as late as the 40s and 50s. An equal number of men and women develop bipolar illness and it is found in all ages, races, ethnic groups and social classes.

More than two-thirds of people with bipolar disorder have at least one close relative with the illness or with unipolar major depression, indicating that the disease has a heritable component.

Women and Bipolar Disorder

Although bipolar disorder is equally common in women and men, research indicates that approximately three times as many women as men experience rapid cycling. Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness

Suicide and Bipolar Disorder

Bipolar disorder results in 9.2 years reduction in expected life span, and as many as one in five patients with bipolar disorder completes suicide.

Children and Adolescents

Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is l5 percent to 30 percent. When both parents have bipolar disorder, the risk increases to 50 percent to 75 percent.

Some 20 percent of adolescents with major depression develop bipolar disorder within five years of the onset of depression. Up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder. When manic, children and adolescents, in contrast to adults, are more likely to be irritable and prone to destructive outbursts than to be elated or euphoric. When depressed, there may be many physical complaints such as headaches, and stomachaches or tiredness; poor performance in school, irritability, social isolation, and extreme sensitivity to rejection or failure.

Source: The Depression and Bipolar Support Alliance