According to the National Institute of Mental Health, over 4% of U.S. adults will experience bipolar disorder, with the condition affecting males and females in equal ratios. Here we’re going to give you a general overview of the disorder, including the signs and symptoms to be aware of.
Bipolar disorders are characterized by the presence of high-energy phases known as manic episodes. A manic episode is characterized by energy and mood shifts that result in an increase in activity level and a decrease in functional ability. Functional impairment can be severe and adversely impact one’s work, school routine, and interpersonal relationships.
Manic episodes are often characterized by feelings of over-exuberance, accompanied by a sense of indomitability. Many times, however, the most prominent mood displayed during a manic episode is one of irritation and even anger.
During a manic episode, individuals often report feeling an increased sense of self-worth, a decreased need for sleep, distractibility, and talkativeness. For example, during a manic episode, an individual may begin several new activities or projects with the sense that they can accomplish anything and everything, regardless of skill level or experience. Risk-taking behavior is often present as well, including excessive spending, sexual indiscretion, and gambling.
A decreased need for sleep is one of the dominant features of a manic episode. Some individuals may experience days on end without sleep, yet not feel fatigued. Angry outbursts can be a hallmark of a manic episode particularly if the person thinks they are being interrupted or not heard correctly. Sometimes this is due to the person’s mind racing with thoughts being expressed in a disjointed, incoherent manner.
These are the types of symptoms which must be present in order to qualify as a manic episode:
- The episode is not due to a medication, substance abuse, or medical condition
- Decreased need for sleep
- Increased distractibility
- Inflated self-esteem or grandiosity, including unrealistic beliefs in one’s capability
- Increased talkativeness
- Significant loss of social or occupational function which may require hospitalization due to psychotic features or to prevent self-harm
- Flight of ideas
- Increased activity (psychomotor agitation)
- Involvement in activities that are likely to have negative consequences, e.g. excessive spending, sexual indiscretions, etc.
In general, bipolar disorders are characterized by the occurrence of at least one depressive episode, an event categorized by depressed mood, feelings of hopelessness, or loss of pleasure/interest in enjoyable activities, for the duration of at least two weeks (https://www.nimh.nih.gov/health/topics/depression/index.shtml).
- These are the types of symptoms which must be present in order to qualify as a depressive manic episode:
- Sleep pattern disruption
- Unintentional weight gain or loss
- A sad, anxious, or empty mood is evident the majority of the day, every day
- Loss of interest or pleasure in all or most activities is present most of the day, every day
- Feeling fatigued nearly every day
- Visible psychomotor agitation or psychomotor retardation
- Decreased ability to focus, concentrate, or make decisions
- Feelings of guilt or worthlessness
- Recurring thoughts of death or suicide, or suicide attempts
- Symptoms are not due to substance abuse or medical condition
A hypomanic episode differs from a manic episode in terms of severity. Alteration of mood and function are apparent, but not to such a degree to cause severe impairment in personal or professional realms or to necessitate hospitalization.
A bipolar disorder may manifest at any point in life, from childhood through maturity, although 25 is the median age of onset. Because bipolar disorders are considered to be chronic conditions, they generally require ongoing management.
There is not one single type of bipolar disorder, and over 90% percent of individuals who experience one manic episode will later experience recurrent episodes of mania or depression.
Bipolar I disorder entails a full-blown manic episode for at least one week’s duration and may or may not include depression. In this case, manic symptoms may be severe enough to warrant hospitalization.
In contrast, Bipolar II disorder includes the incidence of a past or current hypomanic episode, lasting at least four consecutive days, as well as a past or current episode of major depression.
On the other hand, cyclothymic disorder (cyclothymia) occurs when recurring hypomanic and depressive mood shifts in adults appear over a duration of at least two years.
Children of individuals with bipolar disorder are at increased risk for developing the condition, and their symptoms may manifest as anxiety and sleep disturbance. As the child ages, the condition advances from a minor mood disorder to major depressive disorder during adolescence, and on to bipolar disorder during the transition to adulthood in which hypomania or mania is seen or an episode of depression preceded by an episode of psychosis is evident.
The consensus among experts is that there is no single cause associated with bipolar disorders. Genetics plays a role, as a family history of the condition is one of the highest risk factors for developing the disorder.
Brain-imaging tests also reveal that the brains of bipolar disorder patients may differ from those of healthy individuals, with researchers identifying several brain regions that are marked by a decrease in cortex thickness.
Lastly, studies of identical twins show that factors other than genes, e.g. highly stressful events as well as a person’s environment, can play a role in the onset of bipolar disorder.
Bipolar disorders are treatable conditions, with the majority of individuals achieving significant mood stabilization and reduction in symptoms. If you think that you or a loved one may be experiencing bipolar disorder, do not hesitate to seek appropriate help for the condition.
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