Bipolar disorder | |
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Synonyms | Bipolar affective disorder, bipolar illness, manic depression, manic depressive disorder, manic-depressive illness, manic-depressive psychosis, circular insanity, bipolar disease |
Bipolar disorder is characterized by episodes of depression and mania. | |
Specialty | Psychiatry |
Symptoms | Periods of depression and elevated mood |
Complications | Suicide, self-harm |
Usual onset | 25 years old |
Types | Bipolar I disorder, bipolar II disorder, others |
Causes | Environmental and genetic |
Risk factors | Family history, childhood abuse, long-term stress |
Differential diagnosis | Attention deficit hyperactivity disorder, personality disorders, schizophrenia, substance use disorder |
Treatment | Psychotherapy, medications |
Medication | Lithium, antipsychotics, anticonvulsants |
Frequency | 1-3% |
Classification | |
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External resources |
Bipolar disorder, previously known as manic depression, is a mental disorder that causes periods of depression and periods of abnormally elevated mood. The elevated mood is significant and is known as mania or hypomania, depending on its severity, or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy, or irritable. Individuals often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced during manic phases. During periods of depression, there may be crying, a negative outlook on life, and poor eye contact with others. The risk of suicide among those with the illness is high at greater than 6 percent over 20 years, while self-harm occurs in 30–40 percent. Other mental health issues such as anxiety disorders and substance use disorder are commonly associated.
The causes are not clearly understood, but both environmental and genetic factors play a role. Many genes of small effect contribute to risk. Environmental risk factors include a history of childhood abuse, and long-term stress. About 85% of the risk is attributed to genetics. The condition is divided into bipolar I disorder if there has been at least one manic episode, with or without depressive episodes, and bipolar II disorder if there has been at least one hypomanic episode (but no manic episodes) and one major depressive episode. In those with less severe symptoms of a prolonged duration, the condition cyclothymic disorder may be diagnosed. If due to drugs or medical problems, it is classified separately. Other conditions that may present in a similar manner include attention deficit hyperactivity disorder, personality disorders, schizophrenia and substance use disorder as well as a number of medical conditions.Medical testing is not required for a diagnosis, though blood tests or medical imaging can be done to rule out other problems.