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Bipolar disorder, also known as manic depression, is a mental illness involving episodes of serious mania and depression. The person's mood swings from excessively "high" and irritable to sad and hopeless and then back again, with periods of the person's normal mood in between. At least 2 million Americans suffer from bipolar disorder.

Bipolar Disorder

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness and people who have it may suffer needlessly for years or even decades.

Bipolar disorder can be extremely distressing and disruptive for those who have this disease, their spouses, family members, friends and employers. Although there is no known cure, bipolar disorder is treatable, and recovery is possible. Individuals with bipolar disorder have successful relationships and meaningful jobs. The combination of medications and psychotherapy helps the vast majority of people return to productive, fulfilling lives.

"Bipolar disorder is treatable, and recovery is possible.”

What Causes Bipolar Disorder?

Although a specific genetic link to bipolar disorder has not been determined, studies show that 80 to 90 percent of people who suffer from this illness have relatives who have some form of depression. It is also possible that people may inherit a vulnerability to the illness, which may then be triggered by environmental factors. Other research suggests the illness may be caused by a biochemical imbalance which alters a person's moods. This imbalance may be due to irregular hormone production or to a problem with certain neurotransmitters.

What are the Symptoms of Bipolar Disorder?

Bipolar disorder is often difficult to recognize and diagnose. One reason is because of hypomania, which is an early sign of manic depression. Hypomania may cause a person to have a high level of energy, unrealistically expansive thoughts or ideas and impulsive or reckless behavior. These symptoms may feel good to the person, which may lead to denial that there is a problem.

Another reason for the lack of recognition may be that bipolar disorder may appear to be symptoms of other illnesses or may occur with other problems such as substance abuse, poor school performance, or trouble in the workplace.

Symptoms of Mania:

  • Increased energy, activity, restlessness, racing thoughts and rapid talking
  • Denial that anything is wrong
  • Excessive "high" or euphoric feelings
  • Extreme irritability and distractibility
  • Decreased need for sleep
  • Unrealistic beliefs in one's ability and powers
  • Uncharacteristically poor judgment
  • A sustained period of behavior that is different from the person's usual behavior
  • Increased sexual drive
  • Abuse of drugs, particularly cocaine, alcohol and sleeping medications
  • Provocative, intrusive, or aggressive behavior

Symptoms of Depression:

  • Persistent sad, anxious, or empty moods
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in ordinary activities, including sex
  • Decreased energy, a feeling of fatigue or of being "slowed down"
  • Difficulty concentrating, remembering, or making decisions
  • Restlessness or irritability
  • Sleep disturbances
  • Loss of appetite and weight, or weight gain
  • Chronic pain or other persistent bodily symptoms that are not caused by physical disease
  • Thoughts of death or suicide; including suicide attempts

Symptoms of Depression after Mania:

Some people experience periods of normal mood and behavior following a manic phase, however, the depressive phase will eventually appear. Symptoms of depression include:

  • Persistent sad, anxious, or empty mood
  • Sleeping too much or too little, middle-of-the-night or early morning waking
  • Reduced appetite and weight loss or increased appetite and weight gain
  • Loss of interest or pleasure in activities, including sex
  • Irritability or restlessnes
  • Difficulty concentrating, remembering or making decisions.
  • Fatigue or loss of energy
  • Persistent physical symptoms that don’t respond to treatment (such as chronic pain or digestive disorders)
  • Thoughts of death or suicide, including suicide attempts
  • Feeling guilty, hopeless or worthless


Anyone suffering from bipolar disorder should be under psychiatric care; however, he or she may need help and encouragement from friends and family in recognizing the problem and seeking help. If the person is in the midst of an episode, he or she may refuse to get help. In this situation, it may be necessary to have the person hospitalized for his or her own protection in order to receive much needed treatment, particularly if the person is considering suicide.

Most people with bipolar disorder can be helped with medication. Lithium, which is effective in controlling mania; and carbamazepine and valproate, which we mood-stabilizers and anticonvulsants, are some of the medications which are used. In addition, benzodiazepines are sometimes prescribed for insomnia and thyroid medication may also be helpful.

It is often suggested that people with bipolar disorder also receive guidance, education and support from a psychotherapist. A therapist can help the person to deal with personal relationships, maintain a healthy selfimage and ensure that the person complies with his or her treatment. Psychotherapy can also assist the person in coping with the side-effects of the medications. Ongoing encouragement and support from friends and family are also very important. It may be helpful to join a self-help or support group to help those coping with this illness.

Other Resources:

For more information or referrals for local service contact your local mental health association or:

National Mental Health Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968

Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959

Depression and Bipolar Support Alliance
Phone: 800-826-3632

National Institute of Mental Health
Public Inquiries
Phone- 301-443-4513

National Foundation for Depressive Illness
Phone: 800-239-1265

NMHA offers additional pamphlets on a variety of mental health topics. For more information or to order multiple copies of pamphlets, please call 1-800-969-NMHA.

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