Bipolar disorder is a mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience.

The average age-of-onset is about 25, but it can occur in the teens, or more uncommonly, in childhood. The condition affects men and women equally, with about 2.8% of the U.S. population diagnosed with bipolar disorder and nearly 83% of cases classified as severe.

If left untreated, bipolar disorder usually worsens. However, with a good treatment plan including psychotherapy, medications, a healthy lifestyle, a regular schedule and early identification of symptoms, many people live well with the condition.

(National Alliance of Mental Illness)

The defining sign of bipolar I disorder is a manic episode that lasts at least one week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes.

But many people with bipolar disorder experience both hypomanic/manic and depressive episodes. These changing mood states don’t always follow a set pattern, and depression doesn’t always follow manic phases.

Signs and symptoms of a manic episode include:

• Excessive happiness, hopefulness and excitement;
• Sudden and severe changes in mood, such as going from being joyful to being angry and hostile;
• Restlessness;
• Rapid speech and racing thoughts;
• Increased energy and less need for sleep;
• Increased impulsivity and poor judgment, such as suddenly quitting your job;
• Making grand and unattainable plans;
• Reckless and risk-taking behavior, such as drug and alcohol misuse and having unsafe or unprotected sex;
• Feeling like you’re unusually important, talented or powerful;
• Psychosis — experiencing hallucinations and delusions (in the most severe manic episodes).

The symptoms of depressive episodes in bipolar disorder are the same as those of major depression. They include:

• Overwhelming sadness;
• Low energy and fatigue;
• Lack of motivation;
• Feelings of hopelessness or worthlessness;
• Loss of enjoyment of things that were once pleasurable for you;
• Difficulty concentrating and making decisions;
• Uncontrollable crying;
• Irritability;
• Increased need for sleep;
• Insomnia or excessive sleep;
• A change in appetite, causing weight loss or gain;
• Thoughts of death or suicide (suicidal ideation).

(Cleveland Clinic)

The cause of BPAD is uncertain, but we know more today than we did a decade ago.

Chemical Imbalance

Three brain chemicals — norepinephrine, serotonin, and dopamine — are involved in psychiatric disorders. Norepinephrine and serotonin are linked to mood disorders, such as depression and BPAD. Dopamine, is more closely linked to psychotic disorders, such as schizophrenia. However, since these disorders have a number of symptoms in common, all three chemicals are likely involved in different phases of BPAD.

Genetics

Many studies have shown that BPAD runs in families, so relatives of persons diagnosed with BPAD or depression are more likely to have the disorder than the general public.

“Triggers”

The onset of BPAD is often “triggered” by a significant life stressor (i.e., death of a family member, leaving home for the first time, starting college or a new job, etc.). These stressors do not cause BPAD, but can trigger the disorder to become active. “Trigger events” can also cause a person with BPAD to experience a relapse (episode of depression, hypomania, or mania).

Proper treatment helps most people living with bipolar disorder control their mood swings and other symptoms. Because bipolar disorder is a chronic illness, treatment must be ongoing. If left untreated, the symptoms of bipolar disorder get worse, so diagnosing it and beginning treatment early is important.

Treating bipolar disorder may include medication, psychotherapy, education, self-management strategies and external supports such as family, friends and support groups. There is no one approach to treating bipolar disorder.