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Bipolar Disorder Fast Facts

Bipolar disorder affects an estimated 2.8% of adults in the United States. Men and women are affected at very similar rates. Bipolar disorder was once called manic depression, and it is characterized by extreme shifts in mood.

Bipolar disorder is more common among people who have a close relative, such as a parent or sibling, who also has the disorder.

Bipolar disorder is most commonly diagnosed in adults and teenagers, but children have been increasingly diagnosed with the disorder in recent years. Diagnosis of the disorder in children remains a controversial topic in the medical community.

Women are more likely than men to experience rapid cycling between manic and depressive states, and women tend to experience more depressive states than men.

Lack of sleep, excessive use of alcohol or drugs, and stress have been identified as common triggers of bipolar symptoms.

What is Bipolar Disorder?

The defining characteristic of bipolar disorder is the experience of mood swings between periods of extreme happiness and unusually deep sadness. Occasional mood swings, of course, are not out of the ordinary for most people, but bipolar sufferers experience mood shifts that are profound and that interfere with the functioning of their daily lives.

Bipolar disorder produces moods that range from extreme mania to major depression, which is why the disorder was once referred to as a manic depression. These manic and depressive states may last for a few months, or they may last for years, and in between episodes, the sufferer may experience relatively normal moods. In some cases, moods may swing wildly and quickly, with several episodes occurring within a single year.

Manic Symptoms

Symptoms of a manic episode include:

  • Hyperactivity or suddenly increased energy levels
  • Unusually happy or irritable moods
  • Disrupted sleep patterns or a decreased need for sleep
  • Engagement in risky or impulsive behaviors
  • Inability to control racing thoughts
  • Changes in speech patterns, including fast or forceful speech

Depressive Symptoms

Symptoms of a depressive episode include:

  • A decrease in energy levels
  • Feelings of extreme sadness or worthlessness
  • Suicidal thoughts
  • Disrupted sleep patterns, including an increase in the need for sleep or insomnia
  • Lack of interest in positive activities
  • Decreased sex drive

Bipolar types

  • Bipolar I Disorder. This type of bipolar disorder involves the severe manifestation of manic and depressive symptoms. It is usually diagnosed when a manic episode lasts at least seven days or requires hospitalization. In this type, depressive episodes usually last at least two weeks, and there may be some mixing of symptoms, with signs of mania occurring during depressive episodes and vice versa.
  • Bipolar II Disorder. This type of the disorder is generally less severe than Bipolar I. It is typically characterized by the prevalence of depressive episodes and manic episodes that are less extreme and of shorter duration (sometimes called hypomanic episodes) than those in Bipolar I. This type of the disorder is often misdiagnosed as major depression.
  • Cyclothymic Disorder. This disorder is characterized by mood swings between mania and depressive moods, but the length and intensity of the episodes are generally less than those of Bipolar I or Bipolar II.

Rapid-Cycling Bipolar. In this manifestation of the disorder, a sufferer experiences four or more distinct episodes of mania, hypomania or depression with a single one-year period. It is not technically a separate type of the disorder, but rather a pattern of symptoms that can occur in people with bipolar disorder.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes Bipolar Disorder?

Doctors and researchers have not yet determined exactly what causes bipolar disorder, but they have identified several risk factors that increase the likelihood that an individual will develop the disorder.

  • Genetic Predisposition. The prevailing scientific understanding is that there isn’t a single gene that causes bipolar disorder. However, there is a strong connection between family history of the disorder and new diagnoses of the illness; those who have a close relative with bipolar disorder are significantly more likely to develop the disorder themselves. The current consensus is that there are multiple genes that contribute to an increased risk for developing the disorder, and these genes may be triggered by external environmental factors to cause the onset of the illness.
  • Stress, Anxiety or Trauma. Some research has suggested that the brains of people with bipolar disorder are unable to cope with stress in an effective way. Chronic stress or anxiety, or a significant source of sudden trauma often coincides with the onset of the disorder, and these factors may also trigger subsequent episodes after the disorder first occurs.
  • Lack of Sleep. Many sufferers of bipolar disorder experience unhealthy sleep patterns, and lack of sleep is a cause of physical stress that may contribute to the brain chemistry that causes the illness. Like other forms of stress, lack of sleep may also contribute to the onset of manic or depressive episodes after the initial onset of the disorder.
  • Drugs and Alcohol. Nearly half of all people with bipolar disorder also struggle with drug or alcohol abuse. Sufferers often resort to substance abuse to cope with the effects of manic and depressive episodes, and the stress caused by the substance abuse may be a factor in triggering subsequent episodes. In some cases, antidepressants may also trigger episodes.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Is Bipolar Disorder Hereditary?

There appears to be some genetic component of risk for developing bipolar disorder, but the medical community has not yet pinpointed the precise genes that increase risk. However, there is a significant link between the family history of the disorder and the diagnosis of the disorder in new patients.

  • Individuals with one biological parent who has been diagnosed with the disorder have a 10-25% chance of developing the disorder themselves. When both parents have been diagnosed with the disorder, the risk increases to 10-50%.
  • Individuals with a sibling or non-identical twin who has been diagnosed as bipolar have a 10-25% chance of developing the disorder. If an identical twin has the disorder, the chance of the other twin developing the disorder rises to 40-70%.
  • The current consensus among researchers is that bipolar disorder is not caused by a single gene, but by a coincidence of several genes that each increase the risk of developing the disorder. Development of the disorder even in individuals with genetic risk factors is likely triggered by environmental factors.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Bipolar Disorder Detected?

Early detection of bipolar disorder is especially important because the onset of the illness often results in suicidal behavior and other behaviors that put the sufferer at a significant risk of harm. The problem is particularly acute when the disorder manifests itself in adolescents who are less likely to seek help and are vulnerable to harmful behaviors.

Unfortunately, bipolar disorder is very often misdiagnosed or ignored, and the time between the first occurrence of the disorder and a proper diagnosis may span years. The longer a sufferer lives with the illness without being diagnosed, the greater the chance that they will come to harm. Very often, the disorder is misdiagnosed as major depression, and it is treated with antidepressants alone, a course of treatment that may actually be harmful to the sufferer.

Successful early detection of bipolar disorder depends on differentiating signs of the disorder from other mental and physical disorders with similar symptoms. Researchers have attempted to find a pattern of symptoms that suggests that the disorder might manifest in the future, but thus far, a definitive pattern has been difficult to identify.

Lacking a way to spot a patient’s likelihood of developing the disorder, providers are encouraged to watch for symptoms such as mood swings, mania, depression or psychotic episodes that coincide with other risk factors such as stress, anxiety, sleep problems, trauma, family history of the disorder, or drug and alcohol abuse.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Bipolar Disorder Diagnosed?

Proper diagnosis of bipolar disorder usually involves a combination of physical and psychiatric assessments, as well as observation and evaluation of current symptoms. Given the link between bipolar disorder and family history, an assessment of the patient’s family’s mental health and medical history may be helpful, as well.

Although there is no medical test that can identify or rule out the presence of bipolar disorder, a physician will likely conduct a physical exam to exclude other medical conditions whose symptoms are often similar to those of bipolar disorder. Such conditions include lupus, HIV and thyroid disorders.

A psychiatric assessment typically includes a session with a psychiatrist aimed at identifying symptoms, moods, and patterns of behavior that could be indications of bipolar disorder. The patient will most likely be asked to fill out self-assessment questionnaires, and family members may be asked to contribute questionnaires, too.

After an initial assessment, the patient may be asked to keep a diary to track moods, feelings, sleep patterns and other relevant behaviors. The goal here is to identify patterns that are typical of bipolar disorder.

The results of these assessments will be compared to the diagnostic criteria for bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders. Comparison to these criteria will help a psychiatrist to decide whether the symptoms indicate bipolar disorder, another psychiatric problem (such as borderline personality disorder, impulse control disorders, anxiety disorders, or ADHD) whose symptoms are similar to those of bipolar or disorder, or something else entirely.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Bipolar Disorder Treated?

There is no known cure for bipolar disorder, and treatment plans are intended to manage symptoms and lessen the severity of episodes when they occur. Treatment for bipolar disorder is ongoing and life-long, and it is important for sufferers to continue treatment without interruption as directed by their healthcare providers.

Medication

Many different medications may be used to treat and manage the symptoms of bipolar disorder, and individual medication plans are dependent on the particular symptoms that a given sufferer presents.

  • Mood Stabilizers. These drugs are usually used to manage manic episodes. Mood-stabilizing drugs commonly prescribed for bipolar disorder include lithium, valproic acid, divalproex sodium), carbamazepine, and lamotrigine.
  • Antidepressants. These drugs are typically used to manage depressive episodes in sufferers of bipolar disorder. However, antidepressants used alone are known in some cases to trigger manic episodes or rapid cycling, so they are usually used in combination with mood-stabilizing or antipsychotic drugs. The medication Symbyax combines the antipsychotic drug olanzapine with the antidepressant fluoxetine and is often diagnosed for bipolar sufferers.
  • Antipsychotics. These drugs are usually prescribed when the symptoms of manic or depressive episodes don’t respond adequately to other medications alone. Commonly prescribed antipsychotics include olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, lurasidone,  or asenapine.
  • Anti-Anxiety Medications. Anti-anxiety drugs such as benzodiazepines are sometimes used to treat anxiety or sleep problems in bipolar sufferers, typically on a short-term basis.

Psychotherapy

Psychotherapy and counseling are often part of the maintenance phase of treatment once the disorder’s symptoms have been successfully controlled with medications. These therapies may help the patient to decrease stress and establish behaviors that help to lessen the impact of symptoms. Psychotherapy alone, however, is rarely enough to control bipolar disorder, and it is almost always used in conjunction with medications.

Substance Abuse Treatment

Because substance abuse is often coincident with bipolar disorder, treatment of the problem is commonly part of the overall treatment plan for bipolar sufferers. Without substance abuse treatment, patients are more likely to be non-compliant with other treatments, and even when the patient is compliant, the treatment of other symptoms may be less effective.

In-Patient Treatment

It is not uncommon for doctors to require hospitalization as a treatment for bipolar disorder, especially in high-risk patients (such as pregnant women) who are experiencing an extreme manic episode. These patients are likely to engage in potentially harmful behavior and are also likely to be non-compliant with treatment plans if left on their own. In some severe cases, doctors may recommend electroconvulsive therapy (ECT) when the mania does not respond to medications.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does Bipolar Disorder Progress?

Most often, the initial onset of bipolar disorder occurs when the sufferer is in his or her late teens or early 20s, although both earlier and later onset can happen. A quarter of those diagnosed with bipolar disorder will experience a manic state as their first symptom, but many more–nearly half–will first experience a depressive state. Because of this, the disorder is often initially misdiagnosed as depression.

After the first episode, almost all sufferers will experience more episodes, and if the disorder is left untreated, episodes are likely to become more frequent and more severe. Every individual experiences the disorder differently, but a typical timeline has the second episode occurring within four years of the first and subsequent episodes occurring about once a year thereafter.

Episodes typically last 3-6 months, but some depressive states may linger for years. In some cases, sufferers may experience what is known as rapid cycling, in which they experience four or more episodes within a single year.

Medication may lessen the number or severity of episodes, and in some rare cases, episodes may cease altogether. There is no known cure for bipolar disorder, however, and in most cases, it must be treated as a life-long illness.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How is Bipolar Disorder Prevented?

The onset of bipolar disorder cannot be prevented, but early recognition of the signs of an episode can help the sufferer to manage the oncoming episode. Recognizing an episode at the earliest possible sign can allow for prompt medical intervention, and intervention, in turn, may prevent the episode from becoming more severe.

It is important for those diagnosed with bipolar disorder to seek a regular evaluation from their mental health providers and to adhere faithfully to any prescribed plan for medication. Treatment of bipolar disorder typically focuses on the prevention or mitigation of future manic or depressive episodes, and proper use of medication is instrumental in preventing episodes or lessening their severity.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Bipolar Disorder Caregiver Tips

The consequences of manic and depressive episodes often affect not only the bipolar sufferer but their family members, friends, and colleagues, as well. Because of this, it is crucial that those close to the sufferer be educated in the symptoms and effects of the disorder so that they are better able to recognize the onset of episodes, to help their loved one deal with the effects of the episode while it is in progress, and to cope with stresses that the disorder can place on relationships.

It can be helpful for family members to participate in family counseling or therapy sessions so that they can learn how to provide support to the patient.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Bipolar Disorder Brain Science

The causes of bipolar disorder and the nature of potentially effective treatments have remained elusive for researchers, but recent studies have begun to shed new light on brain function and chemistry in a way that could soon revolutionize the diagnosis and treatment of the disorder.

  • Researchers have identified a difference in brain activity between sufferers of bipolar disorder and those suffering from major depression. The study used MRI scans to look at the function of the amygdala, a part of the brain that is instrumental in the processing of emotion and found that the left side of the amygdala is less active in people with bipolar disorder than it is in people with depression. This finding could help lessen the misdiagnosis of depression in people who are actually suffering from bipolar disorder.
  • Researchers have found that people with bipolar disorder have generally poorer cognitive abilities such as memory, processing speed, and executive functioning than those without bipolar disorder.
  • A recent study found that people with bipolar disorder who participated in brain-training exercises designed to boost cognitive abilities saw a significant and sustained improvement in their cognitive skills. The hope is that this kind of brain training can help bipolar sufferers to improve their quality of life.
  • An international research team has suggested a connection between a gene called EGR3 and a protein called brain-derived neurotrophic factor (BDNF) which, in normal conditions, helps the brain react effectively to stress. Previous studies have shown that people with bipolar disorder have lower levels of BDNF during manic or depressive episodes, and this new research suggests that it may be possible to develop drugs that will improve the function of EGR3 and BDNF in bipolar sufferers.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Bipolar Disorder Research

Scientists are working on several research projects to expand on what is known about Bipolar Disorder.  The research will improve knowledge about the factors that increase the risk for Bipolar Disorder, as well as the causes, and best treatments, and will aid people living with Bipolar Disorder and their caregivers.

We are currently gathering the information required to support projects.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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