Bipolar Disorder

What are bipolar disorders?

Bipolar disorder is a long-term chemical imbalance that causes rapid changes in mood and behavior. High moods are called mania. Low moods are called depression. Sometimes you will feel manic and sometimes you will feel depressed. You can have alternating episodes of mania and depression. This is called a mixed bipolar state.

What are the causes and increased risks of bipolar disorder?

Bipolar disorder is caused by a chemical imbalance. You are more likely to have bipolar disorder if someone in your family has a mood disorder. Stress and drug or alcohol abuse are the most common triggers for bipolar disorder symptoms.

Bipolar disorder generally appears to affect men and women equally, although men may be more likely to experience a manic episode as their first episode, while in women, it is more likely to be major depression. Depressive or mixed episodes and rapid cycling are more likely to occur in women. Women with bipolar disorder are at increased risk of developing subsequent episodes during the immediate postpartum period and some women experience their first episode during the postpartum period.

While onset of bipolar disorder can occur at any age, the peak age is between 15 and 24 years and in women onset typically occurs during their teens or early twenties.

How are bipolar disorders diagnosed?

There are no specific diagnostic tests that are used for bipolar disorder. Diagnosis is made by a psychiatrist on the basis of presenting symptoms, ruling out an underlying medical condition, and a patient history.

How are bipolar disorders treated?

An initial psychiatric evaluation is used to assess the patient’s safety and level of functioning, and from that a decision as to the optimal treatment setting may be formulated. Treatment visits will vary considerably, depending on whether the patient is experiencing an acute episode, or if the visit is to be used for maintenance/prevention. The latter regimen is also sometimes referred to as continuation treatment, as patients may remain at particularly high risk of relapse for a period of up to six months after an episode.

Pharmacologic treatment may vary depending on the presentation (e.g., acute mania, depression, maintenance, rapid cycling) and consists of monotherapy or combination therapy with lithium, anticonvulsants, antipsychotics, or antidepressants. Evidence supports the efficacy of psychotherapy for patients with bipolar disorder when combined with pharmacotherapy.

When should I contact my healthcare provider?

• You are having trouble managing your bipolar disorder.
• You cannot sleep, or are sleeping all the time.
• You cannot eat, or are eating more than usual.
• You feel dizzy or your stomach is upset.
• You have questions or concerns about your condition or care.

Call 911 if you are thinking about hurting yourself or someone else.