Bipolar disorder

Bipolar disorder is a mental health condition that causes extreme mood changes, from times of very high energy (manic episodes) to times of depression. These moods can be so extreme that it's hard to function at work, in school, and with family and friends. There's no cure, but medicines and counseling can help.

The different types of bipolar disorder are based on things like how often a person has symptoms and how severe the symptoms are.

Bipolar I.

This form includes having at least one episode of mania. It also may include episodes of depression. Depression is common with this form, but you can still be diagnosed even if you haven't had depression.

Bipolar II.

With this form, the manic highs are less severe. These are called hypomanic episodes. People with bipolar II have both hypomanic and depressive episodes.

Cyclothymia.

The high and low mood swings aren't as severe as in bipolar I or bipolar II.

Other types.

There are a few other types of bipolar disorder. For example, bipolar disorder caused by taking a medication or using a substance is one type. Bipolar disorder caused by another medical condition is another example.

The cause of bipolar disorder isn't completely understood. There are likely many factors involved. It tends to run in families. You are at greater risk of having bipolar disorder if a close family member has it.

The symptoms depend on your mood swings, or highs and lows. During a manic high, you may feel:

• Very happy, energetic, or on edge.
• Like you need very little sleep.
• Overly self-confident.

Some people spend a lot of money or get involved in dangerous activities when they are manic. After a manic episode, you may return to normal. Or your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness.

During a depressive episode, or low, you may have:

• Trouble thinking and making decisions.
• Memory problems.
• Less interest in things you have enjoyed in the past.
• Thoughts about killing yourself.

The mood swings of bipolar disorder can be mild or extreme. They may come on slowly over several days or weeks or suddenly over a few minutes or hours. These mood swings may last for a few hours or for several months.

Bipolar disorder can be hard to diagnose. This is because it has many phases and the symptoms overlap with other mental health conditions.

To find out if you have bipolar disorder, your doctor will ask detailed questions about your symptoms. You will be asked how long your symptoms last and how often you have them. Your doctor will ask about your family history.

Blood and urine tests, such as a test of your thyroid, may be done to make sure another problem isn't causing your symptoms. A toxicology screen looks at blood, urine, or hair for the presence of drugs.

The earlier the condition is diagnosed, the sooner you can get treatment, feel better, and improve the quality of your life. This can also reduce your risk of other health conditions, such as substance use disorder.

Bipolar disorder is treatable. A treatment plan can make you feel better.

You may need to try several medicines to find the best combination.

• Most people with bipolar disorder need to take a medicine called a mood stabilizer every day.
• Antipsychotic medicine can help get a manic phase under control.
• Antidepressants are used carefully for episodes of depression. They cause some people to move into a manic phase.

Counseling is also an important part of treatment. It can help you cope with some of the work and relationship issues that the condition may cause.

You can do a few things on your own. These include getting enough sleep and learning to recognize the early signs of highs and lows. Exercise may also help with depressive symptoms.

People often stop taking their medicines during a manic phase because they feel good. But this is a mistake. Take your medicines regularly, even if you're feeling better.

Almost all people who have bipolar disorder need medicine. But counseling is also important. It helps you cope with work and relationship struggles related to the condition. Types of counseling include:

• Cognitive behavioral therapy. It's aimed at teaching you how to become healthier by changing certain thought and behavior patterns.
• Interpersonal therapy. This type of counseling focuses on social and personal relationships and related problems.
• Problem solving. This focuses on specific problems and how you can solve them.
• Family therapy. It lets each person express any concerns and fears about how the problem affects the person who has bipolar disorder and the family as a whole.

Try to form a long-term relationship with a counselor you like. They will help you recognize personality changes that show when you are moving into a mood swing. Getting early treatment can reduce the length of the high or low.

Medicines can help control bipolar mood swings. Your doctor will vary the amounts and combinations of your medicines based on:

• Your symptoms.
• Which type of bipolar disorder you have.
• How you respond to the medicines.

Medicine choices

Several medicines are used to treat bipolar disorder. The most common ones used are:

• Mood stabilizers, such as lithium. A mood stabilizer and an antipsychotic are recommended as the first medicines for acute manic episodes.
• Anticonvulsants. These include carbamazepine, divalproex, and valproate.
• Antipsychotics. These include aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone. They improve manic episodes.
• Benzodiazepines. An example is diazepam.

Monitoring medicines

You'll need to check in with your doctor regularly when taking medicines for bipolar disorder. You may need regular blood tests to watch the amount of medicine in your blood.

The use of antidepressants alone has been linked to an increase in manic episodes. Antidepressant treatment needs to be monitored closely to avoid causing a manic episode.

If anyone in your family has been diagnosed with bipolar disorder, your risk of having it is higher. Bipolar disorder can be passed down through families.

If you have bipolar disorder, there are some things you can do to help prevent a manic episode. These include:

• Learning the early warning signs of a manic episode. Watch for signs like needing less sleep and feeling happier or grouchier than usual.
• Keeping track of your moods in a daily journal or on a calendar.
• Sticking with a daily routine. For example, eat meals at the same time each day.
• Trying to reduce your stress.
• Going to counseling.
• Taking your medicines as prescribed.