What is Bipolar Disorder?

Bipolar disorder is a common mood disorder which is characterized by extremes of mood from depression to mania. It effects about 3% of the population and in its more severe form is equally common in men and women. It is distinct from major depression. The latter is characterized by bouts of severe depression. In contrast in bipolar disorder there are episodes of marked mood elevation along with periods of deep depression.

What do we mean by mood elevation? These are episodes of either hypomania or mania.

In mania there is a period usually lasting weeks to months of euphoric mood, a grandiose unrealistic sense of self, combined with high energy, a reduced amount of sleep, less need for sleep, talking a lot, a sense of pressure to keep talking, racing thoughts, hyperactivity, distractibility, and disinhibition with risky behaviors suck as overspending, sexual indiscretions or driving recklessly. Sometimes the mood is not euphoric but rather angry and highly irritable causing a lot of distress to those around the patient.

At the far extremes of severe mania there can be grandiose delusions (such has “I will be a billionaire soon” or “God has sent me on a mission to save the world”). This is called mania with psychosis. Distinct from mania, a much more subtle of bipolar disorder, is the occurrence of milder high states called hypomania. In these situations, the mood elevation is more attenuated and may last for relatively short periods such as a week. However, it not simply normal happiness. The symptoms are the same as with mania but they are not as extreme. There is a clear change in functioning that is apparent to friends and family members.

The person may feel they are doing just fine but they are not. Another clue is these periods of acceleration are often followed by depression. Recurrent periods of mania and depression are called Bipolar I and recurrent periods of hypomania and depression are called Bipolar II.