Bipolar Disorder Overview

Introduction

Bipolar disorder, formerly called manic-depression, is characterized by moods that swing between two opposite poles:

• Periods of mania with exaggerated euphoria, irritability, or both
• Episodes of depression

Although chemical imbalances in the brain are a key component of bipolar disorder, it is a complex condition that involves genetic, environmental, and other factors.

Bipolar Disorder Categories

Bipolar disorder is classified according to the pattern and severity of the symptoms as bipolar disorder I, bipolar disorder II, or cyclothymic disorder. Patients with one type may develop another. Nevertheless, they are distinct enough to merit separate classifications. Some doctors believe these conditions are actually separate disorders with different biologic factors that account for their differences.

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Bipolar Disorder I. Bipolar disorder I is characterized by at least one manic episode or mixed episode (symptoms of both mania and depression occurring simultaneously), and one or more depressive episodes, that last for at least 7 days. In most cases, manic episodes precede or follow depressive episodes in a regular pattern. Episodes are more acute and severe than in the other two categories.

Without treatment, patients average four episodes of dysregulated mood each year. With mania, either euphoria or irritability may mark the phase. In addition, there are significant negative effects (such as sexual recklessness, excessive and impulsive shopping, and sudden traveling) on a patient's social life, performance at work, or both. Untreated mania lasts at least a week, and it can last for months. Typically, depressive episodes tend to last 6 - 12 months, if left untreated.

Bipolar Disorder II. Bipolar disorder II is characterized by episodes of predominantly major depressive symptoms, with occasional episodes of hypomania, which last for at least 4 days. Hypomania is similar to mania, but the symptoms (typically euphoria) are less severe and do not last as long.

Patients with bipolar disorder II do not experience manic or mixed episodes, and most return to fully functional levels between episodes. However, these patients have a more chronic course, significantly more depressive episodes, and shorter periods of being well between episodes than patients with bipolar disorder I. Bipolar II disorder is highly associated with the risk for suicide.