We all have our good days and our bad days. We even can go through periods when everything seems to be going our way, only to have setbacks that make us feel defeated. But the difference between normal highs and lows and a diagnosis of bipolar disorder is the duration and severity of mood swings and a pattern of how they play out.
Bipolar disorder, sometimes known as manic-depressive illness, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The symptoms of bipolar disorder are severe and can result in damaged relationships, poor job or school performance, and even suicide. It’s important for us to understand how bipolar disorder is defined and what bipolar episodes look like before we can recognize them and get help for ourselves or for someone who is suffering.
About 5.7 million American adults, or about 2.6 percent of the population age 18 and older, in any given year have bipolar disorder.
Bipolar I. You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
Bipolar II. You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.
When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.
Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both manic and hypomanic episodes include three or more of these symptoms:
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
Although bipolar disorder can occur at any age, typically it’s diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.
Bipolar disorder in teens and children Symptoms of bipolar disorder can be difficult to identify in children and teens. It’s often hard to tell whether these are normal ups and downs, the results of stress or trauma, hormonal fluctuations or signs of another mental health problem.
Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.
When to see a doctor Despite the mood extremes, people with bipolar disorder often don’t recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don’t get the treatment they need. A person may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave them depressed, worn out – and perhaps in financial, legal or relationship trouble.
If you (or someone you love) have any symptoms of depression or mania, you should see a doctor or mental health professional. Bipolar disorder doesn’t get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.
Take thoughts of suicide very seriously and seek help immediately. Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number – in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Remember, there are no do-overs for suicide!