Bipolar disorder, also known as “manic depression,” is a mental disorder that causes severe episodes of alternating depression and mania (euphoria and excitement). While many people without bipolar disorder experience mood swings, those in people who have the disorder are severe enough to affect their life.

Types of Bipolar Disorder

There are three main categories of bipolar disorder: bipolar 1, bipolar 2, and cyclothymic disorder. Diagnoses for each of these conditions are based on criteria set out by the American Psychiatric Association.

Bipolar 1: A person has had at least one manic or one mixed episode (which includes both depression and mania). The person may or may not have had a major depressive episode.

Bipolar 2: A person has had at least one major depressive episode and at least one hypomanic episode (but not a fully manic or mixed episode). A hypomanic episode is characterized by an elevated or irritable mood that lasts four days or more.

Cyclothymic Disorder:  A person has had numerous hypomanic episodes and periods of depression — but has never had a full manic episode, a major depressive episode, or a mixed episode. For a diagnosis of cyclothymic disorder, symptoms last two years or more (one year in children and adolescents).

What Causes Bipolar Disorder, and Who is at Risk?

According to the Mayo Clinic, the cause of bipolar disorder is unknown. However, there are some factors that can contribute to the triggering of symptoms, including: substance abuse, pregnancy, hormone or chemical imbalances, family history, and periods of extreme emotional stress. Anyone can be at risk for bipolar disorder, although there are certain factors that can increase that risk. For most people who have the disorder, symptoms begin in their early 20s.

What are the Symptoms of Bipolar Disorder?

  • Symptoms of mania tend to last at least a week and include at least four of the following:
  • Euphoria (extreme excitement and happiness)
  • Inflated sense of self-importance
  • Poor judgment and risky behaviors
  • Constant talking or rapid speech
  • Racing thoughts
  • Angry outbursts and aggression
  • Spending sprees
  • Increased energy and physical activity
  • Anxiety
  • Easy distraction
  • Delusions of grandeur and separation from reality (psychosis)

Symptoms of depression may occur over a two-week period, in which the person experiences at least five of the following symptoms:

  • Suicidal thoughts or actions
  • Extreme sadness
  • Hopelessness
  • Guilty feelings
  • Difficulty sleeping or sleeping too much
  • Changes in appetite
  • Loss of interest in previously enjoyed activities
  • Irritability
  • Body aches and pains without other known cause
  • Poor performance at school or work
  • Problems concentrating

What Doctors Look For

Mood swings between mania and depression occur at various levels of frequency, ranging from a few times a year to several times a day. According the Mayo Clinic’s website, “The exact symptoms of bipolar disorder vary from person to person. For some people, depression causes the most problems; for other people, manic symptoms are the main concern. Symptoms of depression and symptoms of mania or hypomania may also occur together. This is known as a mixed episode.”

Treating Bipolar Disorder

Initial treatment during a bipolar episode may include hospitalization in a psychiatric facility. This is especially true if the person is suicidal, at risk for harming others, or in a state of delusion or psychosis. Medication and therapy will be started immediately to bring the episode under control. Once that happens, a more long-term treatment plan can be established. Treatment will usually include both medication to stabilize moods and counseling to help the person manage their symptoms. One of the keys to successful treatment is sticking with the treatment schedule, even once the patient feels better.


It is important for patients taking medications for bipolar disorder to remain under the close supervision of their doctor. These medications often involve a period of trial and error before the ideal combination and dosing is found. Patients should ask about and understand potential side effects of each medication they are prescribed.