Week 8: Bipolar Disorder

Bipolar disorder, formerly called manic depression, causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

There are several types of bipolar and related disorders. For each type, the exact symptoms of bipolar disorder can vary from person to person.

Bipolar I disorder. You've had at least one manic episode. The manic episode may be preceded by or followed by hypomanic or major depressive episodes. Mania symptoms cause significant impairment in your life and may require hospitalization or trigger a break from reality.

Bipolar II disorder. You've had at least one major depressive episode lasting at least two weeks and at least one hypomanic episode lasting at least four days, but you've never had a manic episode. Major depressive episodes or the unpredictable changes in mood and behavior can cause distress or difficulty in areas of your life.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing bipolar and related disorders.

Criteria for a manic or hypomanic episode

•       A manic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood that lasts at least one week (or less than a week if hospitalization is necessary). The episode includes persistently increased goal-directed activity or energy.

• •      A hypomanic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood that lasts at least four consecutive days.

Signs and symptoms include:

•   Inflated self-esteem or grandiosity

•   Decreased need for sleep (for example, you feel rested after only three hours of sleep)

•   Unusual talkativeness

•   Racing thoughts

•   Distractibility

•   Increased goal-directed activity (either socially, at work or school, or sexually) or agitation

Doing things that are unusual and that have a high potential for painful consequences — for example, unrestrained buying sprees, sexual indiscretions or foolish business investments

Symptoms in children and teens

The same DSM-5 criteria used to diagnose bipolar disorder in adults are used to diagnose children and teenagers. Children and teens may have distinct major depressive, manic or hypomanic episodes, between which they return to their usual behavior, but that's not always the case. And moods can rapidly shift during acute episodes.

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, or signs of a mental health problem other than bipolar disorder. And children who have bipolar disorder are frequently also diagnosed with other mental health conditions.

    The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

•   Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.

•   Neurotransmitters. An imbalance in naturally occurring brain chemicals called neurotransmitters seems to play a significant role in bipolar disorder and other mood disorders. 
 Inherited traits. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

•   Having a first-degree relative, such as a parent or sibling, with bipolar disorder

•   Periods of high stress

•   Drug or alcohol abuse

•   Major life changes, such as the death of a loved one or other traumatic experiences