Bipolar Disorder

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Bipolar disorder is a mental health condition marked by extreme swings in mood, energy and the ability to function. The two mood extremes of bipolar disorder are mania and depression. In mania, one of the defining symptoms is an increase in energy and a decreased need for sleep. In depression, a down mood with fatigue takes over, often accompanied by irritability.

There are four forms of this condition:

  • Bipolar I disorder: Recurrent episodes of mania often immediately followed by depression; episodes can be severe.
  • Bipolar II disorder: Episodes of less severe mania (called hypomania) that alternate with episodes of major depression.
  • Bipolar disorder not otherwise specified (BP-NOS): The person has symptoms of bipolar disorder, but the symptoms don’t meet the specific criteria for bipolar I or II disorder
  • Cyclothymia: Episodes of hypomania that alternate with episodes of mild depression that last for at least two years

This condition tends to run in families, and specific genes may play a role.


Mania may cause:

  • A mood that is extremely high or overly good
  • Increased energy and effort toward goal-directed activities
  • Restlessness and agitation
  • Racing thoughts, jumping from one idea to another
  • Rapid speech or pressure to keep talking
  • Trouble concentrating
  • Decreased need for sleep
  • Overconfidence or inflated self-esteem
  • Poor judgment, often involving spending sprees and sexual indiscretions

Depression may cause:

  • Prolonged sad, hopeless or empty mood
  • Feelings of guilt, worthlessness or helplessness
  • Loss of interest or pleasure in activities once enjoyed, including sex
  • Decreased energy or fatigue
  • Trouble concentrating, remembering and/or making decisions
  • Restlessness or diminished movements
  • Agitation
  • Sleeping too much or too little
  • Unintended weight loss or gain
  • Thoughts of death or suicide with or without suicide attempts

Severe episodes of mania or depression may sometimes be associated with psychotic symptoms, such as:

  • Hallucinations
  • Delusions
  • Disorders of thought


Your doctor can diagnosis you with mania if your:

  • Mood is elevated and there are three or more manic symptoms
    • If the mood is irritable, not elevated, four symptoms must be present for a diagnosis of mania
  • Symptoms last for most of the day, nearly every day, for one week or longer
  • Symptoms cause problems in day-to-day functioning

Your doctor can diagnosis a depressive episode if:

  • There are five or more of the depressive symptoms
  • Symptoms last for most of the day, nearly every day, for a period of two weeks or longer
  • Symptoms cause problems in day-to-day functioning



Mood stabilizers are a primary source of treatment. There are many different types and combinations of medications, which your doctor tailors to target your symptoms. You may require treatment throughout your life. 


Therapy may include:

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) may be effective when medications fail. It can be used for both mania and depression.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.