Bipolar disorder, also known asmanic depression, is amental disorderthat causes periods ofdepressionand periods of elevatedmood. The elevated mood is significant and is known asmaniaorhypomania, depending on its severity, or whether symptoms ofpsychosisare present. During mania, an individualbehavesor feelsabnormallyenergetic, happy, or irritable.Individuals often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced during manic phases.During periods of depression, there may be crying, a negative outlook on life, and poor eye contact with others.The risk ofsuicideamong those with the illness is high at greater than 6 percent over 20 years, whileself-harmoccurs in 30–40 percent. Other mental health issues such asanxiety disordersandsubstance use disorderare commonly associated.
The causes are not clearly understood, but bothenvironmentalandgeneticfactors play a role.Many genes of small effect contribute to risk.Environmental factors include a history ofchildhood abuse, and long-termstressThe condition is divided intobipolar I disorderif there has been at least one manic episode, with or without depressive episodes, andbipolar II disorderif there has been at least one hypomanic episode (but no manic episodes) and one major depressive episode. In those with less severe symptoms of a prolonged duration, the conditioncyclothymic disordermay be diagnosed. If due to drugs or medical problems, it is classified separately.Other conditions that may present in a similar manner includeattention deficit hyperactivity disorder,personality disorders,schizophrenia, andsubstance use disorderas well as a number of medical conditions. Medical testingis not required for adiagnosis, though blood tests ormedical imagingcan be done to rule out other problems.
Treatment commonly includespsychotherapy, as well asmedicationssuch asmood stabilizersandantipsychotics. Examples of mood stabilizers that are commonly used includelithiumand variousanticonvulsants. Treatment in ahospitalwithout the individual'sconsentmay be required if a person is at risk to themselves or others but refuses treatment. Severe behavioral problems may be managed with short term antipsychotics orbenzodiazepines. In periods of mania it is recommended thatantidepressantsbe stopped. If antidepressants are used for periods of depression they should be used with a mood stabilizer.Electroconvulsive therapy(ECT) may be helpful for those who do not respond to other treatments. If treatments are stopped, it is recommended that this be done slowly. Many individuals have financial, social or work-related problems due to the illness. These difficulties occur a quarter to a third of the time on average. The risk of death fromnatural causessuch as heart disease is twice that of the general population. This is due to poor lifestyle choices and the side effects from medications.