Bipolar affective disorder
Key points
- The disorder usually appears around the age of 25 and affects men and women equally.
- Bipolar affective disorder results in pathological mood swings from mania to depression, which have a tendency to recur and subside spontaneously.
- Note: Manic and depressive symptoms may occur simultaneously or in quick succession in what is called a mixed state.
- A psychiatric history of mood swings and observation of current behavior and mood are critical in diagnosing this disorder.
Alternative names
Bipolar disorder; Manic depressive illness
Definition
Bipolar affective disorder is a mood disorder characterized by mood swings from mania (exaggerated feeling of well-being, stimulation, and grandiosity in which a person can lose touch with reality) to depression (overwhelming feelings of sadness, anxiety, and low self-worth, which can include suicidal thoughts and suicide attempts).
Causes, incidence, and risk factors
The disorder usually appears around the age of 25 and affects men and women equally. Children are rarely affected. The cause is unknown, but genetics do seem to be involved. Relatives of people with bipolar affective disorder and depression are more likely to be affected.
There are different types of bipolar affective disorder. Bipolar I is the classic form of the condition, with discrete periods of mania alternating with depression. In a person with bipolar II, the depressive phase predominates and there is no true mania. There may be periods of elevated mood and energy in which the person doesn't completely lose touch with reality (hypomania).
People with bipolar II may appear to have depression rather than bipolar affective disorder (especially since few people complain about periods of good mood and energy that don't cause problems), but mood stabilizers seem to help more than antidepressants.
Symptoms
Bipolar affective disorder results in pathological mood swings from mania to depression, which have a tendency to recur and subside spontaneously. Either the manic or the depressive episodes can predominate and produce few mood swings, or the patterns of mood swings may be cyclic, often starting with mania that ends in a crash into deep depression.
Some people are known as rapid cyclers because their mood may change several times a day. Others have what are called "mixed states," where depressed thoughts can intrude on an episode of mania, or vice versa. When bipolar affective disorder occurs in children, it usually appears as mixed states.
In the depressive phase:
- loss of self-esteem
- withdrawal
- feelings of helplessness or worthlessness
- excessive or inappropriate guilt
- fatigue (tiredness or weariness) lasting for weeks to months
- overwhelming sluggishness (inertia)
- persistent daytime sleepiness
- insomnia
- difficulty concentrating, easily distracted by inconsequential event(s)
Written and revised by
Andrey Nailor, M.D.
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