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Bipolar Disorder

What is bipolar disorder?
Bipolar disorder (formerly called manic depressive illness) is a condition of the brain that causes extreme changes in a person’s mood, energy, thinking and behavior. People with bipolar disorder have periods (or episodes) of mania and depression.

Manic Episodes: An episode of mania includes a period where a person’s mood has changed and is elevated (overly happy) or very irritable and the person also has increased energy at the same time.

Depressive Episodes: People who have bipolar disorder may also experience periods of depression. An episode of depression can include a low, depressed, or irritable mood.

What causes bipolar disorder?
Brain Structure and Functioning: Some studies indicate that the brains of people with bipolar disorder may differ from the brains of people who do not have bipolar disorder or other mental health condition. Learning more about these differences may help scientists understand bipolar disorder and determine which treatments will work best. Currently, health care providers base the diagnosis and treatment plan on a person’s symptoms and history, rather than brain imaging or other diagnostic tests.

Genetics: Some research suggests that people with certain genes are more likely to develop bipolar disorder. Research also shows that people who have a parent or sibling with bipolar disorder have an increased chance of having the disorder themselves. Many genes are involved, and no one gene can cause the disorder. Learning more about how genes play a role in bipolar disorder may help researchers develop new treatments.

What are some symptoms of bipolar disorder?
People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviors—often without recognizing their likely harmful or undesirable effects. These distinct periods are called “mood episodes.”

Mood episodes in bipolar disorder can last for days, weeks, or even months. According to the official criteria for bipolar disorder, manic episodes last at least a week, whereas depression episodes last for at least two weeks. People with bipolar disorder can also have shorter periods of strong feelings, even if these are not identified as major mood episodes. The length of each episode depends on many factors including the individual’s history, supports and stressors in their life, and in particular, whether they receive effective treatment.

Symptoms of a Manic Episode may include:

  • Unrealistic highs in self-esteem - for example, feeling all-powerful or like a superhero with special powers
  • Distractibility – a person’s attention moves constantly from one thing to the next
  • Increase in talking - talking too much, too fast, changing topics too quickly, and refusing to be interrupted
  • Great increase in energy
  • Loss of appetite
  • Decreased need for sleep such as being able to go with little or no sleep for days without feeling tired
  • Thinking more quickly - for example, thoughts are on “fast forward”
  • Poor judgment, spending or giving away money
  • Repeated high risk-taking behavior, such as abusing alcohol and drugs, reckless driving, or sexual promiscuity

General symptoms of a Depressive Episode may include:

  • Decreased enjoyment of favorite activities, decreased or absent sex drive, inability to experience pleasure
  • Low energy level or fatigue
  • Major change in eating habits such as increased appetite and/or weight gain
  • Feels unable to do even the simplest of tasks, e.g., brushing teeth, changing clothes
  • Talking very slowly, feeling like they have nothing to say, forgetful
  • Major changes in sleeping patterns, such as oversleeping or difficulty falling asleep
  • Poor concentration
  • Thoughts of death or suicide

Other symptoms of a Depressive Episode more common in children or adolescents may include:

  • Complaints of boredom
  • Major change in eating habits such as decreased appetite, failure to gain weight or overeating
  • Frequent complaints of physical illnesses such as headaches or stomach aches
  • Decreased enjoyment of favorite activities, playing with friends

Can bipolar disorder be treated?
Proper diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a doctor or other licensed health care provider is the first step. The health care provider can complete a physical exam and order necessary medical tests to rule out other conditions. The health care provider may then conduct a mental health evaluation or provide a referral to a trained mental health care provider, such as a psychiatrist, psychologist, counselor, or clinical social worker who has experience in diagnosing and treating bipolar disorder.

Mental health care providers usually diagnose bipolar disorder based on a person’s symptoms, lifetime history, experiences, and, in some cases, family history. Accurate diagnosis in youth is particularly important.

Treatment can help many people, including those with the most severe forms of bipolar disorder. An effective treatment plan usually includes a combination of medication and psychotherapy, also called “talk therapy.”

Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment can help people manage these symptoms. Some of these treatments might include:

  • Medications
  • Psychotherapy or “Talk Therapy”, like Cognitive Based Therapy, an Evidence-Based Practice
  • Other non-medication treatments may be available from your provider

Other Common Co-occurring Conditions

Bipolar Disorder – not to be confused with Borderline Personality Disorder in Young People

For more information about Borderline Personality Disorder (BPD) visit www.AACAP.org.

 

Transportation
Nonemergency transportation for medical and behavioral appointments is available for Apple Health (Medicaid) members. For more information, visit:  HCA.WA.Gov/Transportation-Help.