The condition is characterized by intermittent episodes of mania and/or depression, with an absence of symptoms in between. Late adolescence and early adulthood are peak years for the onset of bipolar disorder. Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as coronary heart disease in people with bipolar disorder is twice that of the general population. Bipolar disorder is among the top 20 causes of disability worldwide and leads to substantial costs for society. Around one-quarter to one-third of people with bipolar disorder have financial, social or work-related problems due to the illness. Interest in functioning in the assessment of patients with bipolar disorder is growing, with an emphasis on specific domains such as work, education, social life, family, and cognition. Symptoms most commonly begin between the ages of 20 and 25 years old an earlier onset in life is associated with a worse prognosis. In the United States, about 3% are estimated to be affected at some point in their life rates appear to be similar in females and males. īipolar disorder occurs in approximately 1% of the global population. Admission to a psychiatric hospital may be required if a person is a risk to themselves or others involuntary treatment is sometimes necessary if the affected person refuses treatment.
Electroconvulsive therapy (ECT) is effective in acute manic and depressive episodes, especially with psychosis or catatonia. The treatment of depressive episodes, therefore, is often difficult. The use of antidepressants in depressive episodes is controversial: they can be effective but have been implicated in triggering manic episodes. There is some evidence that psychotherapy improves the course of this disorder. In patients where compliance is of concern, long-acting injectable formulations are available. Antipsychotics are additionally given during acute manic episodes as well as in cases where mood stabilizers are poorly tolerated or ineffective. Mood stabilizers- lithium and certain anticonvulsants such as valproate and carbamazepine as well as atypical antipsychotics such as aripiprazole-are the mainstay of long-term pharmacologic relapse prevention. Medical testing is not required for a diagnosis, though blood tests or medical imaging can rule out other problems. Other conditions that have overlapping symptoms with bipolar disorder include attention deficit hyperactivity disorder, personality disorders, schizophrenia, and substance use disorder as well as many other medical conditions. If these symptoms are due to drugs or medical problems, they are not diagnosed as bipolar disorder.
The condition is classified as bipolar I disorder if there has been at least one manic episode, with or without depressive episodes, and as bipolar II disorder if there has been at least one hypomanic episode (but no full manic episodes) and one major depressive episode. Environmental risk factors include a history of childhood abuse and long-term stress. Genetic factors account for about 70–90% of the risk of developing bipolar disorder. Many genes, each with small effects, may contribute to the development of the disorder. While the causes of bipolar disorder are not clearly understood, both genetic and environmental factors are thought to play a role. Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder. The risk of suicide is high over a period of 20 years, 6% of those with bipolar disorder died by suicide, while 30–40% engaged in self-harm. During periods of depression, the individual may experience crying and have a negative outlook on life and poor eye contact with others. There is usually also a reduced need for sleep during manic phases.
During mania, an individual behaves or feels abnormally energetic, happy or irritable, and they often make impulsive decisions with little regard for the consequences. If the elevated mood is severe or associated with psychosis, it is called mania if it is less severe, it is called hypomania.
Lithium, antipsychotics, anticonvulsants īipolar disorder, previously known as manic depression, is a mood disorder characterized by periods of depression and periods of abnormally-elevated happiness that last from days to weeks each. Periods of depression and elevated mood īipolar I disorder, bipolar II disorder, others įamily history, childhood abuse, long-term stress Īttention deficit hyperactivity disorder, personality disorders, schizophrenia, substance use disorder Bipolar affective disorder (BPAD), bipolar illness, manic depression, manic depressive disorder, manic–depressive illness (historical), manic–depressive psychosis, circular insanity (historical), bipolar disease īipolar disorder is characterized by episodes of depression and mania.