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Also known as manic depressive illness, bipolar disorder is characterized by severe and disabling highs (mania) and lows (depression). Affecting 2.2 million Americans, this illness typically begins in adolescence or early adulthood and continues throughout life, with 80% of patients experiencing multiple manic episodes and 15% ending their lives in suicide. However, effective medical treatments are available, and new research is constantly expanding the range of possible treatment options. With proper treatment, most people with bipolar disorders are able to lead fulfilling and productive lives.

Bipolar Disorder is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. It is distinguished from Schizoaffective Disorder by the absence of psychotic symtoms (such as delusions, halucinations) during periods of stable mood.

Bipolar Disorder is really a spectrum of disorders. Bipolar I disorder is characterized by a history of at least one manic episode, and (usually) depressive episodes. Bipolar II disorder is characterized by hypomanic episodes alternating with depressive episodes. Cyclothymia is characterized by highs which fulfil some but not all criteria for hypomania and lows which fulfil some but not all criteria for depression.

A. A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting for at least one week (or any duration if hospitalization is necessary).

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

 

  1. inflated self-esteem or grandiosity
  2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
  3. more talkative than usual or pressure to keep talking
  4. flight of ideas or subjective experience that thoughts are racing
  5. distractibility (i.e., attention is easily drawn to unimportant or irrelevant external stimuli)
  6. increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
  7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The symptoms do not meet criteria for a Mixed Episode

D. The mood disturbance is sufficiently severe to cause marked impairement in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.

http://www.bipolar.org/

 

Hypomanic episode

A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood.

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:

  1. inflated self-esteem or grandiosity
  2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
  3. more talkative than usual or pressure to keep talking
  4. flight of ideas or subjective experience that thoughts are racing
  5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
  6. increase in goal-directed activity (either socially, at work or school, sexually) or psychomotor agitation
  7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic

D. The disturbance in mood and the change in functioning are observable by others.

E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.

F. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder.

 

Major Depressive Episode

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood; social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. A major depressive episode is also characterized by the presence of a majority of these symptoms:

  1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, this can be irritable mood.
  2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observations made by others)
  3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: in children, consider failure to make expected weight gains.
  4. insomnia or hypersomnia nearly every day
  5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
  6. fatigue or loss of energy nearly every day
  7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
  8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
  9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a mixed episode.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor dysfunction.

 

http://www.stanford.edu/

Edited by Lindsay
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  • 1 year later...

Thank you for the post Lindsay. It is so important to be aware of your symptoms so you can detect any episodes quickly and be able to get treatment when things go from bad to worse. I had an appointment a couple weeks ago and she recognized I was hypomanic. By being aware that I was easily distracted, I was talking fast and finding it difficult to doze off we believe we stopped a major episode in it's tracks

She (my psychiatrist) said that their was three options:

1) I'd be hypomanic for 8 weeks then have a depression

2) A full blown manic episode would take place and a major depression would return

3) Upped my medication for a bit just to get over the hypo and then return it to normal...No manic episode, no depression. We kept in touch and brainstormed together and averted serious illness

Episodes of "highs" LEAD to depression as a result ! So many people in here say they enjoy the benefits of the highs but it is a poor long term strategy. It is my experiential advice to become aware and do your best to treat symptoms before they move for the worst

Using a manic episode to be a confident social butterfly is taking the "get rich quick" way out and leads to poor health...but I will say I believe, in general, that the goal is attainable in a healthy way

Cheers

GC

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  • 2 months later...
  • 1 year later...

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Bipolar disorder cannot be cured, but it can be treated effectively over the long-term. Proper treatment helps many people with bipolar disorder—even those with the most severe forms of the illness—gain better control of their mood swings and related symptoms. But because it is a lifelong illness, long-term, continuous treatment is needed to control symptoms. However, even with proper treatment, mood changes can occur. In the NIMH-funded Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study—the largest treatment study ever conducted for bipolar disorder—almost half of those who recovered still had lingering symptoms. Having another mental disorder in addition to bipolar disorder increased one's chances for a relapse. See step bd for more information.

Treatment is more effective if you work closely with a doctor and talk openly about your concerns and choices. An effective maintenance treatment plan usually includes a combination of medication and psychotherapy.

Only Child Syndrome

Edited by Roshedwardd
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  • 3 weeks later...

I'm a high schooler who really has no idea if I have any sort of disorder or if I'm just a relatively emotional person. I've been reading about depression, bipolar disorder, and anxiety disorders to try to pinpoint what exactly I might have. I think I could possibly have type II bipolar disorder because I definitely have depressive episodes but sometimes I feel completely fine. I realize I worry a lot about unnecessary things and I stress myself out for no reason, and I also get frustrated or irritated really easily if Im in a bad mood. If I do have something, I don't feel like I can tell my parents because I don't know how to bring it up; they've never seen me really depressed before and as far as they're concerned I'm a completely normal kid. The only person that knows about my issues is my ex boyfriend who recently broke up with me and I feel like I can no longer talk to him about it. What should I do?

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I'm a high schooler who really has no idea if I have any sort of disorder or if I'm just a relatively emotional person. I've been reading about depression, bipolar disorder, and anxiety disorders to try to pinpoint what exactly I might have. I think I could possibly have type II bipolar disorder because I definitely have depressive episodes but sometimes I feel completely fine. I realize I worry a lot about unnecessary things and I stress myself out for no reason, and I also get frustrated or irritated really easily if Im in a bad mood. If I do have something, I don't feel like I can tell my parents because I don't know how to bring it up; they've never seen me really depressed before and as far as they're concerned I'm a completely normal kid. The only person that knows about my issues is my ex boyfriend who recently broke up with me and I feel like I can no longer talk to him about it. What should I do?

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  • 8 months later...

@thebaker2 i can totally relate to you. Sometimes i feel like im making all this up in my head. That im depressed or bipolar. But sometimes it feels so real. I feel so empty just want go to the bathroom and cry my eyes out. I cannot tell my family, they dont belive in things like depression they will just ask me to snap out it. But im not even sure if i do have something. I have all the symptons of depression except trying to **** myself or hurt myself. I have absoultly no idea what to do and who to talk to.

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  • 1 year later...

@thebaker2 I can also relate to you. I'm experiencing mood swings but I don't know whether this is bipolar. My mood swings are happening within seconds without any particular reason. I can't express or share my feelings with anyone. Basically, I'm an introvert and I don't have many friends, I don't want either. But I want to get rid of my racing thoughts and negative feelings. I need a change. 

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