Bipolar disorder, also referred to as manic depression, is a disorder of mood that affects adults most often but also occurs in adolescents and children. It is a brain disorder that causes unusual swings in mood, energy, and the ability to function. Bipolar disorder can cause significant impairment of quality of life for patients, their family and friends, and can also affect performance at work and in school. The World Health Organization ranks bipolar disorder as the sixth most important cause of disability in young adults.
In the course of everyday life, we all experience "ups" where we may feel good, productive, optimistic, and happy, and "downs" where we may feel sad, discouraged, or "down on ourselves". We generally do not get mired down in the "down" period and it usually passes in a timely fashion. Bipolar disorder, however, is far more than experiencing the normal ups and downs of everyday life. The moods themselves are much more intense and are called mania and depression and the shifts between moods are extreme. The degree of severity, intensity, and frequency of mood and mood shifts varies with each individual, but in all cases, they are disruptive to relationships, the work/school environment, and quality of life.
Mania and Depression in Bipolar Disorder
Mania, or a manic episode, is defined by the American Psychiatric Association (APA) as a period of at least one week of elevated, euphoric, irritable, or expansive mood, accompanied by at least 3 of the following:
- Inflated self-esteem or grandiosity
- Increased energy levels
- Decreased need for sleep
- Increased talkativeness or pressured speech
- Racing thoughts or flight of ideas
- Distractibility
- Increased activity or psychomotor agitation
- Excessive involvement in pleasurable activities that have high potential for painful consequences
In addition, to meet the criteria of a manic episode, the mood disturbance must cause a significant impairment of occupational and social functioning as well as either:
- Necessitate hospitalization for the safety of the patient or people close to the patient
- Include psychotic features of delusions or hallucinations.
The symptoms cannot be related to other any medical condition or be the result of medication side effects or substance abuse.
Depression, or a depressive episode is defined by the APA as at least a two-week period with depression or irritable mood, diminished interest, loss of pleasure in most activities, or a change from previous functioning, plus at least 4 of the following:
- Feelings of worthlessness or inappropriate guilt (may be accompanied by delusions)
- Sleep disturbance (increased or decreased amount)
- Fatigue or loss of energy
- Decreased concentration or indecisiveness
- Significant weight loss without dieting, weight gain, or change in appetite
- Psychomotor agitation that is noticeable by other people
- Suicidal ideation or thoughts of death in general
In addition, in order to meet the criteria of a depressive episode, the symptoms must cause significant impairment of social and occupational functioning, must not be related to any other medical condition, must not be due to side-effects of medication or substance abuse, and must not be accounted for by bereavement.
