Bipolar disorder

Bipolar disorder (BD), previously known as manic depression, is a <a href="/facts/Mental_disorder/EPNjFtFf">mental disorder</a> characterized by periods of <a href="/facts/Depression_(mood)/GDNFWm1L">depression</a> and periods of abnormally elevated <a href="/facts/Mood_(psychology)/mnozVozL">mood</a> that each last from days to weeks, and in some cases months. If the elevated mood is severe or associated with <a href="/facts/Psychosis/cVGd7MKK">psychosis</a>, it is called <a href="/facts/Mania/qYV8BBbt">mania</a>; if it is less severe and does not significantly affect functioning, it is called <a href="/facts/Hypomania/ruB9Uwrx">hypomania</a>. During mania, an individual behaves or feels abnormally energetic, happy, or irritable, and they often make impulsive decisions with little regard for the consequences. There is usually, but not always, a <a href="/facts/Sleep_deprivation/uAUkKVEM">reduced need for sleep</a> during manic phases. During periods of depression, the individual may experience crying, have a negative outlook on life, and demonstrate poor eye contact with others. The risk of <a href="/facts/Suicide/j92cWcay">suicide</a> is high. Over a period of 20 years, 6% of those with bipolar disorder died by suicide, with about one-third <a href="/facts/Suicide_attempt/IR36s6vF">attempting suicide</a> in their lifetime. Among those with the disorder, 40–50% overall and 78% of adolescents engaged in <a href="/facts/Self-harm/CKkaTnjK">self-harm</a>. Other mental health issues, such as <a href="/facts/Anxiety_disorder/wh9zFH1V">anxiety disorders</a> and <a href="/facts/Substance_use_disorder/pSbdzb6a">substance use disorders</a>, are commonly associated with bipolar disorder. The global prevalence of bipolar disorder is estimated to be between 1–5% of the world's population.
While the causes of this <a href="/facts/Mood_disorder/Y0Mjq3QR">mood disorder</a> are not clearly understood, both <a href="/facts/Genetics/bu8wne0A">genetic</a> and <a href="/facts/Environmental_factor/T6FvWue8">environmental</a> factors are thought to play a role. <a href="/facts/Heritability/REQ3CfRe">Genetic factors</a> may account for up to 70–90% of the risk of developing bipolar disorder. Many genes, each with small effects, may contribute to the development of the disorder. Environmental risk factors include a history of <a href="/facts/Childhood_abuse/Ed2v0ujQ">childhood abuse</a> and long-term <a href="/facts/Stress_(psychological)/eqat8pq9">stress</a>. The condition is classified as <a href="/facts/Bipolar_I_disorder/YWtzmKGI">bipolar I disorder</a> if there has been at least one manic episode, with or without depressive episodes, and as <a href="/facts/Bipolar_II_disorder/KBjuwHyT">bipolar II disorder</a> if there has been at least one hypomanic episode (but no full manic episodes) and one major depressive episode. It is classified as <a href="/facts/Cyclothymia/rkMeAubX">cyclothymia</a> if there are hypomanic episodes with periods of depression that do not meet the criteria for major depressive episodes.
If these symptoms are due to drugs or medical problems, they are not diagnosed as bipolar disorder. Other conditions that have overlapping symptoms with bipolar disorder include <a href="/facts/Attention_deficit_hyperactivity_disorder/uSqjIyhd">attention deficit hyperactivity disorder</a>, <a href="/facts/Personality_disorder/SxFnlSEW">personality disorders</a>, <a href="/facts/Schizophrenia/FMP4lQ57">schizophrenia</a>, and <a href="/facts/Substance_use_disorder/pSbdzb6a">substance use disorder</a> as well as many other medical conditions. <a href="/facts/Medical_test/rRgnuQSD">Medical testing</a> is not required for a <a href="/facts/Diagnosis/VcsPwshd">diagnosis</a>, though <a href="/facts/Blood_tests/zevsf3rC">blood tests</a> or <a href="/facts/Medical_imaging/pL6JyJEp">medical imaging</a> can rule out other problems.
<a href="/facts/Mood_stabilizer/9sj4E0wx">Mood stabilizers</a>, particularly <a href="/facts/Lithium_(medication)/G6Gy0nJU">lithium</a>, and certain <a href="/facts/Anticonvulsant/uR8cxJbj">anticonvulsants</a>, such as <a href="/facts/Lamotrigine/mRmmMuj2">lamotrigine</a> and <a href="/facts/Valproate/q31XYzd9">valproate</a>, as well as atypical antipsychotics, including <a href="/facts/Quetiapine/hI3hPqEH">quetiapine</a>, <a href="/facts/Olanzapine/8BhqJuPM">olanzapine</a>, and <a href="/facts/Aripiprazole/A6g2UwMz">aripiprazole</a> are the mainstay of long-term pharmacologic relapse prevention. <a href="/facts/Antipsychotic/7bNTg7T3">Antipsychotics</a> are additionally given during acute manic episodes as well as in cases where mood stabilizers are poorly tolerated or ineffective. In patients where compliance is of concern, long-acting injectable formulations are available. There is some evidence that <a href="/facts/Psychotherapy/n2hDjaop">psychotherapy</a> improves the course of this disorder. The use of <a href="/facts/Antidepressants/N62ND3Fa">antidepressants</a> in depressive episodes is controversial: they can be effective but certain classes of antidepressants increase the risk of mania. The treatment of depressive episodes, therefore, is often difficult. <a href="/facts/Electroconvulsive_therapy/n498J3Km">Electroconvulsive therapy</a> (ECT) is effective in acute manic and depressive episodes, especially with psychosis or <a href="/facts/Catatonia/7agpD58W">catatonia</a>. Admission to a <a href="/facts/Psychiatric_hospital/d6BxCD3e">psychiatric hospital</a> may be required if a person is a risk to themselves or others; <a href="/facts/Involuntary_treatment/w3LAzN9A">involuntary treatment</a> is sometimes necessary if the affected person refuses treatment.
Bipolar disorder occurs in approximately 2% of the global population. 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. Symptoms most commonly begin between the ages of 20 and 25 years old; an earlier onset in life is associated with a worse prognosis. 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. Around one-quarter to one-third of people with bipolar disorder have financial, social or work-related problems due to the illness. Bipolar disorder is among the top 20 causes of disability worldwide and leads to substantial costs for society. Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as <a href="/facts/Coronary_heart_disease/szCt0nVx">coronary heart disease</a> in people with bipolar disorder is twice that of the general population.

Bipolar disorder open-in-new

Bipolar disorder