Bipolar disorder, formerly known as manic depression, is a problem characterized by excessively energetic moods called mania or manic episodes, which are more intense and very different than normal excitement. Manic episodes are uncontrollable periods of excessive energy that can begin at any time and greatly interfere with a person’s life. During a manic episode, a person can feel extremely happy, restless, irritable, self-confident, or distractible, or some combination of these feelings.
People who are having a manic episode often can’t sleep because they are filled with an excessive amount of irritable energy. They might also experience rapidly paced thoughts that make it impossible to concentrate, remember things, or engage in any activity that requires focus. This can lead to great confusion. As a result of the racing thoughts, they might talk too fast for others to understand what they’re saying. People experiencing a manic episode might notice that others around them look concerned or confused. Often, this is because other people can’t understand them or because they are moving at such a fast pace that others can’t keep up.
The overwhelming energy people experience during a manic episode might lead them to think that they are indestructible, all-powerful, or exceptionally special in comparison to others. This inflated sense of self-esteem might cause them to become angry or irritable with others who don’t agree with their point of view. This grand sense of self-worth might also cause them to think they’re irresistible to others and lead them to aggressively seek out new relationships or to rekindle old relationships with people they haven’t seen in years.
During mania, people may also find themselves engaging in an excessive number of plans and activities. Some of these plans might get out of control because the person hasn’t considered all of the possible pitfalls, like taking on too many projects at work. Some impulsive pleasurable activities, such as shopping sprees and sexual encounters with strangers, might be dangerous or interfere with other relationships, like those with friends and spouses.
Many times, people with bipolar disorder also have episodes of depression or dysthymia (persistent mild depression) in between periods of mania, resulting in severe mood swings from very high to very low.
In order to differentiate how severe a person’s problem is, three different types of bipolar disorder have been identified: bipolar I, bipolar II, and cyclothymia.
A person with bipolar I will have a manic episode that lasts for at least one week. On average, these episodes usually last from three to six months. Bipolar I may also include episodes of depression or dysthymia in between the manic episodes. In severe cases of bipolar I, the person may even experience visual or auditory hallucinations or delusional thoughts, such as the belief that he or she possess great powers. On average, a person with bipolar I can expect a manic episode every two to four years, and the odds of having a second manic episode after the first one are greater than 90 percent.
Some people experience a less disabling degree of mania, called hypomania, that doesn’t interfere with their lives as much. Typically, these hypomanic episodes last for at least a few days and include many of the same symptoms as a manic episode. In between these hypomanic periods, a person might also experience depression or dysthymia, but hypomanic episodes never include hallucinations or delusions. Someone who experiences hypomanic episodes and at least one depressive episode might be diagnosed with bipolar II, while a person who experiences hypomanic episodes and less disabling depressive symptoms, such as dysthymia, might be diagnosed with cyclothymia.
People who experience hypomania might actually look forward to their hypomanic episodes because they become excessively creative and/or productive during these periods. It’s also possible that during hypomania their shyness disappears and they become more outgoing. People with hypomania might even be able to think a little more quickly and clearly than normal, and they might feel powerful and irresistible to others. However, these feelings can also lead them to make an excessive number of rash judgments, like going on impulsive shopping sprees.
Someone who experiences four or more manic or hypomanic episodes every year has rapid cycling bipolar disorder. An equally severe complication is called a mixed episode. This refers to a span of one week during which a person experiences both depression and mania almost every day.
Officially, all of these bipolar disorders, along with depression and dysthymia, are collectively referred to as mood disorders.