Bipolar Disorders

Am Fam Physician. 2012;85(5):499-500

See related article on bipolar disorders.

What are bipolar disorders?

They are mental conditions that cause different types of mood changes (episodes). The cause of bipolar disorders is unclear, but they may run in families. Bipolar disorders can cause depression. They can also cause symptoms of mania, which can make you feel energized and impulsive. You can have symptoms of both depression and mania. This is called a mixed episode. Hypomania is similar to mania, but less severe.

If you have a bipolar disorder, you may sometimes lose touch with reality, misunderstand information, and hear things that aren't there. Some people with bipolar disorders have thoughts of harming themselves or others. Call your doctor right away if you are having these thoughts.

Symptoms usually switch between depression and mania, hypomania, or mixed episodes. This cycle can happen over days, weeks, or years. Some people have only one bipolar episode in their lifetime.

What are the symptoms?

Depression: sadness, anxiety, crying, change in sleep or appetite, less interest in things you used to enjoy, difficulty concentrating, feelings of guilt, thoughts of hurting yourself or others
Mania: bursts of energy, feeling better than usual, little or no need for sleep, racing thoughts, talking more than usual, risky behavior (e.g., increased spending, driving fast, suddenly quitting a job)
Mixed episode: depression with increased energy and racing thoughts
Hypomania: less severe symptoms of mania

Who gets bipolar disorders?

Anyone can get a bipolar disorder, but certain factors make it more likely. These include:

Stress
Changes in season or exposure to daylight (such as daylight savings time or change in time zone)
Previous depression
Family members with depression or mental illness

How are bipolar disorders treated?

Your doctor may prescribe a medicine called a mood stabilizer. You may need additional medicines to help control your mood episodes. Your doctor may also recommend therapy to help you cope with your feelings.

Some people will improve within a few weeks of starting treatment. Others may have symptoms for several months, especially those with more severe symptoms or who have had symptoms in the past.

What else can I do to feel better?

Talk with your doctor about making an action plan. The plan should include specific things you can do to help you feel better. Make sure that you have a friend or family member you can talk to if you are depressed or have thoughts of hurting yourself.