Bipolar disorder, also called manic depression, is a type of affective or mood disorder affecting more than 5.7 million American adults. 

Bipolar disorder is characterized by periodic episodes of extreme elation, elevated mood or irritability (also called mania) countered by periodic, classic depressive symptoms.

Affecting men and women equally—although women are more likely to experience more depressive and fewer manic symptoms—bipolar disorder often begins in adolescence or early adulthood. In fact, the average age for a first manic episode is during a person's early 20s. (When symptoms are present before the age of 12, they're often confused with attention-deficit hyperactivity disorder, or ADHD.) People with the condition can experience dramatic mood swings that take them from euphoria to depression, from recklessness to listlessness, often in short periods of time. Or the mood swings can be less dramatic, ranging from an increase in energy alternating with episodes of depression.


Bipolar disorder is likely to run in families and, in some cases, is believed to be hereditary. Researchers are still working to identify a gene that may be responsible for this disorder.


For a diagnosis of bipolar disorder to be made, an individual must exhibit both depressive and manic symptoms to a varying degree, depending on the severity of the disorder. Because depression often co-exists with other medical conditions, such as heart disease, cancer, or diabetes, and other psychiatric disorders, such as substance abuse or anxiety disorders, seeking early diagnosis and treatment is crucial to recovery. A diagnosis is often made after a psychiatrist or other mental health professional performs a careful psychiatric exam and medical history.

Bipolar Disorder Symptoms

During the manic phase, symptoms can include:

  • High level of energy and activity
  • Irritable mood
  • Decreased need for sleep (sleeping very little without feeling tired)
  • Exaggerated, puffed-up self-esteem ("grandiosity")
  • Rapid or "pressured" speech
  • Rapid thoughts
  • Tendency to be easily distracted
  • Increased reckless behaviors
  • False beliefs (delusions) or false perceptions (hallucinations)
  • Distinctly low or irritable mood
  • Loss of interest or pleasure
  • Eating more or less than normal
  • Gaining or losing weight
  • Sleeping more or less than normal but feeling tired or low energy
  • Appearing slowed or agitated
  • Fatigue and loss of energy
  • Feeling worthless or guilty
  • Poor concentration
  • Indecisiveness
  • Thoughts of death, suicide attempts or plans


Treatment for bipolar disorder may include one or more of the following:

  • Medication: Mood-stabilizing anticonvulsants such as lithium, valproate, or carbamazepine, and/or antidepressants such as Prozac, Zoloft, or Paxil

  • Psychotherapy: Most often cognitive-behavioral and/or interpersonal therapy that's focused on changing the person's distorted views, working through difficult relationships, and identifying stressors

  • Electroconvulsive therapy: For resistant cases

Recognizing the varied and extreme mood swings associated with bipolar disorder is crucial in obtaining effective treatment and avoiding the potentially painful consequences of the reckless, manic behavior.

Medical Reviewer: Mukamal, Kenneth MD Last Annual Review Date: 2009-11-17T00:00:00-07:00 Copyright: © 2000-2010 The StayWell Company, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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Bipolar symptoms are hard to recognize because they're the same as the everyday ups and downs we all feel.