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Writer's pictureAlan Frischer, MD, MPH

Bipolar Disorder

Bipolar disorder can be devastating. Previously known as manic depression, it is a mental health condition that causes extreme mood swings.


Bipolar disorder affects almost six million adult Americans, or about 2.6% of adults in the United States, and roughly 60 million people worldwide. It most typically starts at around the age of 25, although it can begin in early childhood or as late as the 40’s and 50’s. It affects both men and women, and crosses all races, ethnic groups and social classes.


There are three major symptoms: depression, mania, and hypomania. During times of depression, victims feel sad or hopeless, lose interest or pleasure in most activities, feel a loss of energy, experience periods of too much or too little sleep, and may have suicidal thoughts. When the mood shifts to mania, they experience an emotional high. They can feel excited, impulsive, and euphoric, have rapid pressured speech, difficulty focusing, and be full of energy. Due to this high energy, they will sleep little. They will likely be irritable and impulsive, and use poor judgment. Behaviors may include spending sprees, unprotected and frequent sex, and drug and alcohol use. Hypomania is generally associated with bipolar II disorder. It is similar to mania, but not as severe.


Episodes of mood swings may occur rarely, or happen multiple times a year. Depression tends to last at least two weeks. Mania can last for several days or weeks. It is possible to feel normal in between episodes. Those with bipolar disorder may very likely have trouble managing everyday life tasks such as school or work, and maintaining relationships.


While the condition is seen in equal numbers between men and women, the symptoms may differ. Women tend to be diagnosed later in life, have milder episodes of mania, experience more depressive episodes than manic episodes, experience other conditions at the same time (such as thyroid disease, obesity, anxiety disorder and migraines), and have a higher lifetime risk of alcohol abuse.

Men with bipolar disorder are often diagnosed earlier in life, experience more severe episodes (especially mania), act out during manic episodes, have substance abuse issues, and seek medical attention less often. They are more likely to attempt suicide.


Bipolar disorder is a lifelong condition, but a treatment plan of medication and counseling can help to manage mood swings and other symptoms. Mood stabilizers, antipsychotics, antidepressants, and anxiety medications may all be used for treatment.


Bipolar disorder is common, but what causes some people to develop it and not others is still a mystery. There is a strong genetic link; those with a family history of bipolar disorder are four to six times more likely than others to develop it. Stress, traumatic experiences, and physical illness may trigger it.


If you think that you’re experiencing symptoms of bipolar disorder, I urge you to see your doctor. If you feel that a friend, relative, or loved one may be suffering from it, your support and understanding are crucial. Encourage them to see a doctor to discuss any symptoms they’re experiencing.

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