(Manic/Depression)
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

More than 2 million American adults, or about 1 percent of the adult population have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood; however, some people have their first symptoms during childhood and some develop them late in life. It is often not recognized as an illness and people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.

Symptoms of Bipolar Disorder
Bipolar disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal moods in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called “episodes” of mania and depression.

Signs and symptoms of mania (or a manic episode) include:
• Increased energy and activity.
• Excessively "high,” euphoric mood.
• Extreme irritability and restlessness.
• Racing thoughts, often accompanied by rapid speech, marked by the inability to maintain a single thought or idea.
• Distractibility.
• Little need for sleep.
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Not realizing that anything is wrong
• Unable to concentrate
• A manic episode is 3 or more symptoms that occur most of the day, nearly every day, for at least 1 week or longer.

Signs and symptoms of depression (or a depressive episode) include:
• Lasting sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy or a feeling of fatigue.
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or unable sleep
• Change in appetite and/or unintended weight loss or weight gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
• Thoughts of death, suicide, or suicide attempts

A depressive episode is 5 or more of these symptoms which last most of the day, nearly every day, for a period of 2 weeks or longer.

A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with enhanced productivity. Thus even when family and friends learn to recognize the mood swings, as possible bipolar disorder, the person may not realize that anything is wrong. Without proper treatment however, hypomania may become severe mania in some people or may switch into depression.

Sometimes, severe episodes of mania or depression include symptoms of psychosis (psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing, or otherwise sensing the presence of things that are not actually there) and delusions (false, strongly held beliefs not influenced by logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect an extreme mood. For example, delusions of grandiosity, such as believing one is the President, has special powers, or is wealthy, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness.

It may be helpful to think of the various moods of bipolar disorder as a spectrum or continuous range. The bottom of the spectrum is severe depression, followed by moderate depression and mild depression. Mild depression is sometimes referred to as “the blues when it is short-lived, but is called “dysthymia” when it is chronic. The middle of the spectrum is “normal” or more accurately balanced. From balanced, the spectrum leads to hypomania (mild to moderate mania) and then the other extreme of severe mania.