About Manic Depressive Illness

One of the more enigmatic mental illnesses, bipolar disorder (or manic depressive illness) causes shifts in mood, energy, and activity levels that are often severe enough to affect one's day-today functioning. Characterized by unpredictable highs and lows and self-destructive behavior, the illness affects approximately 5.7 million adults in the United States.

While bipolar disorder usually strikes initially in adolescence or early adulthood, experts estimate that about 10 percent of people with the condition have their first episode after age 50. Some of these people remain undiagnosed, as their symptoms are mistaken for such disorders as cognitive impairment, delirium, or substance abuse.

As with any chronic illness, managing bipolar disorder requires lifelong attention. Without treatment, episodes become more frequent and severe. When successfully controlled, however, people with bipolar disorder can lead full and productive lives.

Beyond Typical Mood Swings

Bipolar disorder involves mood swings that are more exaggerated than typical fluctuations. The "up" periods are known as manic episodes, mania, or hypomania (a less severe form of mania); the "down" periods are called depressive episodes, or depression.

Manic episodes are characterized by aggression, agitation, or irritation; a decreased need for sleep; euphoria; high distractibility; an increased sex drive; inflated self-esteem; racing thoughts; rapid speech; spending sprees; and delusions, hallucinations, or psychosis.

Depressive episodes are marked by difficulty concentrating, remembering, or making decisions; eating disturbances; loss of appetite and weight loss, or overeating and weight gain; fatigue or listlessness; feelings of worthlessness, hopelessness, and/or guilt; loss of self-esteem; persistent sadness; sleep disturbances; suicidal thoughts; or withdrawal from people and activities that were once enjoyed.

Mood swings vary in length and frequency. Some people suffer mostly with major depression, with only the occasional manic episode; others experience "rapid cycling," with at least four episodes of depression, mania, or hypomania occurring within one year.

Sometimes, people with bipolar disorder have "mixed" states, during which mania and depression occur simultaneously or in rapid sequence. A person in a mixed state might have tremendous energy but also feel extremely sad or hopeless. In between mood swings, many people have periods of stable mood.

Publication Review By: Karen L. Swartz, M.D.

Published: 03 Mar 2011

Last Modified: 20 Jun 2013