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Depression & Anxiety


Bipolar Disorder

Persistent feelings of sadness, apathy, or hopelessness lasting more than two weeks.
Diminished interest in most daily activities, particularly pleasurable ones.
Decreased appetite and subsequent weight loss; increased appetite and weight gain.
Lack of sleep (insomnia), frequent awakening throughout the night, or conversely, an increased need for sleep.
Anxiety; diminished ability to think or concentrate.

Elated mood.
Feelings of irritability, grandeur, and inflated self-esteem.
Diminished need for sleep.
Being extremely talkative.
Sensing that thoughts and ideas are racing.
Being easily distracted.
Increased productivity and/or activity at work, at school, or in social situations.
Excessive involvement in high-risk activities that are likely to have painful consequences (such as extramarital affairs or unsound business deals).
Increased sex drive.

When To Call Your Doctor

Call a doctor if you or someone you know shows significant signs of bipolar disorder.

What Is It?

Bipolar disorder is a condition characterized by episodes of low mood (depression) or elated mood (mania), separated by periods of normal mood and functioning. Mania is marked by inflated self-esteem; an elated, euphoric, or grandiose mood; increased activity; and a decreased need for sleep. Episodes of mania or depression can last from a few weeks to several months and are frequently severe enough to affect day-to-day functioning at work and at home. Men tend to have more bouts of mania; women have more episodes of depression (see Depression for more information). Bipolar disorder has also been called manic-depressive illness.

Affecting about 1% of the general population, bipolar disorder typically begins between ages 20 and 30, though it can start at any age. For most patients, the condition is recurring. The rate of this "cycling" varies among individuals. Fortunately, although bipolar disorder can be a lifelong condition, treatment helps the majority of patients to have episodes that are less frequent and less severe.

What Causes It?

Genetics plays a primary role in the development of bipolar disorder. If you have a family history of bipolar disorder, there is a greater chance that you will be vulnerable to it.

Recurrent manic episodes may be caused by sleep deprivation or antidepressant drug therapy.

The more episodes a patient has had, the more likely he or she is to have another.


There is no way to prevent bipolar disorder, but medications such as lithium, carbamazepine, and divalproex may prevent recurrences.


Physical examination and patient history by a mental health professional are necessary. Because symptoms of a single manic episode can mimic those of schizophrenia, patients may need several exams before getting an accurate diagnosis.

Laboratory tests should be done to rule out an underlying medical illness (such as hyperthyroidism), an adverse drug reaction, another medical or psychiatric condition, or the effects of alcohol or illicit drugs.

How To Treat It

Lithium and divalproex are the treatments of choice for mania. Carbamazepine is also effective. Beneficial effects appear in two to six weeks.

Because of the slow therapeutic response to these medications, antipsychotic medications may be administered for treatment of severe mania.

Severe manic episodes may need to be treated in the hospital.


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