How Common Is Bipolar Disorder? The National Institute of Mental Health (NIMH) estimates that 2.8 percent of U.S. adults have had bipolar disorder in the last year. It affects men and women equally. (1) According to the National Alliance on Mental Illness, the average age of onset is 25, though it can occur in teenagers and, less commonly, in children. (2) More than 80 percent of all cases of the disorder are classified as severe, according to the NIMH.
What Is the Difference Between Bipolar Disorder and Manic Depression?
You may have heard the term "manic depression" used to describe a mental health disorder with similar symptoms as bipolar disorder. In fact, bipolar disorder was officially known as manic depression until the 1980s. At that time, mental health professionals decided to change the name of the illness in the Diagnostic and Statistical Manual of Mental Disorders — the guide that mental health professionals use to assist in diagnosis — because they felt the term "bipolar disorder" better described the condition and its symptoms. It's also been argued that the older term carries a stigma in popular culture and that both "manic" and "depression" are now used to describe everyday feelings and emotions. As a result, bipolar disorder is now the preferred term and the one that healthcare professionals use in diagnosis.
Recognizing Bipolar Disorder Symptoms and Getting a Diagnosis
There are different types of bipolar disorder, with different corresponding symptoms.
Bipolar I is marked by at least one manic episode, and the vast majority of people with bipolar I also experience major depressive episodes.
Bipolar II is characterized by a major depressive episode as well as an episode of hypomania (which is less severe than full mania) and in-between periods of a stable mood.
With cyclothymia, a milder form of bipolar disorder, less severe hypomanic and depressive episodes alternate for at least two years.
Hypomania: A hypomanic episode is an emotional state characterized by a distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least four (4) consecutive days, according to the American Psychiatric Association (2013). The mood must be present for most of the day, nearly every day.
Signs and Symptoms of Depression
A manic episode consists of at least a week of an abnormally and persistently elevated or irritable mood, with increased goal-directed activity or energy; multiple other symptoms are present most of the day each day. For an episode to be considered manic, it must cause severe impairment or hospitalization or include some psychotic features. A hypomanic episode is similar but is not as intense or disabling and is shorter in duration, lasting at least four days.
You may feel easily distracted, as though your thoughts are racing, and be excessively talkative. You may also need less sleep. And along with an inflated sense of self-confidence, you might engage in pleasurable but reckless, risky behaviors with negative consequences.
Manic episodes involve a distinct and observable change in mood and functioning, and are severe enough to result in problems in your daily activities or to require hospitalization to prevent harm to yourself or others. A manic episode may also trigger a break from reality (psychosis), including hallucinations or delusions.
Symptoms of a major depressive episode include a loss of interest in regular activities you normally derive pleasure in or purpose from, significant changes in weight or appetite, changes in sleep, restlessness or fatigue, feelings of emptiness and worthlessness, trouble concentrating, and thoughts of suicide. Experiencing five or more of these sustained and disruptive symptoms every day over a two-week period, with at least one of the symptoms being depressed mood, is considered a major depressive episode.
Diagnosis typically involves these components:
Learn More About the Symptoms of Bipolar Disorder
What Are the Different Types of Bipolar Disorder? There are several different types of bipolar disorder, which differ in their symptoms and severity. A hallmark of every type is discrete mood episodes that are interspersed with periods of normal, level mood and functioning. Your doctor will diagnose your condition based on the length, frequency, and pattern of episodes of your mania and depression.
There are four types of bipolar disorder:
Bipolar I This is considered the most severe form of the condition.
People with bipolar I experience at least one manic episode, and most people will also have depressive episodes — or at least some features of depressive episodes.
Episodes are defined as symptoms that affect a person every day for at least a week. The manic episodes that people with bipolar I experience are often extreme.
Bipolar II This type of bipolar disorder is usually diagnosed after a person experiences at least one major depressive episode and at least one episode of hypomania. The highs in bipolar II aren't as high as those in bipolar I, although it's important to understand that bipolar II is a separate condition, not a milder form of bipolar I. Unfortunately, bipolar II is sometimes misdiagnosed as major depressive disorder when a person's hypomanic episodes go unrecognized.
Cyclothymia This is a milder form of bipolar disorder, sometimes known as cyclothymic disorder. People with this condition experience periods of hypomanic and depressive symptoms, though they don’t meet the full criteria for either a hypomanic or depressive episode.
Other Specified or Unspecified Bipolar Disorder When a person doesn’t meet the criteria for any of the other types of bipolar disorder but still experiences periods of a significant, abnormal elevation in mood, this diagnosis is used.
Cyclothymia
Cyclothymia is a milder form of bipolar disorder that’s sometimes referred to as cyclothymic disorder. Both cyclothymia and bipolar disorder are characterized by extreme mood swings, from the highs of mania to the lows of depression, with short periods of neutral time in between. The difference lies in the intensity: People with bipolar disorder will experience clinically diagnosed mania and usually major depression, while people with cyclothymia have low-grade depression and mild symptoms of hypomania.
With cyclothymia, "It may seem like you’re just going through a string of good days and a string of bad days,” says psychiatrist Kathleen Franco, MD, of the Cleveland Clinic Lerner College of Medicine in Cleveland. “But the mood shifts keep going, and there’s little neutral time in between.”
Symptoms of Cyclothymia: What to Look For Besides cycling between the two mood extremes, there are other criteria that will determine a diagnosis of cyclothymia:
The same kinds of symptoms may be present in a cyclothymic depression, but they’re less severe in degree (though they can have a significant impact on quality of life and social functioning).
The cyclothymic symptoms may last no more than two weeks, and they may cause less of a disruption in your daily routine.
The true mania of bipolar disorder, essentially the opposite of major depression, can likewise be debilitating. It may be accompanied by feelings of euphoria and indestructibility — a sense of being on top of the world — that can include reckless behaviors such as driving too fast or abusing drugs or alcohol.
A manic person may go a day or two without sleeping. They may talk rapidly, moving from topic to topic without making much sense.
The hypomania symptoms seen with cyclothymia are less dramatic and not as long-lasting. They may be so mild as to seem normal — mild sleeplessness, for example, or chattiness and increased energy.
While some people living with cyclothymia are happy to go without treatment, it may be important for others to recognize and monitor the condition: It’s estimated that there’s a 15 to 50 percent risk that people with cyclothymic disorder may go on to develop full-blown bipolar disorder.
This escalation is especially prevalent if bipolar disorders run in the family.
What Is the Difference Between Bipolar Disorder and Manic Depression?
You may have heard the term "manic depression" used to describe a mental health disorder with similar symptoms as bipolar disorder. In fact, bipolar disorder was officially known as manic depression until the 1980s. At that time, mental health professionals decided to change the name of the illness in the Diagnostic and Statistical Manual of Mental Disorders — the guide that mental health professionals use to assist in diagnosis — because they felt the term "bipolar disorder" better described the condition and its symptoms. It's also been argued that the older term carries a stigma in popular culture and that both "manic" and "depression" are now used to describe everyday feelings and emotions. As a result, bipolar disorder is now the preferred term and the one that healthcare professionals use in diagnosis.
Recognizing Bipolar Disorder Symptoms and Getting a Diagnosis
There are different types of bipolar disorder, with different corresponding symptoms.
Bipolar I is marked by at least one manic episode, and the vast majority of people with bipolar I also experience major depressive episodes.
Bipolar II is characterized by a major depressive episode as well as an episode of hypomania (which is less severe than full mania) and in-between periods of a stable mood.
With cyclothymia, a milder form of bipolar disorder, less severe hypomanic and depressive episodes alternate for at least two years.
Hypomania: A hypomanic episode is an emotional state characterized by a distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least four (4) consecutive days, according to the American Psychiatric Association (2013). The mood must be present for most of the day, nearly every day.
Signs and Symptoms of Depression
A manic episode consists of at least a week of an abnormally and persistently elevated or irritable mood, with increased goal-directed activity or energy; multiple other symptoms are present most of the day each day. For an episode to be considered manic, it must cause severe impairment or hospitalization or include some psychotic features. A hypomanic episode is similar but is not as intense or disabling and is shorter in duration, lasting at least four days.
You may feel easily distracted, as though your thoughts are racing, and be excessively talkative. You may also need less sleep. And along with an inflated sense of self-confidence, you might engage in pleasurable but reckless, risky behaviors with negative consequences.
Manic episodes involve a distinct and observable change in mood and functioning, and are severe enough to result in problems in your daily activities or to require hospitalization to prevent harm to yourself or others. A manic episode may also trigger a break from reality (psychosis), including hallucinations or delusions.
Symptoms of a major depressive episode include a loss of interest in regular activities you normally derive pleasure in or purpose from, significant changes in weight or appetite, changes in sleep, restlessness or fatigue, feelings of emptiness and worthlessness, trouble concentrating, and thoughts of suicide. Experiencing five or more of these sustained and disruptive symptoms every day over a two-week period, with at least one of the symptoms being depressed mood, is considered a major depressive episode.
Diagnosis typically involves these components:
- A physical exam
- A psychiatric evaluation
- Tracking your moods and behaviors on a day-to-day basis to confirm your diagnosis
Learn More About the Symptoms of Bipolar Disorder
What Are the Different Types of Bipolar Disorder? There are several different types of bipolar disorder, which differ in their symptoms and severity. A hallmark of every type is discrete mood episodes that are interspersed with periods of normal, level mood and functioning. Your doctor will diagnose your condition based on the length, frequency, and pattern of episodes of your mania and depression.
There are four types of bipolar disorder:
Bipolar I This is considered the most severe form of the condition.
People with bipolar I experience at least one manic episode, and most people will also have depressive episodes — or at least some features of depressive episodes.
Episodes are defined as symptoms that affect a person every day for at least a week. The manic episodes that people with bipolar I experience are often extreme.
Bipolar II This type of bipolar disorder is usually diagnosed after a person experiences at least one major depressive episode and at least one episode of hypomania. The highs in bipolar II aren't as high as those in bipolar I, although it's important to understand that bipolar II is a separate condition, not a milder form of bipolar I. Unfortunately, bipolar II is sometimes misdiagnosed as major depressive disorder when a person's hypomanic episodes go unrecognized.
Cyclothymia This is a milder form of bipolar disorder, sometimes known as cyclothymic disorder. People with this condition experience periods of hypomanic and depressive symptoms, though they don’t meet the full criteria for either a hypomanic or depressive episode.
Other Specified or Unspecified Bipolar Disorder When a person doesn’t meet the criteria for any of the other types of bipolar disorder but still experiences periods of a significant, abnormal elevation in mood, this diagnosis is used.
Cyclothymia
Cyclothymia is a milder form of bipolar disorder that’s sometimes referred to as cyclothymic disorder. Both cyclothymia and bipolar disorder are characterized by extreme mood swings, from the highs of mania to the lows of depression, with short periods of neutral time in between. The difference lies in the intensity: People with bipolar disorder will experience clinically diagnosed mania and usually major depression, while people with cyclothymia have low-grade depression and mild symptoms of hypomania.
With cyclothymia, "It may seem like you’re just going through a string of good days and a string of bad days,” says psychiatrist Kathleen Franco, MD, of the Cleveland Clinic Lerner College of Medicine in Cleveland. “But the mood shifts keep going, and there’s little neutral time in between.”
Symptoms of Cyclothymia: What to Look For Besides cycling between the two mood extremes, there are other criteria that will determine a diagnosis of cyclothymia:
- You’ve experienced these mood swings for at least two years.
- At least once in the two-year period, you have had significant distress or social impairment.
- Your symptom-free intervals last no more than two months.
- Your symptoms don’t meet the requirements of any other bipolar disorder.
The same kinds of symptoms may be present in a cyclothymic depression, but they’re less severe in degree (though they can have a significant impact on quality of life and social functioning).
The cyclothymic symptoms may last no more than two weeks, and they may cause less of a disruption in your daily routine.
The true mania of bipolar disorder, essentially the opposite of major depression, can likewise be debilitating. It may be accompanied by feelings of euphoria and indestructibility — a sense of being on top of the world — that can include reckless behaviors such as driving too fast or abusing drugs or alcohol.
A manic person may go a day or two without sleeping. They may talk rapidly, moving from topic to topic without making much sense.
The hypomania symptoms seen with cyclothymia are less dramatic and not as long-lasting. They may be so mild as to seem normal — mild sleeplessness, for example, or chattiness and increased energy.
While some people living with cyclothymia are happy to go without treatment, it may be important for others to recognize and monitor the condition: It’s estimated that there’s a 15 to 50 percent risk that people with cyclothymic disorder may go on to develop full-blown bipolar disorder.
This escalation is especially prevalent if bipolar disorders run in the family.
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