BIPOLAR DISORDERS
Extreme Mood Swings

What Are Bipolar Disorders?

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Bipolar Disorders, formerly called manic‑depressive illness, are a set of chronic mental health conditions marked by clear, extreme shifts in mood, energy, activity, and concentration. People experience episodes of mania or hypomania, the "highs", alternating with depression, the "lows", often with periods of relatively normal mood, called euthymia, in between. These are far more intense and disruptive than ordinary mood changes.

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They are serious but treatable conditions. With appropriate care, many people manage symptoms well and lead full lives. This is not medical advice; diagnosis and treatment require a qualified clinician.

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Prevalence

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In the U.S., about 2.8 percent of adults experience bipolar disorder in a given year, and roughly 4.4 percent meet criteria at some point in their lives, with similar rates in men and women overall. Onset is often in the late teens or early 20s.

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Worldwide estimates vary but generally fall in a similar range; the condition is underdiagnosed, and the average delay from first symptoms to a correct diagnosis is often years.

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Main Types In DSM‑5‑TR

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• Bipolar I disorder: At least one manic episode, lasting at least 7 days or severe enough to require hospitalization. Depressive episodes are common but not required for the diagnosis. Psychotic features such as hallucinations or delusions can occur in mania.
• Bipolar II disorder: At least one hypomanic episode of at least 4 days, plus at least one major depressive episode. No full manic episodes. Depressive periods are often more frequent or prolonged and can still cause major impairment.
• Cyclothymic disorder: Numerous periods of hypomanic and depressive symptoms lasting at least 2 years, or 1 year in children and adolescents, that do not meet full criteria for mania, hypomania, or major depression.
• Other specified or unspecified bipolar and related disorders: Symptoms that cause distress or impairment but do not neatly fit the above categories.

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Specifiers can further describe the presentation, such as rapid cycling, which is four or more episodes a year, mixed features, a seasonal pattern, or anxious distress.

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Symptoms

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Manic episode, or full mania: Abnormally elevated, expansive, or irritable mood plus increased energy or goal‑directed activity for most of the day nearly every day for at least 7 days, or any duration if hospitalization is needed. Additional symptoms, at least 3, or 4 if mood is only irritable, include decreased need for sleep, grandiosity, racing thoughts, pressured speech, distractibility, and risky or impulsive behavior. It causes marked impairment or includes psychosis.

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Hypomanic episode: Similar symptoms but milder, lasting at least 4 days, without marked functional impairment, hospitalization, or psychosis.

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Major depressive episode: At least 2 weeks of depressed mood or loss of interest or pleasure, plus symptoms such as fatigue, sleep or appetite changes, concentration problems, feelings of worthlessness or guilt, psychomotor changes, and thoughts of death or suicide.

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Mixed features, with symptoms of both mania or hypomania and depression at the same time, are common.

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Mood episodes vary widely in frequency, duration, and severity between individuals.

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Causes

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The exact cause is unknown. It is multifactorial:

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• Genetics play a major role, with heritability estimates often 70 to 90 percent. It runs in families, though no single gene is responsible.
• Neurobiology: Dysregulation of neurotransmitters such as dopamine, serotonin, and norepinephrine, and of other brain systems; circadian rhythm and sleep disruptions are frequently involved.
• Environmental triggers: Stress, sleep loss, substance use, and certain medications can precipitate or worsen episodes in vulnerable people.

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Diagnosis

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Diagnosis is clinical, based on a history of mood episodes meeting DSM‑5‑TR or ICD‑11 criteria. There is no lab test. Clinicians look carefully at past highs, which people sometimes minimize or enjoy, as well as depressions. Misdiagnosis as unipolar depression is common early on. Collateral information from family and careful mood charting help.

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Treatment

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Treatment is usually long‑term and combines approaches tailored to the person and the current phase, whether mania, depression, or maintenance:

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• Medications: Mood stabilizers such as lithium, valproate, and lamotrigine, atypical antipsychotics, and carefully selected other agents. Antidepressants are used cautiously because they can trigger mania. Regular monitoring, such as lithium levels and metabolic and organ function, is important.
• Psychotherapy: Cognitive‑behavioral therapy, family‑focused therapy, interpersonal and social rhythm therapy, and psychoeducation improve outcomes and help with adherence and lifestyle.
• Lifestyle and self‑management: Consistent sleep‑wake schedules, routine, avoiding substances, stress management, and early recognition of warning signs.
• Other options for severe or treatment‑resistant cases: Electroconvulsive therapy ECT, and emerging approaches under study.

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Early intervention and consistent treatment improve prognosis. People with bipolar disorder have elevated risks of suicide and of physical health problems, including cardiovascular disease, so comprehensive care is essential.

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Resources And Support

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• National Institute of Mental Health NIMH bipolar disorder pages and publications.
• Substance Abuse and Mental Health Services Administration SAMHSA treatment locator.
• Local crisis services: In the U.S., call or text 988, the Suicide and Crisis Lifeline, if you or someone else is in crisis.

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If you or a loved one has symptoms, start with a primary care clinician or a psychiatrist for a proper evaluation. Support groups and peer resources can also be helpful alongside professional care.

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What Are My Options?

If you are wondering if we could be a good fit for you or have questions about how we can craft your own specialized treatment plan, please reach out to learn more.

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Call us directly at 512-600-3121 and we will be happy to quickly answer your questions.

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Alternatively, you can get the process started by filling out our New Patient Request Form, and a member of our Patient Care Team will reach out to you at your convenient time.

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For individuals with urgent needs we may be able to offer same-day or next-day appointments to ensure that you get the care you need as quickly as possible.