What is Bipolar Disorder? A Medical, Scientific and Historical Definition & Guide

 

Many people wonder “what is bipolar disorder?”
– and if you’re visiting this page, you’re probably asking the same question.

Well, you’ve come to the right place: on this page you’ll get well-researched answers and in-depth information to help you deal with, cope with, and properly understand just what is bipolar disorder.

Let’s Get Straight to the Answer of What Bipolar Disorder Is

Bipolar disorder is a long-term mental illness that can cause significant psychological and physical problems if left untreated. So bipolar disorder can be serious, but you’re by no means helpless to deal with it.

Fortunately the modern treatments are very effective, and can help everyone with bipolar disorder to keep their condition under control.

People with bipolar disorder experience extreme changes of mood that cycle between the two states of mania and depression.

The symptoms of bipolar mania and depression can affect how a person thinks, feels, and behaves. They may lose touch with reality for a time, or make impulsive decisions that can cause havoc in their personal lives and relationships.

Some Risks of Bipolar Disorder

In serious cases the symptoms of untreated bipolar disorders can be severe and disabling, making it very challenging for a person function normally in daily life. Untreated bipolar symptoms can also cause havoc in personal relationships, and create significant problems for the families and friends of people with the disorder.

In extreme cases a person suffering from some symptoms of bipolar disorder may need to be hospitalized for a time to help them recover.

Some people may become so overwhelmed by their symptoms that they may struggle with thoughts of suicide. Fortunately help is readily at hand in such emergencies, including telephone help lines in many countries, and your local doctor or hospital.

Care and understanding from family members and friends can also be important.

But Bipolar Disorder Can Be Treated Effectively

Fortunately, most cases of bipolar disorder can be controlled with a program of medical treatment, psychological training and self-help techniques. Thanks to modern treatments, most people with a bipolar disorder are now able to live happy, productive and normal lives.

What You’ll Find On This Page About Bipolar Disorder

In the main sections of this page you can learn about the Definition of Bipolar Disorder and the different Types of Bipolar Disorder.

You’ll also learn how the different types of bipolar disorder vary in the severity of their symptoms.

The main types of bipolar disorder are:

You can also read a Brief History of Bipolar Disorder and a summary of the Science of Bipolar Disorder.

In the last section of this page, titled What Bipolar Disorder Is Not, you can learn about some of the myths of bipolar disorder.

For an overview of the symptoms of bipolar disorder and their treatments, please visit the main page of this website, Bipolar Disorder Symptoms.

What is Bipolar Disorder? – The Science of Bipolar Disorder: Brain Chemistry, Genetics and Environment

Medical research has show that bipolar symptoms result from abnormal chemical changes in the parts of the brain that regulate our emotional state. These changes can be measured with brain scans and blood tests. But relatively little is known about their causes.

Genetics and Bipolar Disorder

Bipolar disorder is more often found in people who have a history of similar mental disorders in their families, and studies of identical twins – who share the same genetic pattern – have shown that when one twin develops a bipolar disorder, the second twin is far more likely to develop the disorder too.

Researchers have identified several genes that often appear in the chromosomes of people with bipolar disorder. But fortunately not everyone who has those genes develops bipolar disorder, and not all people diagnosed with bipolar disorder symptoms have those genes.

But Psychological and Environmental factors Also Play a Part

Bipolar episodes can be triggered by psychological stress, physical illnesses, and some medical and illicit drugs. Even seasonal changes in the weather and daylight hours have been known to trigger bipolar episodes.

A Brief History of Bipolar Disorder

The symptoms of bipolar disorder have been recognized for thousands of years:

  • In the 1st Century AD, the Greek physician Aretaeus of Cappadocia first noted the link between melancholia – as depression was then known – and mania.
  • From ancient times until the development of modern medicine in the 18th and 19th Centuries, the disorder was said to be caused by black bile, one of the four so-called humors of the body thought to govern health.
  • In the 19th Century, bipolar disorder was known as biphasic illness, circular insanity, or dual-form insanity.
  • In the early 20th Century the German psychiatrist Emil Kraeplin called bipolar mood disorders manic-depressive insanity to distinguish them from other forms of mental illness.
  • In the 1950s another German psychiatrist, Karl Leonhard introduced the term bipolar disorder and classified the main sub-types of the disorder recognized today. The term manic depression is still in common use.

A Textbook Bipolar Definition of What Bipolar Disorder Is

A commonly used definition of what is bipolar disorder is found in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. The manual is widely referred to as the DSM-IV, because it is in its fourth major edition.

The DSM-IV deals with the question of what bipolar disorder is like this:

Bipolar Disorder is a mood disorder where there has been at least one or more manic, hypomanic or mixed manic episode – often accompanied by depressive episodes.

This definition of bipolar disorder hinges on a person experiencing at least one episode of mania, or the related conditions of hypomania – a less intense form of mania – and mixed bipolar episodes, where the symptoms of mania and depression occur at the same time.

Even if a person suffers mainly from depression – and in some cases, even if they appear to suffer no depression at all – according to this definition of bipolar disorder, even one episode of mania, hypomania or mixed symptoms is enough to qualify their condition as bipolar disorder.

Manic symptoms of some kind are a defining feature

(Bipolar Definition and Characteristics of Bipolar Disorder)
Manic symptoms are what distinguishes bipolar disorder from a unipolar depression, also known as major depressive disorder – another type of serious type of mental illness, but one that is treated differently.

Usually, for a patient to be diagnosed with bipolar disorder, he or she must have had a manic episode lasting for at least one week, or a hypomanic episode that lasts for at least four days, according to the DSM-IV.

Cycles of Mood and Behavior

(Bipolar Definition and Characteristics of Bipolar Disorder)
Another important thing to note about the common definition of what is bipolar disorder is that episodes of mania and depression are seen to cycle, or alternate, over a period of time.

The mood of a person with bipolar disorder will change from one extreme to another, often with a period of a “normal” emotional state between them.

Each Episode can Last for Different Lengths of Time

(Bipolar Definition and Characteristics of Bipolar Disorder)
A few weeks is common, but in some cases an episode might last just a few days – or it might last for several months.

Bipolar Episodes Can be Difficult to Recognize

(Bipolar Definition and Characteristics of Bipolar Disorder)
Because there may be no clear-cut change in mood, and because the symptoms of each manic or depressive episode can be more or less severe than other times, it can be very difficult to recognize when bipolar episodes begin and end.

Some people can think they are just “over their depression” when they start to become manic. But this exaggerated emotional state is also part of their bipolar illness.

The Trouble with Textbook Definitions

(Bipolar Definition and Characteristics of Bipolar Disorder)
Short definitions of what bipolar disorder can be useful to explain something quickly – but a few words cannot cover the many different facets of the condition.

They also do nothing to describe the major and often disabling emotional changes experienced by people suffering from the symptoms of bipolar disorder.

A Definition Is Not a Diagnosis

(Bipolar Definition and Characteristics of Bipolar Disorder)
In many cases the symptoms of mania can be subtle, and hard to recognize. They may be mistaken for a good mood, or a newly optimistic outlook – especially after an episode of depression has lifted.

Mixed bipolar episodes – where symptoms of depression and mania occur together – can be especially confusing. It can be hard even for a skilled psychiatrist to determine if a positive change in mood is an episode of mania.

These are some of the reasons that many people with bipolar disorder are misdiagnosed with other conditions, sometimes for many years, before their condition is correctly identified.

The Different Types of Bipolar Disorder

The term bipolar disorder covers a group of what are known as mood disorders – because their main symptom are changes in emotional state, or mood. Some types of bipolar disorders are more severe than others, and together they are known as the bipolar spectrum.

A List of the Main Types of Bipolar Disorder

According to the American Association of Psychiatrists, the main types of bipolar disorder are classified as:

  • Bipolar 1 disorder (also known as bipolar I disorder) in which most people cycle between episodes of depression and mania.
  • Bipolar 2 disorder (also known as bipolar II disorder) in which most people cycle between episodes of depression and hypomania – a less intense form of mania.

  • Cyclothymia, in which most people cycle between episodes of hypomania and mild depression.
  • Bipolar disorder NOS (Not Otherwise Specified) is a “catch-all” term for bipolar disorders that do not fit into one of the other main types.

The following sections look at each of these types of bipolar depression:

Bipolar 1 disorder

Bipolar 1 disorder is the most severe condition on the bipolar spectrum.

Patients who have had at least one episode of mania, or mixed episodes of both depression and mania at the same time, are diagnosed with bipolar 1 disorder.

The extreme emotional states of mania and depression can be a real disability in daily life, and badly affect family and social relationships.

The symptoms of mania can include severe psychotic episodes, such as delusions or hallucinations, which are also associated with schizophrenia.

The phases of depression and mania can also be “mixed” – for example, a sense of intense grief combined with the restlessness of a manic episode, or delusions experienced during an episode of depression. These mixed bipolar episodes can be among the most distressing and confusing types of bipolar episode.

Bipolar 2 disorder

People with Bipolar 2 disorder do not have episodes of full mania, but go through episodes of high energy and impulsiveness called hypomania.

Hypomania literally means “below mania” in Greek.

Many symptoms of hypomania are similar to symptoms of mania, but they are less intense. They can include a reduced need for sleep, or being extremely competitive or outgoing.

Unlike many people with full mania, people with hypomania can usually function well in their daily lives, and may even be more productive than usual.

Cyclothymia

Cyclothymia is a less intense form of bipolar disorder than either bipolar 1 or bipolar 2. Its name means “circle of temper” in Greek.

People with cyclothymia experience recurrent episodes of:
hypomania – a less intense form of mania – and
dysthymia, a less intense form of depression.

In many cases, people with cyclothymia are able to function well in their daily lives, and may even be uncommonly productive and happy during hypomania episodes. But they experience a repeating pattern of episodes when their mood fluctuates noticeably from their “normal” mood.

And although the symptoms of Cyclothymia are less severe than bipolar 1 or bipolar 2 disorders, they still have the potential to seriously disrupt a person’s life.

Untreated cyclothymia can be dangerous because it can develop into a more severe form of bipolar disorder. Up to 30 per cent of people diagnosed with cyclothymia eventually experience a full blown episode of mania or depression if their condition is untreated, and their diagnosis is changed to bipolar 1 or bipolar 2.

Bipolar Disorder NOS

The abbreviation NOS here stands for “Not Otherwise Specified.” Bipolar disorder NOS is a diagnosis for a bipolar disorder that does not fall into one of the other main types.

It is sometimes called subthreshold bipolar disorder, and is described as severe or drastic changes in mood.

Bipolar NOS may be used by psychiatrists as an early diagnosis when a person shows some symptoms of bipolar disorder, but not enough is known about their condition to classify it further.

Or it may be used to describe people who have experienced an episode of mania, but with no corresponding episodes of depression.

What Bipolar Disorder Is NOT: Seven Myths

When answering the question “What is Bipolar disorder?”, it can be helpful to note some of the things that it is not.

There are many myths and misconceptions about bipolar disorder, and this section looks at some of them.

Bipolar Disorder is NOT just an Emotional Problem

(Myth Buster #1)
Bipolar disorder is NOT a figment of over-excited emotions, or a “weak-mind”, or “all in your head.”

The symptoms of bipolar disorder are severe changes in a person’s emotional state, but they are quite beyond the control of the person who suffers from them.

Medical research has established that the manic and depressive phases of bipolar disorder are related to chemical changes in the parts of the brain that govern our moods and emotions.

These chemical changes are the source of the symptoms, and their effects can be measured by brain scans and blood tests.

Scientists are still unsure about the causes of the chemical changes that bring on bipolar symptoms, but they appear to be linked to both genetic and environmental factors.

Bipolar Disorder is NOT just a Medical Problem

(Myth Buster #2)
According to modern medical research, bipolar disorder is NOT simply a biological condition that can be treated with medical drugs alone.

Although there is a definite biological component involving abnormal chemical changes in the brain, bipolar disorder is a complex condition also known to involve psychological and social factors.

As a result, treatments of bipolar disorder that focus only on treating biological causes with mood stabilizing drugs often fail to work.

A combined program of medical treatment, psychological training and self-help techniques has been shown to be the most effective way to control bipolar disorder.

Bipolar Disorder Is NOT Just “Good Moods and Bad Moods”

(Myth Buster #3)
The manic and depressive symptoms of bipolar disorder are very different than passing good or bad moods, or the normal feelings of elation, happiness, sadness or grief that everyone feels in response to events in their lives.

Although psychological stress or shock can trigger bipolar episodes of mania or depression, in many cases there may be no apparent reason for the changes in the emotional state of a bipolar person.

The emotional changes from bipolar disorder can be severe and disabling. They can cause major disruptions in a person’s life and the lives of the people around them, such as their family and friends.

A person suffering from extreme mania or depression can lose touch with reality for a time. They may experience psychotic symptoms, such as delusions and hallucinations, or they may try to take their own life.

Bipolar Disorder is NOT Depression

(Myth Buster #4)
Bipolar disorder is often misdiagnosed as a type of unipolar depression because some of the manic symptoms – such as an increased feeling of energy, or unusual productivity at work, or a powerful feeling of optimism – can seem to have a positive effect on the patient.

Most people with bipolar disorder only seek help for their condition during times of depression – and may not even think that their manic episodes are more than ordinary.

Up to a quarter of the people who have bipolar disorder are first misdiagnosed with a unipolar depressive disorder.

One of the main risks of a misdiagnosis of depression is that the common treatment for depressive disorders is to prescribe anti-depressant drugs. But anti-depressants can make the manic episodes of bipolar disorder worse.

This is one of the reasons that it is important for people who may have bipolar disorder to be assessed by a specialist psychiatric doctor. General practitioners may not have enough experience to recognize the signs of bipolar disorder.

Bipolar Disorder is NOT Schizophrenia

(Myth Buster #5)
Because the symptoms of Bipolar disorder can be so varied, the disorder can often be confused with other mental illnesses, including anxiety disorders and psychotic disorders such as schizophrenia and schizo-affective disorder.

Even medical professionals can be confused by the symptoms of bipolar disorder.

In addition, people with bipolar disorder are often found to suffer from other mental disorders at the same time. These can include substance abuse disorders, obsessive compulsive disorder, and panic disorders.

These factors are yet more reasons why people who may be suffering from any sort of mental illness need to be carefully assessed by psychiatric medical specialists.

If you or anyone you know is showing signs of what may be a mental illness, ask your local doctor or hospital for a referral to a psychiatric specialist.

Bipolar Disorder Is Not Something You Can Diagnose Yourself

(Myth Buster #6)
Bipolar disorder is notoriously difficult to diagnose, even for qualified doctors with years of experience treating the condition.

Although some people may casually describe themselves or others as “bipolar” to explain their changes in mood, some studies have shown that in most cases people who are labeled “bipolar” without any medical diagnosis do not have the condition at all.

But at the same time, many people who do have bipolar disorder have not been diagnosed with the condition.

Only a qualified medical specialist can make a diagnosis of bipolar disorder, and then only after many tests and a long period of observation of their patient’s behavior

If you think you see signs of bipolar behavior in yourself or someone you know, it is important that you contact a doctor, who can refer you to a psychiatric specialist experienced in bipolar disorder.

Bipolar Disorder Is Not Untreatable

(Myth Buster #7)
In most cases bipolar disorder can now be treated effectively, and most people with bipolar disorder today are able to lead happy and productive lives with their families and friends.

But if bipolar disorder is NOT treated, it can become much worse.

The most effective treatments for bipolar disorders now use a multi-faceted approach of medical drugs, psychological training such as mood monitoring, and self-help techniques for relaxation and healthy living.

Mood stabilizing drugs such as Lithium are commonly be used to alleviate the symptoms of mania and to moderate the extreme changes of mood. Anti-depressants may be described during episodes of depression.

Bipolar disorder is a complex condition and the treatments must be carefully monitored. So it is important that treatments for bipolar disorder are carried out under the supervision of a psychiatric specialist.

What Would You Like to Read Now After This Article on What Is Bipolar Disorder?

The Essence Bipolar 1 Disorder: Learn to Spot Bipolar Disorder Symptoms and See Treatments of Bipolar Type 1

Learn About Bipolar 2 Disorder: Bipolar Type 2 in Detail along with Typical Bipolar Disorder Symptoms

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