Perhaps you've heard the term "bipolar" used to describe someone who's moody or has mood swings. However, this colloquial use of the term is quite different from bipolar disorder. Bipolar disorder, formerly known as manic depression, is a serious mental illness that causes a person to experience dramatic shifts in emotions, mood, and energy levels, moving from extreme lows to extreme highs. These shifts don't occur moment to moment; they usually happen over several days or weeks. There are several types of bipolar disorders, but they share some common features. Firstly, the low moods are identical to those in a related disorder, major depressive disorder, also known as unipolar depression. Individuals with this disorder can feel hopeless and discouraged, lack energy and mental focus, and can have physical symptoms like eating and sleeping too much or too little. What sets bipolar disorders apart from unipolar depression is that individuals can also have periods of high moods, known as manic episodes or hypomanic episodes, depending on their severity. In a manic state, people can feel energetic, overly happy or optimistic, even euphoric with high self-esteem. These might seem like positive characteristics, but during a full manic episode, these symptoms can reach a dangerous extreme. A person experiencing mania might invest all their money in a risky business venture, or behave recklessly. They might have pressured speech where they talk constantly at a rapid pace, or they might have racing thoughts and feel wired, as if they don't need sleep. Manic episodes can also include delusions of grandeur, such as believing they're on a personal mission from God, or that they have supernatural powers. Finally, they might make poor decisions without any regard for later consequences. One way to understand these mood swings is by charting them on a graph. Let's say that the y-axis represents mood, with mania and depression being on the far ends of the axis, and the x-axis represents time. The average healthy individual might have normal ups and downs throughout their life, and they might even have some serious lows once in a while, perhaps after losing a job or moving to a new place and feeling lonely. An individual with unipolar depression, however, might have normal highs, but they'll likely also have some crushing lows that last for a long period of time and might not even have an obvious trigger. Now, for the bipolar disorders. The first one is called bipolar I, and these individuals have major lows that last at least two weeks, and major highs that last at least a week or require hospitalization. Untreated manic episodes can last as long as 3-6 months, and even though depression is seen in most cases, it's not actually required for a diagnosis. The second type is called bipolar II, and this is when a person experiences similar lows and additional highs called hypomania, which are less severe manic episodes than those seen in bipolar I. To qualify for a diagnosis, these hypomanic states need to last for at least four days. These symptoms generally last a few weeks to a few months. The third type is called cyclothymia, or sometimes cyclothymic disorder. These individuals have milder lows as well as milder highs, or hypomania like you see in bipolar II, and they cycle back and forth between these two over a period lasting at least two years. Sometimes people with bipolar disorder can show other, less common symptoms as well, such as having what are referred to as mixed episodes, experiencing symptoms of both depression and mania at the same time. Another symptom they might have is rapid cycling, which describes a situation where a person has four or more episodes of depression or mania within a given year. Like most mental health conditions, the exact underlying cause of bipolar disorder isn't known, and there's no single "bipolar gene" that's been identified. However, it's thought that there are genetic and environmental factors that play a part. For example, people with family members who have bipolar disorders are 10 times more likely to have it themselves. Some drugs and medications can trigger manic episodes, like selective serotonin reuptake inhibitors, or SSRIs. It's also worth mentioning that people with bipolar disorder often have other disorders like anxiety disorders, substance abuse disorders, ADHD, and personality disorders as well, making diagnosis and treatment a real challenge. Even though there's no cure for bipolar disorder, identifying and treating individuals is really important, since there's a real danger that the person could harm themselves or even commit suicide. One of the oldest treatments is also one of the most effective treatments, and that's lithium salts. Lithium acts as a mood stabilizer, smoothing out the highs and lows that they experience. However, it's much better at treating manic rather than depressive episodes, and so individuals who take it often have to take other medications as well, which can be problematic since some antidepressants, like SSRIs, can trigger manic episodes in people that are predisposed to them. Other treatment options include antipsychotics, anticonvulsants, and benzodiazepines, but many of these, including lithium, have side effects that can be severe and lead to non-adherence, which can be dangerous for the person. Unlike certain disorders like unipolar depression, psychological interventions like talk therapy or cognitive behavioral therapy are not particularly effective in treating the manic episodes of bipolar disorder. However, they can still be very helpful tools to help someone with bipolar disorder in general, especially after a manic episode has ended. They can also help the person handle stressful situations that might otherwise lead to a manic episode, thereby helping to prevent a potential manic episode in the first place. In summary, bipolar disorder is a mental disorder characterized by depression, periods of lowered mood, as well as mania, periods of heightened mood.