Bipolar disorder history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


History and Symptoms

Bipolar disorder is a cyclic illness where people periodically exhibit elevated (Manic) and depressive episodes. Most people will experience a number of episodes, averaging 0.4 to 0.7 a year with each lasting 3-6 months.[1] Late adolescence and early adulthood are peak years for the onset of the illness.[2][3] These are critical periods in a young adult's social and vocational development, and they can be severely disrupted by disease onset.

  • The manic phase may last from days to months. It can include the following symptoms:
  • Easily distracted
  • Little need for sleep
  • Poor judgment
  • Poor temper control
  • Reckless behavior and lack of self control
  • Binge eating, drinking, and/or drug use
  • Poor judgment
  • Sex with many partners (promiscuity)
  • Spending sprees
  • Very elevated mood
  • Excess activity (hyperactivity)
  • Increased energy
  • Racing thoughts
  • Talking a lot
  • Very high self-esteem (false beliefs about self or abilities)
  • Very involved in activities
  • Very upset (agitated or irritated)
  • These symptoms of mania occur with bipolar disorder I. In people with bipolar disorder II, the symptoms of mania are similar but less intense.
  • The depressed phase of both types of bipolar disorder includes the following symptoms:
  • Daily low mood or sadness
  • Difficulty concentrating, remembering, or making decisions
  • Eating problems
  • Loss of appetite and weight loss
  • Overeating and weight gain
  • Fatigue or lack of energy
  • Feeling worthless, hopeless, or guilty
  • Loss of pleasure in activities once enjoyed
  • Loss of self-esteem
  • Thoughts of death and suicide
  • Trouble getting to sleep or sleeping too much
  • Pulling away from friends or activities that were once enjoyed
  • There is a high risk of suicide with bipolar disorder. Patients may abuse alcohol or other substances, which can make the symptoms and suicide risk worse.
  • Sometimes the two phases overlap. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.


Recent studies have found that bipolar disorder involves certain cognitive deficits or impairments, even in states of remission. [4][5][6]

Deborah Yurgelun-Todd of McLean Hospital in Belmont, Massachusetts has argued these deficits should be included as a core feature of bipolar disorder. According to McIntyre et al. (2006),

Study results now press the point that neurocognitive deficits are a primary feature of BD; they are highly prevalent and persist in the absence of overt symptomatology. Although disparate neurocognitive abnormalities have been reported, disturbances in attention, visual memory and executive function are most consistently reported.[7]

However, in the April-June 2007 issue of the Journal of Psychiatric Research, Spanish researchers reported that people with bipolar 1 who have a history of psychotic symptoms do not necessarily experience an increase in cognitive impairment.


A number of recent studies have observed a correlation between creativity and bipolar disorder, although it is unclear in which direction the cause lies, or whether both conditions are caused by some third, unknown, factor. It has been hypothesized that temperament may be one such factor.


  1. Kessler, RC; McGonagle, KA; Zhao, S; Nelson, CB; Hughes, M; Eshleman, S; Wittchen, HU; Kendler, KS (1994), "Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States", Archives of General Psychiatry, 51 (1): 8–19
  2. Christie KA, Burke JD Jr, Regier DA, Rae DS, Boyd JH, Locke BZ (1988). (abstract) "Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults" Check |url= value (help). Am J Psychiatry. 145: 971–975. Retrieved 2007-07-01.
  3. Goodwin & Jamison. p121
  4. Martínez-Arán, A; Vieta, E; Reinares, M; Colom, F; Torrent, C; Sánchez-Moreno, J; Benabarre, A; Goikolea, JM; Comes, M; Salamero, M (February 2004), "Cognitive Function Across Manic or Hypomanic, Depressed, and Euthymic States in Bipolar Disorder", American Journal of Psychiatry, 161 (2): 262–270
  5. Rossi, A; Arduini, L; Daneluzzo, E; Bustini, M; Prosperini, P; Stratta, P (July 2000), "Cognitive function in euthymic bipolar patients, stabilized schizophrenic patients, and healthy controls", Journal of Psychiatric Research, 34 (4–5): 333–339, doi:10.1016/S0022-3956(00)00025-X
  6. "Second Biennial Conference of the International Society for Bipolar Disorders, 2–4 August 2006, Edinburgh, Scotland, Thursday, August 3, Cognitive Function in BD", Bipolar Disorders, 8 (Supplement 1): 2–3, August 2006, doi:10.1111/j.1399-5618.2006.00379_2.x
  7. Roger S. McIntyre, MD, Joanna K. Soczynska, and Jakub Konarski (2006). "Bipolar Disorder: Defining Remission and Selecting Treatment". Psychiatric Times. Unknown parameter |cite= ignored (help).