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Bipolar Disorder

Roller coaster rides of emotion from frantic highs to devastating lows are the classic signs of bipolar illness. Bipolar disorder is one of the most treatable mental illnesses, but left untreated it can cause mental suffering, disruption of family life, poor job performance, and reckless or dangerous behavior.


A person with bipolar disorder experiences mood swings from mania to depression, with a “normal” period between these cycles of up and down. The length of the cycles varies from a few days to several months and they can occur without warning.

During the manic phase, a person may feel “on top of the world” and have an abundance of energy. He seems to talk and think faster and espouse a number of ideas. He also may think he is invincible, leading to reckless behavior and acts that may endanger his life or well-being. A person in the manic phase also may have delusions of fame or believe she has a special relationship with a famous person. During this phase she also sleeps less, is easily distracted, and often is irritable.

During the depressive phase, a person may feel hopeless and lose all interest in other people or usual activities. Weight may fluctuate and one may feel tired all the time. One may sleep more than usual or have insomnia. There may be complains of unexplained aches or pains and trouble concentrating. A person in the depressive phase is a suicide risk.

The symptoms of the depressive stage are the same as for clinical depression, a different mental illness that does not have the manic phase. Bipolar disorder mimics several physical disorders and only a comprehensive physical and mental health evaluation can provide an accurate diagnosis.


The causes of manic depression are uncertain, but there are factors known to play a role.


Bipolar disorder runs in families and may be carried by a gene inherited from one or both parents.

Chemical Changes

Persons with bipolar disorder have chemical changes in the brain that continue to be studied for their cause and effect.


Situations that cause unusual stress, such as physical illness or money problems, may trigger a manic or depressive episode.
As with any mental illness, bipolar disorder is not a sign of moral weakness or caused by something the person did or did not do. And, as with any mental illness, it cannot be willed away and will not go away if left untreated.


A person with bipolar disorder who receives proper treatment can lead a normal life at work and home. Hospitalization is rare and only necessary if the person is a threat to him or herself or to others.

There are three methods of treating manic-depressive illness:


The most common is lithium carbonate. It works by maintaining chemical balances in the brain to prevent mood swings. Other drugs may be used to treat the symptoms of depression. The medications can have side effects, sometimes severe enough to rule out their use. Constant monitoring of the levels of drugs in the body and their effects is essential. It also may take time to determine the correct dosage, but many people with manic depression are successfully and safely using drug therapy.


Used to help a person deal with the illness, its causes, and its effect. Through psychotherapy, persons can learn to deal with situations and people in ways that avoid triggering a manic or depressive episode. The therapy also helps a person develop a positive self-image and attitude – both essential for good mental health.


This information was developed by the Missouri Department of Mental Health, Division of Comprehensive Psychiatric Services, and modified for this use by the MU Counseling Center