Why does someone develop bipolar disorder?

Bipolar Disorder

Do you go through intense moods? Do you feel very happy and energized some days, and very sad and depressed on other days? Do these moods last for a week or more? Do your mood changes make it hard to sleep, stay focused, or go to work? Some people with these symptoms have bipolar disorder, a serious mental illness. This brochure will give you more information. What is bipolar disorder? Bipolar disorder is a serious brain illness. It is also called manic-depressive illness or manic depression. People with bipolar disorder go through unusual mood changes. Sometimes they feel very happy and up, and are much more energetic and active than usual. This is called a manic episode. Sometimes people with bipolar disorder feel very sad and down, have low energy, and are much less active. This is called depression or a depressive episode. Bipolar disorder is not the same as the normal ups and downs everyone goes through. The mood swings are more extreme than that and are accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms are so strong that they can damage relationships and make it hard to go to school or keep a job. They can also be dangerous. Some people with bipolar disorder try to hurt themselves or attempt suicide. People with bipolar disorder can get treatment. With help, they can get better and lead successful lives. Who develops bipolar disorder? Anyone can develop bipolar disorder. It often starts in a person s late teen or early adult years. But children and older adults can have bipolar disorder too. The illness usually lasts a lifetime. Why does someone develop bipolar disorder? Doctors do not know what causes bipolar disorder, but several things may contribute to the illness. Family genes may be one factor because bipolar disorder sometimes runs in families. However, it is important to know that

just because someone in your family has bipolar disorder, it does not mean other members of the family will have it as well. Another factor that may lead to bipolar disorder is the brain structure or the brain function of the person with the disorder. Scientists are finding out more about the disorder by studying it. This research may help doctors do a better job of treating people. Also, this research may help doctors to predict whether a person will get bipolar disorder. One day, doctors may be able to prevent the illness in some people. What are the symptoms of bipolar disorder? Bipolar mood episodes include unusual mood changes along with unusual sleep habits, activity levels, thoughts, or behavior. People may have manic episodes, depressive episodes, or mixed episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two or sometimes longer. During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels. People having a manic episode may: Feel very up or high Feel jumpy or wired Have trouble sleeping Become more active than usual Talk really fast about a lot of different things Be agitated, irritable, or touchy Feel like their thoughts are going very fast Think they can do a lot of things at once Do risky things, like spend a lot of money or have reckless sex People having a depressive episode may: Feel very down or sad Sleep too much or too little Feel like they can t enjoy anything Feel worried and empty Have trouble concentrating Forget things a lot

Eat too much or too little Feel tired or slowed down Have trouble sleeping Think about death or suicide Can someone have bipolar disorder along with other problems? Yes. Sometimes people having very strong mood episodes may have psychotic symptoms. Psychosis affects thoughts and emotions as well as a person s ability to know what is real and what is not. People with mania and psychotic symptoms may believe they are rich and famous, or have special powers. People with depression and psychotic symptoms may believe they have committed a crime, they have lost all of their money, or that their lives are ruined in some other way. Sometimes behavior problems go along with mood episodes. A person may drink too much or take drugs. Some people take a lot of risks, like spending too much money or having reckless sex. These problems can damage lives and hurt relationships. Some people with bipolar disorder have trouble keeping a job or doing well in school. Is bipolar disorder easy to diagnose? No. Some people have bipolar disorder for years before the illness is diagnosed. This is because bipolar symptoms may seem like several different problems. Family and friends may notice the symptoms but not realize they are part of a bigger problem. A doctor may think the person has a different illness, like schizophrenia or depression. People with bipolar disorder often have other health problems as well. This may make it hard for doctors to recognize the bipolar disorder. Examples of other illnesses include substance abuse, anxiety disorders, thyroid disease, heart disease, and obesity. How is bipolar disorder treated? Right now, there is no cure for bipolar disorder, but treatment can help control symptoms. Most people can get help for mood changes and behavior problems. Steady, dependable treatment works better than treatment that starts and stops. Treatment options include:

1. Medication. There are several types of medication that can help. People respond to medications in different ways, so the type of medication depends on the patient. Sometimes a person needs to try different medications to see which works best. Medications can cause side effects. Patients should always tell their doctors about these problems. Also, patients should not stop taking a medication without a doctor s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse. 2. Therapy. Different kinds of psychotherapy, or talk therapy, can help people with bipolar disorder. Therapy can help them change their behavior and manage their lives. It can also help patients get along better with family and friends. Sometimes therapy includes family members. 3. Other treatments. Some people do not get better with medication and therapy. These people may try electroconvulsive therapy, or ECT. This is sometimes called shock therapy. ECT provides a quick electric current that can sometimes correct problems in the brain. Sometimes people take herbal and natural supplements, such as St. John s wort or omega-3 fatty acids. Talk to your doctor before taking any supplement. Scientists aren t sure how these products affect people with bipolar disorder. Some people may also need sleep medications during treatment. PERSONAL STORY James has bipolar disorder. Here s his story. Four months ago, James found out he has bipolar disorder. He knows it s a serious illness, but he was relieved when he found out. That s because he had symptoms for years, but no one knew what was wrong. Now he s getting treatment and feeling better. James often felt really sad. As a kid, he skipped school or stayed in bed when he was down. At other times, he felt really happy. He talked fast and felt like he could do anything. James lived like this for a long time, but things changed last year. His job got very stressful. He felt like he was having more up and down times. His wife

and friends wanted to know what was wrong. He told them to leave him alone and said everything was fine. A few weeks later, James couldn t get out of bed. He felt awful, and the bad feelings went on for days. Then, his wife took him to the family doctor, who sent James to a psychiatrist. He talked to this doctor about how he was feeling. Soon James could see that his ups and downs were serious. He was diagnosed with bipolar disorder, and he started treatment. These days, James takes medicine and goes to talk therapy. Treatment was hard at first, and recovery took some time, but now he s back at work. His mood changes are easier to handle, and he s having fun again with his wife and friends. Getting Help If you re not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency. Finally, the Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to help you find mental health services in your area. You can find it here: https://findtreatment.samhsa.gov. How can I help myself if I have bipolar disorder? You can help yourself by getting treatment and sticking with it. Recovery takes time, and it s not easy. But treatment is the best way to start feeling better. Here are some tips: Talk with your doctor about your treatment. Stay on your medication. Keep a routine for eating and sleeping. Make sure you get enough sleep. Learn to recognize your mood swings. Ask a friend or relative to help you stick with your treatment. Be patient with yourself. Improvement takes time.

How can I help someone I know with bipolar disorder? Help your friend or relative see a doctor to get the right diagnosis and treatment. You may need to make the appointment and go to the doctor together. Here are some helpful things you can do: Be patient. Encourage your friend or relative to talk, and listen carefully. Be understanding about mood swings. Include your friend or relative in fun activities. Remind the person that getting better is possible. with the right treatment. I know someone who is in crisis. What do I do? If you know someone who might hurt himself or herself, or if you re thinking about hurting yourself, get help quickly. Here are some things you can do: Do not leave the person alone. Call your doctor. Call 911 or go to the emergency room. Call the National Suicide Prevention Lifeline, toll-free: 1-800-273-TALK (8255). The TTY number is 1-800-799-4TTY (4889). How does bipolar disorder affect friends and family? When a friend or relative has bipolar disorder, it affects you too. Taking care of someone with bipolar disorder can be stressful. You have to cope with the mood swings and sometimes other problems, such as drinking too much. Sometimes the stress can strain your relationships with other people. Caregivers can miss work or lose free time. If you are taking care of someone with bipolar disorder, take care of yourself too. Find someone you can talk to about your feelings. Talk with the doctor about support groups for caregivers. If you keep your stress level down, you will do a better job, and it might help your loved one stick to his or her treatment.

Contact us to find out more about bipolar disorder. National Institute of Mental Health Office of Science Policy, Planning, and Communications Science Writing, Press, and Dissemination Branch 6001 Executive Boulevard Room 6200, MSC 9663 Bethesda, MD 20892-9663 Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free TTY: 301-443-8431 or 1-866-415-8051 toll-free Fax: 301-443-4279 Email: nimhinfo@nih.gov Website: http://www.nimh.nih.gov U.S. Department of Health and Human Services National Institutes of Health National Institute of Mental Health November 2015 NIH Publication Number TR 15-3679

relationships. to yourself. Besides seeing a doctor and a counselor, you can also help your depression by being patient with yourself and good to yourself. Don t expect to get better immediately, but you will feel yourself improving gradually over time. Daily exercise, getting enough sleep, spending time outside in nature and in the sun, or eating healthy foods can also help you feel better. Your counselor may teach you how to be aware of your feelings and teach you relaxation techniques. Use these when you start feeling down or upset. Try to spend time with supportive family members. Talking with your parents, guardian, or other family members who listen and care about you gives you support, and they can make you laugh. Try to get out with friends and try fun things that help you express yourself. Depression can affect It s understandable that you don t want to tell other people that you have been struggling with depression. But know that depression can affect your relationships with family and friends, and how you perform at school. Maybe your grades have dropped because you find it hard to concentrate and stay on top of school. Teachers may think that you aren t trying in class. Maybe because you re feeling hopeless, peers think you are too negative and start giving you a hard time. Know that their misunderstanding won t last forever because you are getting better with treatment. Think about talking with people you trust to help them understand what you are going through. National Institute of Mental Health 1-800-273-TALK (8255) Be good Depression is not your fault or caused by something you did wrong. Depression is a real, treatable brain illness, or health problem. Depression can be caused by big transitions in life, stress, or changes in your body s chemicals that affect your thoughts and moods. Depression can run in families. Maybe you haven t realized that you have depression and have been blaming yourself for being negative. Remember that depression is not your fault! Learn more. National Institute of Mental Health (NIMH): www.nimh.nih.gov Drugs & Health: A blog for teens from the National Institute on Drug Abuse: http://teens.drugabuse.gov/blog National Suicide Prevention Lifeline: 1-800-273-TALK (8255), free 24-hour help TEEN DEPRESSION You are not alone. OM 15-4302 Revised 2015 National Institute of Mental Health There are ways you can feel better.

If you have been feeling sad, hopeless, or irritable for what seems like a long time, you might have depression. Depression is a real, treatable brain illness, or health problem. Depression can be caused by big transitions in life, stress, or changes in your body s chemicals that affect your thoughts and moods. Even if you feel hopeless, depression gets better with treatment. There are lots of people who understand and want to help you. Ask for help as early as you can so you can get back to being yourself. 1-800-273-TALK (8255) Regular sadness and depression are not the same. Regular sadness Feeling moody, sad, or grouchy? Who doesn t once in a while? It s easy to have a couple of bad days. Your schoolwork, activities, and family and friend drama, all mixed with not enough sleep, can leave you feeling overwhelmed. On top of that, teen hormones can be all over the place and also make you moody or cry about the smallest thing. Regular moodiness and sadness usually go away quickly though, within a couple of days. Depression Untreated depression is a more intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer, such as for weeks, months, or longer. These feelings make it hard for you to function as you normally would or participate in your usual activities. You may also have trouble focusing and feel like you have little to no motivation or energy. You may not even feel like seeing your best friends. Depression can make you feel like it is hard to enjoy life or even get through the day. If you think you are depressed, ask for help as early as you can. If you have symptoms of depression for more than 2 weeks, ask for help. Depression can get better with care and treatment. Don t wait for depression to go away by itself. If you don t ask for help, depression may get worse. 1. Talk to: Your parents or guardian Your teacher or counselor Your doctor A helpline, such as 1-800-273-TALK (8255), free 24-hour help Or call 911 if you are in a crisis or want to hurt yourself 2. Ask your parent or guardian to make an appointment with your doctor for a checkup. Your doctor can make sure that you do not have another health problem that is causing your depression. If your doctor finds that you do not have another health problem, he or she can treat your depression or refer you to a mental health professional. A mental health professional can give you a thorough evaluation and also treat your depression. 3. Talk to a mental health professional, such as a psychiatrist, counselor, psychologist, or other therapist. These mental health professionals can diagnose and treat depression and other mental health problems. Know the signs and symptoms of depression. Most of the day or nearly every day you may feel one or all of the following: Sad Hopeless Empty Angry, cranky, or frustrated, even at minor things You also may: Not care about things or activities you used to enjoy. Have weight loss when you are not dieting or weight gain from eating too much. Have trouble falling asleep or staying asleep, or sleep much more than usual. Move or talk more slowly. Feel restless or have trouble sitting still. Feel very tired or like you have no energy. Feel worthless or very guilty. Have trouble concentrating, remembering information, or making decisions. Think about dying or suicide or try suicide. Not everyone experiences depression the same way. And depression can occur at the same time as other mental health problems, such as anxiety, an eating disorder, or substance abuse. There are ways you can feel better. Effective treatments for depression include talk therapy or a combination of talk therapy and medicine. Talk therapy A therapist, such as a psychiatrist, a psychologist, a social worker, or counselor can help you understand and manage your moods and feelings. You can talk out your emotions to someone who understands and supports you. You can also learn how to stop thinking negatively and start to look at the positives in life. This will help you build confidence and feel better about yourself. Research has shown that certain types of talk therapy or psychotherapy can help teens deal with depression. These include cognitive behavioral therapy, which focuses on thoughts, behaviors, and feelings related to depression, and interpersonal psychotherapy, which focuses on working on relationships. Read more about talk therapies at www.nimh.nih.gov/health/topics/psychotherapies. Medicines If your doctor thinks you need medicine to help your depression, he or she can prescribe an antidepressant. There are a few antidepressants that have been widely studied and proven to help teens. If your doctor recommends medicine, it is important to see your doctor regularly and tell your parents or guardian about your feelings, especially if you start feeling worse or have thoughts of hurting yourself. Read more about medicines for depression at www.nimh.nih.gov/health/publications/mental-health-medications. National Institute of Mental Health