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  • Psychology Assessment Center

    The pediatric neuropsychology specialists at Massachusetts General Hospital’s Psychology Assessment Center provide neuropsychological assessments to aid in the diagnosis and treatment of neurological, medical, genetic and developmental disorders.

    For more information, please call: 617-643-3997

About This Condition

Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a mood disorder. It causes a person to have cycles of extreme mood changes that go beyond normal ups and downs. A person with bipolar cycles between periods of feeling elated, energized and excited with periods of feeling sad and depressed.  For this reason, it’s also known as manic depression.

Depression affects your body, mood, and thoughts. It also affects the way you eat and sleep, think about things, and feel about yourself. It’s not the same as being unhappy or in a "blue" mood. It’s not a sign of weakness or a condition that can be willed away. Treatment is often needed and is key to recovery.

Bipolar affects equal numbers of men and women. But, women tend to have more symptoms of depression than of mania. Bipolar often begins in the teens or early adulthood.

What causes bipolar disorder?

The cause of bipolar is not known. Experts agree many factors seem to play a role. This includes environmental, psychological, and genetic factors.

Bipolar tends to run in families. Researchers are still trying to find genes that may be linked to this disorder.

What are the symptoms of bipolar disorder?

While each person may experience symptoms differently, the following are the most common symptoms:

Depressive symptoms may include:

  • Constant sad, anxious, or “empty” mood
  • Loss of interest in things that you once enjoyed, including sex
  • Feeling restless or irritable
  • Inability to focus, think, and/or make decisions
  • Low energy, fatigue, being "slowed down"
  • Recurring thoughts of death or suicide, wishing to die, or attempting suicide (Note: People with this symptom should get treatment right away!)
  • Feeling worthless and/or hopeless
  • Feeling undue guilt
  • Changes in eating habits, eating too much or not enough
  • Changes in sleep patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much
  • Headaches, digestive problems, or chronic pain

Manic symptoms may include:

  • Inflated self-esteem
  • Need for less rest and sleep
  • Easily distracted  or irritable
  • Racing thoughts
  • Physical agitation
  • Risky, aggressive, or destructive behavior
  • Talking a lot and talking fast
  • Excessive "high" or euphoric feelings (feeling overly happy)
  • Increased sex drive
  • Increased energy
  • Unusual poor judgment (for instance, buying sprees or sexual indiscretion)
  • Increased denial

How is bipolar disorder diagnosed?

To diagnose bipolar, your doctor will ask about your symptoms. You may have both depressive and manic symptoms to a varying degree. The symptoms of bipolar may look like other mental health conditions.

Always see a health care provider for a diagnosis. A diagnosis is made after a careful psychiatric exam and medical history done by a mental health professional.

How is bipolar disorder treated?

There is no cure for bipolar, but treatment works well for many people. Treatment may include one or a combination of the following:

  • Medication. Many different drugs are available for bipolar. But, it often takes 4 to 6 weeks for anti-depressants to have a full effect. So, it’s important to keep taking the medicine, even if it doesn’t seem to be working at first. It’s also important to talk to the doctor before stopping. Some people have to switch medicines or add medicines to get results.
  • Therapy. This is most often cognitive-behavioral or interpersonal therapy. It focuses on changing the distorted views you have of yourself and your environment. It works to improve your interpersonal relationship skills. It also helps you identify stressors and learn how to manage them.
  • Electroconvulsive therapy (ECT). This treatment may be used in people with severe, life-threatening depression that has not responded to medicines. A brief electrical current is passed through the brain, triggering a mild seizure. For unknown reasons, this helps restore the normal balance of chemicals in the brain and ease symptoms.

In most cases, consistent, long-term, treatment is needed to stabilize the mood swings.

Self care

You can also take steps to help yourself. During periods of depression, consider the following:

  • Get help. If you think you may be depressed, see a health professional right away.
  • Set realistic goals and don’t take on too much.
  • Break large tasks into small ones. Set priorities, and do what you can as you can.
  • Try to be with other people and confide in someone. This is usually better than being alone and secretive.
  • Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Expect your mood to get better slowly, not right away. Feeling better takes time.
  • Eat healthy, well-balanced meals.
  • Avoid alcohol and drugs. These can make depression worse.
  • It’s best to postpone big decisions until the depression has lifted. Before making big decisions -- change jobs, get married or divorced -- discuss it with others who know you well and have a more objective view of your situation.
  • People don’t  "snap out of" a depression. But with treatment they can feel a little better day-by-day.
  • Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression, and the negative thoughts will disappear as your depression responds to treatment.
  • Let your family and friends help you.


Key points

  • Bipolar disorder causes cycles of extreme mood changes that go beyond life's ordinary ups and downs. Treatment is key to recovery.
  • There is no clear cause of bipolar. Doctors think it’s a result of chemical imbalances in the brain. It seems to run in families, but no genes have yet been linked to it.
  • Bipolar causes unusual mood swings and is characterized by episodes of extreme elation, elevated mood, or irritability (called mania). This alternates with periods of depression.
  • Bipolar may be diagnosed after a careful psychiatric exam and medical history done by a mental health professional.
  • It’s most often treated with medication, therapy, or a combination of medication and therapy.
  • There is no cure for bipolar, and in most cases, long-term, treatment is needed to stabilize the mood swings.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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