Clinical Research

At the Bipolar Clinic & Research Program, we have three missions: we are dedicated to providing quality clinical care, conducting clinically informative research, and educating our colleagues, our patients, as well as the greater community about bipolar disorder.

Research Registry

To join the BCRP's Volunteer Research Registry, e-mail your contact information to BCRPnewsletter@partners.org

Understanding Bipolar Disorder

What are the symptoms of mania?
Patients with Bipolar Disorder may experience manic episodes as a period lasting several days or longer when they feel much more excited and full of energy than usual. Their minds may go too fast. They may talk a lot. They may be very restless or unable to sit still, and they may do things that are unusual for them such as driving too fast or spending too much money. They may also experience mania as a period lasting several days or longer when most of the time they are so irritable or grouchy that they start arguments, shout at people, or hit people.

During these episodes of feeling excited, full of energy, or grouchy, patients with Bipolar Disorder often feel more talkative, experience racing thoughts, constantly change their plans or activities, are unable to concentrate, sleep far less than usual without getting tired, act very restless (pace up and down or can’t stand still), go on buying sprees (spending so much more money than usual that it causes financial difficulties), and behave in ways they would normally think are inappropriate (talking about private topics, doing things that are impossible to do, or taking on large amounts of work).

What is the difference between mania and hypomania?
Symptoms of mania last longer and are more intense than symptoms of hypomania. A collection of these symptoms must last at least a week and severely impair a patient’s daily functioning in order to be considered a manic episode. Patients with Bipolar Disorder are often hospitalized during a manic episode.

What is the difference between Bipolar I and Bipolar II?
A patient with Bipolar I has experienced at least one manic episode in their lifetime. A patient with Bipolar II experiences hypomanic episodes but does not experience manic episodes.

How do I know if I have Bipolar Disorder? A psychiatrist, psychologist, or other mental health professional can help you decide if you have Bipolar Disorder. If you believe that you may have Bipolar Disorder, consult your physician.

How common is Bipolar Disorder?
Bipolar Disorder affects between 1 and 3 out of every 100 people (or 1 to 3%) in the U.S.

Are patients with Bipolar Disorder always either manic or depressed?
No. Patients with Bipolar Disorder may recover from their depressed or manic episodes and have a normal mood state. However, they always run the risk of having further episodes of depression or mania, especially if they are not on mood-regulating medication.

In addition, patients may be hypomanic. That is, they may have some symptoms of mania but not for long enough or severely enough to interfere with their functioning in a marked way. This can be difficult to distinguish from feeling "average" or "normal" in mood.

What is the course of the illness?
While some people have only one episode of depression or mania without recurrence, the vast majority of patients (95%) have multiple episodes of depression and mania. At first, episodes may occur in response to stressful events, such as the break-up of a relationship, the death of a loved one, a move, or the loss of a job. Later on, episodes may come on "out of the blue," without connection to stressful events. There is evidence that the more episodes a person has, the more likely they are to have new episodes. In addition, the longer a person has the disorder, the shorter the time until the next episode. Therefore, as people have more episodes, they spend more and more time being ill.

The pattern of episodes can vary. Some people have single episodes of depression or mania with periods of normal mood in between. Others may have a manic episode immediately followed by a depressive episode, or a depressive episode immediately followed by a manic episode. Some people have both manic and depressed symptoms within a given episode. Some people have what is known as rapid cycling, where they have many episodes within a short period of time. While the frequency of mood switches can vary greatly, a person is considered to have rapid cycling if he or she has four or more episodes per year. Thus, a frequency of episodes of every 3 months is sufficient to diagnose a rapid-cycling course.

What causes Bipolar Disorder?
Bipolar Disorder is thought to be caused by chemical imbalances in certain brain cells responsible for regulating emotions and behavior. These imbalances probably come about through an interaction of genetic factors and life experiences. It is not entirely genetic or entirely environmental. Examples of life experiences that can lead to bipolar disorder in people genetically predisposed to this illness include stressful life events, medical conditions (e.g., thyroid abnormalities), or use of medications like steroids. The disorder is clearly a medical illness, and differences in brain function can be identified in people who are depressed or manic compared with a person experiencing a normal mood state.

What are some complications of Bipolar Disorder?
Going through depressed, manic, or mixed episodes can be very debilitating for the affected person and his or her family. The symptoms of the illness can interfere with a person's ability to take part in relationships and to function well at work. For instance, a person who is depressed may withdraw from friends and family or feel too irritable to be with him or her. He or she may be unable to concentrate on work or even to get out of bed to go to work. A person who is manic may have difficulty communicating with friends or family and may be irritable and potentially aggressive. He or she may be too disorganized and distracted to function at work.

Once the person recovers from the episode, he or she may face an abundance of debilitating consequences. People may find that their behavior has lost them their jobs, strained their relationships, and caused financial hardship or even homelessness. They may feel embarrassed by the way they behaved when depressed or manic. These hardships can lead to grief and demoralization. People often need help, such as psychotherapy and support groups to cope with these complications.

Suicide is another potential consequence resulting from Bipolar Disorder, particularly among patients who remain untreated.

Can Bipolar Disorder be cured?
The disorder cannot be cured, but it can be treated or controlled. In this way it is similar to chronic medical conditions like diabetes or heart disease, and just like these conditions, better treatments are being developed.

How can you help someone with Bipolar Disorder who does not want treatment? Many patients with acute mania do not realize that they are experiencing manic symptoms. Family members may benefit from joining organizations like NAMI and DBSA Boston to educate themselves and the individual who may have bipolar disorder. Talking to others with bipolar disorder who have experienced the same issues and benefited from treatment can be quite helpful. Individuals should be encouraged to see a psychiatrist or other mental health professional to ask questions about mania and bipolar disorder and to respond to their doubts and concerns about being diagnosed with bipolar disorder.