Bipolar affective disorder

Alternative names:

affective bipolar disorder; bipolar disorder; manic depressive illness

Symptoms:

• alternating mania (exaggerated feeling of well-being) or depression; one emotional tone may predominate
• little or no observable change in mood, or mood is inappropriate for the situation
• anxiety, stress, and tension

In the depressive phase:

• loss of self-esteem
• withdrawal
• feelings of helplessness or worthlessness
• excessive or inappropriate guilt
• fatigue (tiredness or weariness) lasting for weeks to months
• overwhelming sluggishness (inertia)
• persistent daytime sleepiness
• insomnia
• difficulty concentrating, easily distracted by inconsequential event(s)
• loss of appetite
• weight loss (unintentional)
• abnormal thoughts about death
• thoughts about suicide, plans to commit suicide, or suicide attempt(s)
• diminished interest in daily activities
• diminished pleasure in daily activities
• memory loss (amnesia) episode

In the manic phase:

• elevated mood
• increased activities
• flight of ideas or racing thoughts
• inflated self-esteem
• decreased need for sleep
• agitation
• more talkative than usual or pressure to keep talking
• increased purposeless activity (e.g., pacing, hand wringing)
• extreme restlessness
• weight gain (unintentional)
• poor temper control
• excessively irresponsible behavior pattern
• increased goal-directed social or sexual activity
• impaired excessive involvement in pleasurable activities with high potential for painful consequences
• false beliefs (delusions)
• hallucinations

Signs and tests:

A psychiatric history of mood swings and an observation of current behavior and mood are helpful in the diagnosis of this disorder. A family history of manic-depressive illness may be present. A physical examination may be performed to rule out physical causes of the disorder.