Signs and symptoms An lithograph captioned 'Melancholy passing into mania' Both mania and depression are characterized by disruptions in normal moodpsychomotor activity, circadian rhythmand cognition. Mania can present with varying levels of mood disturbance, ranging from euphoria that is associated with "classic mania" to dysphoria and irritability. The core symptom of mania involves an increase in energy of psychomotor activity.
Mania can present with varying levels of mood disturbance, ranging from euphoria that is associated with "classic mania" to dysphoria and irritability. The core symptom of mania involves an increase in energy of psychomotor activity. Mania can also present with increased self-esteem or grandiosityrapid speech, the subjective feeling of rapid thoughts, disinhibited social behavior, or impulsivity.
Unlike mania, hypomania is not always associated with impaired functioning. Hypomania may feel good to some persons who experience it, though most people who experience hypomania state that the stress of the experience is very painful.
Even when family and friends recognize mood swingsthe individual will often deny that anything is wrong.
These symptoms include delusions and hallucinations. A major depressive episode persists for at least two weeks, and may result in suicide if left untreated. Mixed affective state In bipolar disorder, mixed state is a condition during which symptoms of both mania and depression occur simultaneously.
Associated features of bipolar disorder Associated features are clinical phenomena that often accompany the disorder but are not part of the diagnostic criteria. In adults with the condition, bipolar disorder is often accompanied by changes in cognitive processes and abilities.
For bipolar disorder type I, the rate at which identical twins same genes will both have bipolar disorder type I concordance is estimated at around 40 percent, compared to about 5 percent in fraternal twins.
There is overlap with major unipolar depression and if this is also counted in the co-twin the concordance with bipolar disorder rises to 67 percent in identical twins and 19 percent in fraternal twins. Conditions like these and injuries include stroketraumatic brain injuryHIV infectionmultiple sclerosisporphyriaand rarely temporal lobe epilepsy.
Meta-analyses of structural MRI studies in bipolar disorder report decreased volume in the left rostral anterior cingulate cortex ACCfronto-insular cortexventral prefrontal cortex, and claustrum. Increases have been reported in the volume of the lateral ventriclesglobus pallidussubgenual anterior cingulateand amygdala as well as in the rates of deep white matter hyperintensities.
On the other hand, pretreatment hyperactivity in the amygdala is reduced post-treatment but is still increased relative to controls, suggesting that it is a trait marker. During attentional tasks and resting, mania is associated with decreased orbitofrontal cortex activity, while depression is associated with increased resting metabolism.
Consistent with affective disorders due to lesionsmania and depression are lateralized in vPFC dysfunction, with depression primarily being associated with the left vPFC, and mania the right vPFC. Abnormal vPFC activity, along with amygdala hyperactivity is found during euthymia as well as in healthy relatives of those with bipolar, indicating possible trait features.
There is evidence supporting an association between early-life stress and dysfunction of the hypothalamic-pituitary-adrenal axis HPA axis leading to its overactivation, which may play a role in the pathogenesis of bipolar disorder.
This results in decreased dopamine transmission characteristic of the depressive phase. Increased dopaminergic activity has been hypothesized in manic states due to the ability of dopamine agonists to stimulate mania in people with bipolar disorder.
Low plasma GABA levels on both sides of the mood spectrum have been found. VMAT2 binding was found to be increased in one study of people with bipolar mania.
In diagnosis, caregiver-scored rating scales, specifically the mother, has been found to be more accurate than teacher and youth report in predicting identifying youths with bipolar disorder. The ICD criteria are used more often in clinical settings outside of the U. Several rating scales for the screening and evaluation of bipolar disorder exist,  including the Bipolar spectrum diagnostic scaleMood Disorder Questionnairethe General Behavior Inventory and the Hypomania Checklist.
These disorders include schizophreniamajor depressive disorder,  attention deficit hyperactivity disorder ADHDand certain personality disorders, such as borderline personality disorder. Infectious causes of mania that may appear similar to bipolar mania include herpes encephalitisHIVinfluenzaor neurosyphilis.
The DSM-5 lists three specific subtypes: At least one manic episode is necessary to make the diagnosis;  depressive episodes are common in the vast majority of cases with bipolar disorder I, but are unnecessary for the diagnosis.
No manic episodes and one or more hypomanic episodes and one or more major depressive episode. A history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes. Individuals who have subthreshold symptoms that cause clinically significant distress or impairment, but do not meet full criteria for one of the three subtypes may be diagnosed with other specified or unspecified bipolar disorder.
Other specified bipolar disorder is used when a clinician chooses to provide an explanation for why the full criteria were not met e.Understanding Bipolar Disorder: Symptoms The primary symptoms of bipolar disorder are periods of elevated or irritable mood accompanied by dramatic increases in energy, activity, and fast thinking.
People with bipolar disorder are seven to eight times more likely to fall apart during stressful times. Learn about the most common triggers for bipolar mood episodes. Bipolar disorder, previously known as manic depression, is a mental disorder that causes periods of depression and periods of abnormally elevated mood.
The elevated mood is significant and is known as mania or hypomania, depending on its severity, or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy, or irritable. Two patterns of antecedent or 'prodromal' psychiatric symptoms may help to identify young persons at increased risk of developing bipolar disorder (BD), according to a new analysis.
Early signs of. The cause of bipolar disorder is not entirely known. Genetic, neurochemical, and environmental factors probably interact at many different levels to play a role in the onset and progression of.
"A comparison of selected risk factors for unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder, and schizophrenia from a Danish population-based cohort." The Journal of Clinical Psychiatry ():