Bipolar disorder is a severe mental illness characterized by extreme shifts in mood and levels of energy. There is a phase of elevated mood known as mania or hypomania (slightly milder form of mania), as well as a period of depression. There may also be a mixed phase, in which mania and depression appear together, causing a state of extreme agitation. Moving from one mood phase to another is known as cycling. Each cycle may last for a few months at a time.

During mania, the patient may feel unusually happy, energetic or even agitated (during a mixed state). Some manic patients become reckless and take part in behaviors that are completely out of character, such as gambling, excessive spending, indulging in drugs or heavy drinking, or participating in risky sexual behaviors. Some stay awake for long periods of time, requiring very little sleep due to the extreme levels of energy. During very severe mania, a patient may experience psychosis.

During the depression phase, the patient may feel extreme hopelessness, sadness, loss of interest in activities, anxiety and heavy fatigue. There may also be depersonalization or suicidal thoughts. When the episode is severe, the person may experience psychosis, such as delusions and, in rare cases, hallucinations. The depressive episode may last for a few weeks, or if left untreated, may continue for several months.

Some bipolar patients experience a mixed state, a condition in which symptoms of both mania and depression occur simultaneously. A person with a mixed episode may experience hopelessness, anxiety, agitation, grandiose thoughts and impulse control. This state has a high risk for suicide and substance abuse.

About 3 percent of the population has bipolar disorder with the condition occurring equally in men and women. The age of onset is approximately 25. Both genetics and environmental factors play a role in bipolar disorder. Treatment often consists of mood stabilizers, such as lithium, and psychotherapy. Bipolar patients often have a bad reaction to antidepressant drugs.

Example: During a depressive phase, Bob becomes hopeless and listless, but while he’s experiencing a manic phase, he feels unstoppable and powerful.