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Bipolar Disorder

[Cover of publication] [ blank box ] What is Bipolar Disorder?
Getting Help
For further information contact:
Message from the Director of the NIMH


Bipolar disorder, which is also known as manic-depressive illness and will be called by both names throughout this publication--is a mental illness involving episodes of serious mania and depression. The person's mood usually swings from overly "high" and irritable to sad and hopeless and then back again, with periods of normal mood in between.

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as an illness, and people who have it may suffer needlessly for years or even decades.

Effective treatments are available that greatly alleviate the suffering caused by bipolar disorder and can usually prevent its devastating complications. These include marital break-ups, job loss, alcohol and drug abuse, and suicide.

Here are some facts about bipolar disorder.


Manic-Depressive Illness Has a Devastating Impact on Many People.

D/ART: A National Educational Program

The National Institute of Mental Health (NIMH) has launched the Depression/Awareness, Recognition, and Treatment (D/ART) campaign to help people:

D/ART Also:


Bipolar disorder involves cycles of mania and depression.

Signs and symptoms of mania include discrete periods of:

Signs and symptoms of depression include discrete periods of:

It may be helpful to think of the various mood states in manic-depressive illness as a spectrum or continuous range. At one end is severe depression, which shades into moderate depression; then come mild and brief mood disturbances that many people call "the blues," then normal mood, then hypomania (a mild form of mania), and then mania.

Some people with untreated bipolar disorder have repeated depressions and only an occasional episode of hypomania (bipolar II). In the other extreme, mania may be the main problem and depression may occur only infrequently. In fact, symptoms of mania and depression may be mixed together in a single "mixed" bipolar state.

Descriptions provided by patients themselves offer valuable insights into the various mood states associated with bipolar disorder:


I doubt completely my ability to do anything well. It seems as though my mind has slowed down and burned out to the point of being virtually useless....[I am] haunt[ed]...with the total, the desperate hopelessness of it all... Others say, "It's only temporary, it will pass, you will get over it," but of course they haven't any idea of how I feel, although they are certain they do. If I can't feel, move, think, or care, then what on earth is the point?


At first when I'm high, it's tremendous...ideas are shooting stars you follow until brighter ones appear...all shyness disappears, the right words and gestures are suddenly there...uninteresting people, things, become intensely interesting. Sensuality is pervasive, the desire to seduce and be seduced is irresistible. Your marrow is infused with unbelievable feelings of ease, power, well-being, omnipotence, can do anything...but, somewhere this changes.


The fast ideas become too fast and there are far too many...overwhelming confusion replaces stop keeping up with it--memory goes. Infectious humor ceases to amuse. Your friends become frightened...everything is now against the are irritable, angry, frightened, uncontrollable, and trapped.

Recognition of the various mood states is essential so that the person who has manic-depressive illness can obtain effective treatment and avoid the harmful consequences of the disease, which include destruction of personal relationships, loss of employment, and suicide.

Manic-depressive illness is often not recognized by the patient, relatives, friends, or even physicians.


Most people with manic depressive illness can be helped with treatment.

Getting Help

Anyone with bipolar disorder should be under the care of a psychiatrist skilled in the diagnosis and treatment of this disease.

Other mental health professionals, such as psychologists and psychiatric social workers, can assist in providing the patient and his or her family with additional approaches to treatment.

Help can be found at:

People With Manic-Depressive Illness Often Need Help To Get Help.


National Institute of Mental Health
Public Inquiries, Room 7C-02
5600 Fishers Lane
Rockville, MD 20857

National Depressive and Manic Depressive Association
730 Franklin Street, Suite 501
Chicago, IL 60610
(312) 642-0049; (312) 642-7243 FAX; 1-800-826-3632

National Alliance for the Mentally Ill
200 North Glebe Road, Suite 1015
Arlington, VA 22203-3754
(703) 524-7600; (703) 524-9094 FAX; 1-800-950-NAMI (6264)

National Foundation for Depressive Illness
P.O. Box 2257
New York, NY 10116
(212) 268-4260; (212) 268-4434 FAX; 1-800-248-4344

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
(703) 684-7722; (703) 684-5968 FAX; 1-800-969-NMHA (6642)


The year 1996 marks the fiftieth anniversary of the National Institute of Mental Health (NIMH). Throughout the past 50 years, the results of research supported by the Institute have brought new hope to millions of people who suffer from mental illness and to their families and friends. In work with animals as well as human participants, researchers have advanced our understanding of the brain and vastly expanded the capability of mental health professionals to diagnose, treat, and prevent mental and brain disorders.

During this last decade of the twentieth century--designated "The Decade of the Brain" by the U.S. Congress--knowledge of brain function has exploded. Research is yielding information about the causes of mental disorders such as depression, bipolar disorder, schizophrenia, panic disorder, and obsessive-compulsive disorder. With this knowledge, scientists are developing new therapies to help more people overcome mental illness.

The National Institute of Mental Health is part of the National Institutes of Health (NIH), the Federal Government's primary agency for biomedical and behavioral research. NIH is a component of the U.S. Department of Health and Human Services.


This publication was written by Mary Lynn Hendrix of the Office of Scientific Information, National Institute of Mental Health. Expert assistance was provided by Frederick K. Goodwin, M.D., Robert M. Post, M.D., Hagop S. Akiskal, M.D., and William Z. Potter, M.D.

All material in this pamphlet is free of copyright restrictions and may be copied, reproduced, or duplicated without permission from the Institute; citation of the source is appreciated.

U.S. Department of Health and Human Services
National Institutes of Health

NIH Publication No. 95-3679
September 1995


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