Materiały źródłowe

• #1 Bipolar disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

  Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings. These include emotional highs, also known as mania or hypomania, and lows, also known as depression. Hypomania is less extreme than mania. […] When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania, you may feel very excited and happy (euphoric), full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. […] Episodes of mood swings from depression to mania may occur rarely or multiple times a year. Each bout usually lasts several days. Between episodes, some people have long periods of emotional stability. Others may frequently have mood swings from depression to mania or both depression and mania at the same time.

• #2 Bipolar Disorder (Manic Depression): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9294-bipolar-disorder

  Bipolar disorder is a chronic mood disorder that causes intense shifts in mood, energy levels and behavior. Manic and hypomanic episodes are the main sign of the condition, and most people with bipolar disorder also have depressive episodes. The defining sign of bipolar I disorder is a manic episode that lasts at least one week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes. […] During a depressive episode, you experience a low or depressed mood and/or loss of interest in most activities, as well as many other symptoms of depression, such as tiredness, changes in appetite, and feelings of worthlessness and hopelessness. […] Mood changes in bipolar disorder can happen over a period of weeks, months and sometimes even years. An important aspect of the mood changes is that they’re a departure from your regular self and that the mood change is sustained for a long time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression.

• #3 Bipolar disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

  Bipolar disorder can start at any age, but usually it’s diagnosed in the teenage years or early 20s. Symptoms can differ from person to person, and symptoms may vary over time. […] Mania and hypomania are different, but they have the same symptoms. Mania is more severe than hypomania. It causes more noticeable problems at work, school and social activities, as well as getting along with others. Mania also may cause a break from reality, known as psychosis. You many need to stay in a hospital for treatment. […] Manic and hypomanic episodes include three or more of these symptoms: Being much more active, energetic or agitated than usual. Feeling a distorted sense of well-being or too self-confident. Needing much less sleep than usual. Being unusually talkative and talking fast. Having racing thoughts or jumping quickly from one topic to another. Being easy to distract. Making poor decisions. For example, you may go on buying sprees, take sexual risks or make foolish investments.

• #4 Early Warning Signs of Bipolar Disorder | FHE Health

  https://fherehab.com/bipolar/early-signs

  According to several analyses, nearly 50 percent of individuals begin to show symptoms before the age of 21. […] The sooner someone is diagnosed with bipolar disorder, the sooner effective treatment can be personalized for his or her condition. […] Early diagnosis of bipolar disorder is critically important in being able to get the disorder under control and lead a productive life. Effective treatment can put an end to constant mood swings and the awful insecurities characteristic of the disorder.

• #5 Bipolar Disorder – National Institute of Mental Health (NIMH)

  https://www.nimh.nih.gov/health/topics/bipolar-disorder

  Bipolar disorder usually requires lifelong treatment, but an effective treatment plan can help people manage their symptoms and improve their quality of life. […] This research includes studies examining how different factors influence when bipolar disorder symptoms appear and how they change over time. Other research focuses on identifying patterns in brain activity that could help predict and track symptom progression.

• #6 Bipolar I Disorder – PsychDB

  https://www.psychdb.com/bipolar/bipolar-i

  Bipolar I Disorder is a mental disorder characterized by episodes of highly elevated or irritable mood, known as mania. Individuals may also present with decreased sleep, grandiosity, talkativeness, racing thoughts, and indiscretion or risk-taking behaviours. In some presentations, one’s mood can shift very quickly between mania, anger, irritability, and/or depression, indicating a mixed features presentation of bipolar disorder. […] With treatment, up to 25% of patients will experience a relapse of symptoms, compared to up to 40% for those on placebo. Risk factors for relapse include young age of onset, psychotic features, rapid cycling, comorbid substance use, and comorbid anxiety. […] More than 90% of individuals with a single manic episode will go onto have another mood episode. […] About 60% of manic episodes happen right before a depressive episode.

• #7 Bipolar I Disorder – PsychDB

  https://www.psychdb.com/bipolar/bipolar-i

  Between 6 to 7% of individuals will die by suicide, and suicide is a significant cause of bipolar disorder mortality. […] Individuals are at highest risk during and following hospital admission, and over 70% of suicide deaths occur during depressive and mixed episodes. […] Factors associated with good prognosis are: good treatment adherence, lack of early childhood adversity, higher age of onset, good social supports, the absence of rapid cycling, and absence of personality disorders. […] Factors associated with poor prognosis are: male gender, mixed episodes/features, rapid cycling, co-morbid anxiety disorder, co-morbid substance abuse, co-morbid personality disorder, and/or obesity. […] The typical age of onset is at age 20 (in the US), and closer to age 29 (in European countries). […] Evidence suggests that age of onset for bipolar disorder has a trimodal distribution pattern, with distinct groups represented by onset in late teens, mid 20s, and early 40s.

• #8 Bipolar disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

  Bipolar disorder can start at any age, but usually it’s diagnosed in the teenage years or early 20s. Symptoms can differ from person to person, and symptoms may vary over time. […] Mania and hypomania are different, but they have the same symptoms. Mania is more severe than hypomania. It causes more noticeable problems at work, school and social activities, as well as getting along with others. Mania also may cause a break from reality, known as psychosis. You many need to stay in a hospital for treatment. […] Manic and hypomanic episodes include three or more of these symptoms: Being much more active, energetic or agitated than usual. Feeling a distorted sense of well-being or too self-confident. Needing much less sleep than usual. Being unusually talkative and talking fast. Having racing thoughts or jumping quickly from one topic to another. Being easy to distract. Making poor decisions. For example, you may go on buying sprees, take sexual risks or make foolish investments.

• #9 Bipolar disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

  Bipolar disorder can start at any age, but usually it’s diagnosed in the teenage years or early 20s. Symptoms can differ from person to person, and symptoms may vary over time. […] Mania and hypomania are different, but they have the same symptoms. Mania is more severe than hypomania. It causes more noticeable problems at work, school and social activities, as well as getting along with others. Mania also may cause a break from reality, known as psychosis. You many need to stay in a hospital for treatment. […] Manic and hypomanic episodes include three or more of these symptoms: Being much more active, energetic or agitated than usual. Feeling a distorted sense of well-being or too self-confident. Needing much less sleep than usual. Being unusually talkative and talking fast. Having racing thoughts or jumping quickly from one topic to another. Being easy to distract. Making poor decisions. For example, you may go on buying sprees, take sexual risks or make foolish investments.

• #10 Mania: What Is It, Causes, Triggers, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21603-mania

  Symptoms of a manic episode include having an abnormally high level of activity or energy, feeling extremely happy or excited even euphoric, not sleeping or only getting a few hours of sleep but still feeling rested, having inflated self-esteem, being more talkative than usual, having racing thoughts, being easily distracted, being obsessed with an activity, displaying purposeless movements, and showing impulsive behavior that can lead to poor choices. […] After a manic episode, you may feel happy or embarrassed about your behavior, feel overwhelmed by all the activities you’ve agreed to take on, have only a few or unclear memories of what happened during your manic episode, feel very tired and need sleep, and feel depressed (if your mania is part of bipolar disorder). […] Early signs (called prodromal symptoms) that you’re getting ready to have a manic episode can last weeks to months. If you’re not already receiving treatment, episodes of bipolar-related mania can last between three and six months. With effective treatment, a manic episode usually improves within about three months. […] If your mania is related to a diagnosis of bipolar I disorder, this is a lifelong disease. Although there’s no cure for mania, medication and talk therapy (psychotherapy) can manage your condition in most cases.

• #11 Bipolar Disorder | Conditions & Treatments | UR Medicine

  https://www.urmc.rochester.edu/conditions-and-treatments/bipolar-disorder

  Feeling worthless or hopeless […] Feeling extreme guilt […] Changes in eating habits, or eating too much or not enough […] Changes in sleep patterns, such as fitful sleep, inability to sleep, waking up very early, or sleeping too much […] Headaches, digestive problems, or chronic pain […] Having thoughts of death or suicide, wishing to die, or attempting suicide […] Very inflated self-esteem […] Need for less rest and sleep […] Easily distracted or irritable […] Racing thoughts […] Physical agitation […] Risky, aggressive, or destructive behavior […] Talking a lot and talking fast […] Very high or euphoric feelings (feeling overly happy) […] Increased sex drive […] Increased energy […] Unusual poor judgment (ex: buying sprees, drug or alcohol abuse, risky sexual behavior)

• #12 What is Bipolar Disorder? | Bipolar Disorders Clinic | Stanford Medicine

  https://med.stanford.edu/bipolar/bipolar.html

  Bipolar disorder is characterized by severe and disabling highs (mania) and lows (depression). Affecting 2.2 million Americans, this illness typically begins in adolescence or early adulthood and continues throughout life, with 80% of patients experiencing multiple manic episodes and 15% ending their lives in suicide. […] Bipolar Disorder is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. […] Manic Episode: A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting for at least one week (or any duration if hospitalization is necessary). During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: inflated self-esteem or grandiosity, decreased need for sleep (e.g., feels rested after only 3 hours of sleep), more talkative than usual or pressure to keep talking, flight of ideas or subjective experience that thoughts are racing, distractibility, increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences.

• #13 What is Bipolar Disorder? | Bipolar Disorders Clinic | Stanford Medicine

  https://med.stanford.edu/bipolar/bipolar.html

  Bipolar disorder is characterized by severe and disabling highs (mania) and lows (depression). Affecting 2.2 million Americans, this illness typically begins in adolescence or early adulthood and continues throughout life, with 80% of patients experiencing multiple manic episodes and 15% ending their lives in suicide. […] Bipolar Disorder is distinguished from Major Depressive Disorder by the presence of manic or hypomanic episodes. […] Manic Episode: A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting for at least one week (or any duration if hospitalization is necessary). During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: inflated self-esteem or grandiosity, decreased need for sleep (e.g., feels rested after only 3 hours of sleep), more talkative than usual or pressure to keep talking, flight of ideas or subjective experience that thoughts are racing, distractibility, increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences.

• #14 What is Bipolar Disorder? | Bipolar Disorders Clinic | Stanford Medicine

  https://med.stanford.edu/bipolar/bipolar.html

  The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. […] Hypomanic Episode: A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, flight of ideas or subjective experience that thoughts are racing, distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences.

• #15 Understanding Bipolar Disorder | The Jed Foundation

  https://jedfoundation.org/resource/understanding-bipolar-disorder/

  Getting really irritated or agitated more easily than usual […] Trouble thinking, focusing, or sitting still […] Talking really fast […] Feeling thrilled about unrealistic or out-of-character plans or big ideas that are typically not on your to-do list or would take much more time to plan and execute […] Working on multiple projects at once in a frenzied haze […] Struggling to make good decisions or think clearly […] Doing increasingly risky things like getting into fights, having a lot of unprotected sex, drinking, using drugs, going on shopping sprees, or driving recklessly […] Seeing or hearing things that are not there (hallucinations) […] Believing things that aren’t true (delusions) […] Hypomanic episodes are less severe than manic episodes and last for a shorter period of time (up to four days).

• #16 Bipolar Disorder Symptoms and Diagnosis

  https://www.everydayhealth.com/bipolar-disorder/guide/symptoms/

  The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, commonly known as the DSM-5 and which doctors use to guide diagnosis, describes a manic episode as a period of abnormally and persistently elevated mood characterized by increased goal-directed activity or energy that lasts for at least a week. A manic episode can also consist of a period of irritable mood. Both elevated and irritable manic episodes are accompanied by some of the following symptoms: […] A hypomanic episode has similar daily symptoms, but they are less intense and severe. The episode is also shorter in duration, lasting at least four days. […] A major depressive episode includes the following signs and symptoms: […] To be considered a major depressive episode, you must experience five or more of these symptoms daily or nearly every day for most of the day over a two-week period. At least one of the symptoms must be a depressed mood or loss of interest or pleasure in activities.

• #17 Bipolar disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

  A major depressive episode includes symptoms that are severe enough to cause you to have a hard time doing day-to-day activities. These activities include going to work or school, as well as taking part in social activities and getting along with others. […] An episode includes five or more of these symptoms: Having a depressed mood. You may feel sad, empty, hopeless or tearful. Children and teens who are depressed can seem irritable, angry or hostile. Having a marked loss of interest or feeling no pleasure in all or most activities. Losing a lot of weight when not dieting or overeating and gaining weight. When children don’t gain weight as expected, this can be a sign of depression. Sleeping too little or too much. Feeling restless or acting slower than usual. Being very tired or losing energy. Feeling worthless, feeling too guilty or feeling guilty when it’s not necessary. Having a hard time thinking or concentrating, or not being able to make decisions. Thinking about, planning or attempting suicide.

• #18 What is Bipolar Disorder? | Bipolar Disorders Clinic | Stanford Medicine

  https://med.stanford.edu/bipolar/bipolar.html

  Major Depressive Episode: Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. […] The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

• #19 Bipolar Disorder – Depression and Bipolar Support Alliance

  https://www.dbsalliance.org/education/bipolar-disorder/

  Symptoms of depression include prolonged sadness or unexplained crying spells; significant changes in appetite and sleep patterns; irritability, anger, worry, agitation, anxiety; pessimism, indifference; loss of energy, persistent lethargy; feelings of guilt, worthlessness; inability to concentrate, indecisiveness; inability to take pleasure in former interests, social withdrawal; unexplained aches and pains; and recurring thoughts of death or suicide. […] People with bipolar disorder experience bipolar depression (the lows) more often than mania or hypomania (the highs). […] Bipolar depression is also more likely to be accompanied by suicidal thinking and behavior. […] Mood swings that come with bipolar disorder are usually more severe than ordinary mood swings and symptoms can last weeks or months, severely disrupting a persons life.

• #20 Bipolar disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

  Symptoms of bipolar disorders, including depressive episodes, may include other features, such as: Anxious distress, when you’re feeling symptoms of anxiety and fear that you’re losing control. Melancholy, when you feel very sad and have a deep loss of pleasure. Psychosis, when your thoughts or emotions disconnect from reality. […] The timing of symptoms may be described as: Mixed, when you have symptoms of depression and mania or hypomania at the same time. Rapid cycling, when you have four mood episodes in the past year where you switch between mania and hypomania and major depression. […] Symptoms of bipolar disorder can be hard to identify in children and teens. It’s often hard to tell whether these symptoms are the usual ups and downs or due to stress or trauma, or if they’re signs of a mental health problem other than bipolar disorder.

• #21 Signs and symptoms of bipolar disorder: What to do next – Harvard Health

  https://www.health.harvard.edu/healthbeat/signs-and-symptoms-of-bipolar-disorder-what-to-do-next

  Signs of psychosis include delusions (a false belief or judgment that is held despite incontrovertible evidence to the contrary) and hallucinations (hearing voices, seeing visions, or experiencing something that is not real). […] Bipolar disorder can manifest in different combinations of symptoms. A loved one with bipolar disorder might not recognize the signs to ask for help. If you have noticed changes in a loved one’s behavior or your own behavior that have a real and noticeable effect on the daily life and relationships, it may be time to seek help.

• #22 Bipolar Disorder: MedlinePlus

  https://medlineplus.gov/bipolardisorder.html

  Having racing thoughts and talking very fast […] Needing less sleep […] Feeling like you are unusually important, talented, or powerful […] Do risky things that show poor judgment, such as eating and drinking too much, spending or giving away a lot of money, or having reckless sex. […] The symptoms of a depressive episode can include […] Feeling very sad, hopeless, or worthless […] Feeling lonely or isolating yourself from others […] Talking very slowly, feeling like you have nothing to say, or forgetting a lot […] Having little energy […] Sleeping too much […] Eating too much or too little […] Lack of interest in your usual activities and being unable to do even simple things […] Thinking about death or suicide. […] The symptoms of a mixed episode include both manic and depressive symptoms together. For example, you may feel very sad, empty, or hopeless, while at the same time feeling extremely energized. […] Your mood episodes may last a week or two or sometimes longer. During an episode, symptoms usually occur every day for most of the day.

• #23 Bipolar Stages: 3 Phases to Be Aware of

  https://www.healthline.com/health/bipolar-disorder/bipolar-stages

  Maintenance stage: In the maintenance stage, you aim to manage your disorder and maintain stability via medication and therapy. […] The mood episodes in bipolar vary as well. […] They include the following: mania, hypomania (a less severe form of mania), depression, mixed features (depression and mania together). […] The severity and duration of these episodes also vary from person to person. They primarily differ according to the type of bipolar disorder you have. […] Depressive episodes in bipolar disorder result in a low mood or loss of pleasure in life. Research shows that depressive episodes in bipolar disorder tend to last longer than mania or hypomania episodes. The episodes last at least 2 weeks, but in some cases, they can last for months. […] During a depressive episode, you might have the following symptoms: extreme sadness, feelings of hopelessness or worthlessness, very low energy levels, memory and concentration difficulties, loss of interest in previously enjoyed activities, feelings of guilt, low appetite, insomnia.

• #24

  https://www.mercy.net/service/bipolar-disorder-manic-depression/stages/

  Bipolar disorder is characterized by mood episodes. These episodes include stages of depression and mania, but there are other stages involved in an episode. Its important to recognize the symptoms of each stage so your Mercy provider can help provide the right treatment. […] Acute mania is marked by energetic or irritable moods and accelerated activity. Other symptoms might include exaggerated self-esteem, less need for sleep, racing thoughts, extreme distractibility and bouts of irresponsible behavior like spending binges, sexual activity and substance use. […] Mixed mood state includes symptoms of both manic and depressed mood. Periods of depressed mood powered by the impulsive overactivity and poor judgment of manic mood can lead to a higher risk of self-harm or violence toward others.

• #25 Bipolar Disorders – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/bipolar-disorders

  An episode of mania or hypomania is designated as having mixed features if 3 depressive symptoms are present for most days of the episode. This condition is often difficult to diagnose and may shade into a continuously cycling state; the prognosis is then worse than that in a pure manic or hypomanic state. […] Risk of suicide during mixed episodes is particularly high.

• #26 How to prevent the malignant progression of bipolar disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7524411/

  There is increasing recognition that, in a high percentage of cases, bipolar disorder is a progressive illness. […] One of the clearest is that of episode sensitization, where increased numbers of prior episodes are associated with: faster recurrences; more dysfunction; disability; social, educational, and employment deficits; suicide; medical comorbidities; cognitive dysfunction; and an increased incidence of dementia in old age. […] Each type of sensitization appears to have an epigenetic basis, such that preventing sensitization should minimize the accumulation of adverse epigenetic chemical marks on DNA, histones, and microRNA. […] The cognitive dysfunction associated with a first episode improves only if there are no further episode recurrences during the next year. […] In some individuals with unipolar or bipolar depression, repeated episodes occur on average with increasingly shorter euthymic intervals and increasing severity and treatment resistance.

• #27 SciELO Brazil – How to prevent the malignant progression of bipolar disorder How to prevent the malignant progression of bipolar disorder

  https://www.scielo.br/j/rbp/a/jKqnQYQwFkbK3Jc4bJkg39P/

  There is increasing recognition that, in a high percentage of cases, bipolar disorder is a progressive illness. […] One of the clearest is that of episode sensitization, where increased numbers of prior episodes are associated with: faster recurrences; more dysfunction; disability; social, educational, and employment deficits; suicide; medical comorbidities; cognitive dysfunction; and an increased incidence of dementia in old age. […] The cognitive dysfunction associated with a first episode improves only if there are no further episode recurrences during the next year. […] The sensitization phenomena and the kindling-like illness progression of affective episodes also emphasize the importance of early and sustained prophylactic intervention before the illness becomes increasing complex and treatment-resistant, a phenomenon that occurs both in the clinical realm and in the animal models.

• #28 SciELO Brazil – How to prevent the malignant progression of bipolar disorder How to prevent the malignant progression of bipolar disorder

  https://www.scielo.br/j/rbp/a/jKqnQYQwFkbK3Jc4bJkg39P/

  The occurrence of early stressors is also a vulnerability factor for later development of PTSD, and is a potent risk factor for animals and humans developing and sustaining substance abuse. […] In some individuals with unipolar or bipolar depression, repeated episodes occur on average with increasingly shorter euthymic intervals and increasing severity and treatment resistance. […] Greater numbers of prior episodes are also associated with increasing cognitive dysfunction. […] Two episodes of unipolar or bipolar depression do not increase the risk of a diagnosis of dementia in old age, while four episodes double this risk, and each additional episode thereafter further increases the risk. […] Importantly, if the pharmacological dissociations revealed in the kindling model are pertinent to those in the affective disorders, the data indicate that different drugs are effective at different stages of disease progression.

• #29 How to prevent the malignant progression of bipolar disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7524411/

  Greater numbers of prior episodes are also associated with increasing cognitive dysfunction. […] Two episodes of unipolar or bipolar depression do not increase the risk of a diagnosis of dementia in old age, while four episodes double this risk, and each additional episode thereafter further increases the risk. […] The occurrence of early stressors is also a vulnerability factor for later development of PTSD, and is a potent risk factor for animals and humans developing and sustaining substance abuse. […] Bipolar disorder should be viewed as a systemic illness affecting a wide variety of organs in the periphery and the brain. […] Illness progression in the affective disorders appears to have multiple interacting mechanisms. […] Early treatment is easier and less complicated than at later stages.

• #30 Progression of the Bipolar Disorder | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/diseases/bipolar-disorder/progression-of-the-illness

  With treatment, the outcome, in general, is good. Without treatment, on the other hand, the outcome is almost always very negative, with constant relapses and serious family, occupational, and social consequences. […] Generally, although there are exceptions, the illness develops imperceptibly during adolescence, a stage already known for its proclivity to emotional instability, and reaches its splendour in adult age, in the form of a depressive or even a hypomanic/manic phase. […] Very often, the first episode is preceded by a stressing environmental situation. However, from then on, the illness becomes independent of the environmental and psychological circumstances, as such that the biological mood regulator mechanisms seem to enter into a permanent fluctuation, which leads the individuals to lose the point of reference of their usual mood state.

• #31 Progression of the Bipolar Disorder | Hospital Clínic Barcelona

  https://www.clinicbarcelona.org/en/assistance/diseases/bipolar-disorder/progression-of-the-illness

  Each relapse makes the individual more vulnerable to stress, as such that, some patients, can begin to present with so-called rapid cycling, which is the uninterrupted succession of depression and euphoria (by convention, those that have 4 or more episodes per year are included in this sub-group). […] Furthermore, it is important to highlight that there is a sub-group of patients that, in parallel with the mood symptoms, have a gradual decrease in their cognitive abilities and functional performance. This is more common in those cases in which the progression is more problematical, with frequent and severe relapses.

• #32 Bipolar Stages: 3 Phases to Be Aware of

  https://www.healthline.com/health/bipolar-disorder/bipolar-stages

  Bipolar disorder can unfold in stages over time. Heres what it might look like. […] Bipolar disorder is a mental health disorder characterized by severe shifts in mood and energy levels. […] Similar to other mental disorders, bipolar can come in stages. These stages arent always clearly defined, and they dont necessarily occur in any particular order. But heres how the condition may play out. […] Bipolar disorder varies widely from person to person, but its generally described with the following stages: […] Early or prodromal stage: Years before the onset of a manic or depressive episode, you might begin to notice changes in your mood, behavior, or ability to function. These symptoms might include anxiety, depression, or difficulty sleeping. […] Acute stage: During the acute stage, you experience a full-on mood episode (mania, depression, or a mixed episode).

• #33 Bipolar Stages: 3 Phases to Be Aware of

  https://www.healthline.com/health/bipolar-disorder/bipolar-stages

  Maintenance stage: In the maintenance stage, you aim to manage your disorder and maintain stability via medication and therapy. […] The mood episodes in bipolar vary as well. […] They include the following: mania, hypomania (a less severe form of mania), depression, mixed features (depression and mania together). […] The severity and duration of these episodes also vary from person to person. They primarily differ according to the type of bipolar disorder you have. […] Depressive episodes in bipolar disorder result in a low mood or loss of pleasure in life. Research shows that depressive episodes in bipolar disorder tend to last longer than mania or hypomania episodes. The episodes last at least 2 weeks, but in some cases, they can last for months. […] During a depressive episode, you might have the following symptoms: extreme sadness, feelings of hopelessness or worthlessness, very low energy levels, memory and concentration difficulties, loss of interest in previously enjoyed activities, feelings of guilt, low appetite, insomnia.

• #34 Bipolar Stages: 3 Phases to Be Aware of

  https://www.healthline.com/health/bipolar-disorder/bipolar-stages

  A mixed episode occurs when depressive and manic symptoms happen together. Its essentially like having a low mood with high levels of energy. […] Symptoms include: inner tension, racing thoughts, irritability, agitation, rage, weeping spells, difficulty falling asleep, intense emotions. […] Rapid cycling is characterized by four or more mood episodes of mania, hypomania, or depression within a year. It can occur in all types of bipolar. […] The symptoms of those who developed bipolar (24.5%) typically unfolded in the following order: nonspecific symptoms such as sleep and anxiety symptoms, minor mood problems, adolescent depression, full-on bipolar disorder. […] Research shows that the following conditions are common precursors to bipolar disorder: anxiety disorders, mood shifts, cyclothymia, subthreshold manic and hypomanic symptoms, subsyndromal depression, psychotic features in depression, early age of onset of depressive episodes. […] Bipolar disorder is highly individualized, and its symptoms vary significantly from person to person. […] The disorder can occur in various stages, but similar to the disorders mood episodes, the stages arent always clearly defined, and they dont necessarily occur in any particular order.

• #35 Bipolar I Disorder – PsychDB

  https://www.psychdb.com/bipolar/bipolar-i

  Between 6 to 7% of individuals will die by suicide, and suicide is a significant cause of bipolar disorder mortality. […] Individuals are at highest risk during and following hospital admission, and over 70% of suicide deaths occur during depressive and mixed episodes. […] Factors associated with good prognosis are: good treatment adherence, lack of early childhood adversity, higher age of onset, good social supports, the absence of rapid cycling, and absence of personality disorders. […] Factors associated with poor prognosis are: male gender, mixed episodes/features, rapid cycling, co-morbid anxiety disorder, co-morbid substance abuse, co-morbid personality disorder, and/or obesity. […] The typical age of onset is at age 20 (in the US), and closer to age 29 (in European countries). […] Evidence suggests that age of onset for bipolar disorder has a trimodal distribution pattern, with distinct groups represented by onset in late teens, mid 20s, and early 40s.

• #36 Bipolar Disorder Symptoms, Causes and Effects – PsychGuides.com

  https://www.psychguides.com/bipolar/symptoms-causes-and-effects/

  Short-term effects of manic depression include an inability to perform a job, damage to social and familial relationships, and loss of self-confidence. Long-term effects include an inability to maintain employment, inability to perform basic personal care activities, becoming lost in delusional worlds, loss of marriage or other relationships, and even loss of life. […] Depression within a bipolar disorder can be dangerous. Not only are people suffering from bipolar-related depression hit with intense feelings of sorrow, guilt and worthlessness, but they also may reach a point where they act out on these feelings. […] According to the National Institute of Mental Health, substance abuse and bipolar disorder are a common dual diagnosis. The highs and lows of bipolar disorder can drive someone to abuse drugs or alcohol. At the same time, substance abuse can worsen the symptoms of mood-related problems.

• #37 How to prevent the malignant progression of bipolar disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7524411/

  Preventing further episodes in the year after a first manic episode is no easy task, and the types and aggressiveness of treatment needed to achieve this end require further study. […] One of the strongest studies supporting the need for early, comprehensive, long-term specialty treatment is that of Kessing et al. […] Early comprehensive treatment can moderate the long-term course of bipolar disorder and change it for the better. […] Bipolar disorder is a progressive, potentially lethal medical illness that all too often is not given the attention and respect that is required to moderate its course. […] Such a progression can involve the accumulation of and sensitization and cross-sensitization to stressors, mood episodes themselves, and bouts of substance abuse. […] Early attempts at stress reduction and modulation, as well as episode and substance abuse treatment and prevention, would appear to be critical to preventing a malignant transformation of bipolar disorder from a manageable illness to an incapacitating and treatment-resistant one.

• #38 SciELO Brazil – How to prevent the malignant progression of bipolar disorder How to prevent the malignant progression of bipolar disorder

  https://www.scielo.br/j/rbp/a/jKqnQYQwFkbK3Jc4bJkg39P/

  The types and consistency of intervention after the occurrence of a first manic episode needs major revision. […] Studies reveal the cognitive and structural deficits that occur with first mania are resolved over the next year only on the condition that no further episodes occur. […] Preventing further episodes in the year after a first manic episode is no easy task, and the types and aggressiveness of treatment needed to achieve this end require further study. […] One of the strongest studies supporting the need for early, comprehensive, long-term specialty treatment is that of Kessing et al. […] Early comprehensive treatment can moderate the long-term course of bipolar disorder and change it for the better. […] Bipolar disorder is a progressive, potentially lethal medical illness that all too often is not given the attention and respect that is required to moderate its course.

• #39 SciELO Brazil – How to prevent the malignant progression of bipolar disorder How to prevent the malignant progression of bipolar disorder

  https://www.scielo.br/j/rbp/a/jKqnQYQwFkbK3Jc4bJkg39P/

  Such a progression can involve the accumulation of and sensitization and cross-sensitization to stressors, mood episodes themselves, and bouts of substance abuse. […] Early attempts at stress reduction and modulation, as well as episode and substance abuse treatment and prevention, would appear to be critical to preventing a malignant transformation of bipolar disorder from a manageable illness to an incapacitating and treatment-resistant one.

• #40 Bipolar Disorder in Children, Teens, Adults: Symptoms & Types

  https://www.medicinenet.com/bipolar_disorder/article.htm

  Characteristics of depressive episodes (bipolar depression) include a number of the following symptoms: Persistently depressed or irritable mood, Feelings of apprehension, Frequent crying, inability to feel pleasure, Loss of interest in previously pleasurable activities, Apathy, low motivation, Increased or decreased appetite, weight loss, or weight gain, Difficulty falling asleep, Excess sleepiness, agitation, or lack of activity, Fatigue/low energy, Feelings of worthlessness, Lack of concentration, Slowness in activity and thought, Inappropriate feelings of guilt, Hopelessness, Thoughts of death, self-harm, or suicidal thoughts, plans, or actions. […] While the prognosis for bipolar disorder indicates that individuals with this disorder can expect to experience episodes of some sort of mood problem (like depression, mania, or hypomania) up to 60% of the time, those episodes can be well managed by the combination of psychotherapy and medication treatment. Clinical trials indicate that people who have a mixed pattern of symptoms can be more difficult to stabilize with treatment and have a more problematic course than those who do not have mixed episodes. Individuals who were misdiagnosed with other mental illnesses, thereby delaying treatment for bipolar disorder, are at risk for a longer, more difficult duration of illness. […] The risk of committing suicide is 60 times higher for people with bipolar disorder compared to the general population.

• #41 Bipolar disorder – Wikipedia

  https://en.wikipedia.org/wiki/Bipolar_disorder

  The risk of suicide is high. Over a period of 20 years, 6% of those with bipolar disorder died by suicide, with about one-third attempting suicide in their lifetime. […] Among those with the disorder, 40-50% overall and 78% of adolescents engaged in self-harm. […] Symptoms most commonly begin between the ages of 20 and 25 years old; an earlier onset in life is associated with a worse prognosis. […] The condition is classified as bipolar I disorder if there has been at least one manic episode, with or without depressive episodes, and as bipolar II disorder if there has been at least one hypomanic episode (but no full manic episodes) and one major depressive episode. […] The earlier the age of onset, the more likely the first few episodes are to be depressive. […] For most people with bipolar types 1 and 2, the depressive episodes are much longer than the manic or hypomanic episodes.

• #42 Bipolar Disorder – National Institute of Mental Health (NIMH)

  https://www.nimh.nih.gov/health/topics/bipolar-disorder

  Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes clear shifts in a persons mood, energy, activity levels, and concentration. People with bipolar disorder often experience periods of extremely up, elated, irritable, or energized behavior (known as manic episodes) and very down, sad, indifferent, or hopeless periods (known as depressive episodes). […] The symptoms of bipolar disorder can impose serious challenges to a persons mental and physical health. People with bipolar disorder often have other mental disorders, and some people may experience symptoms of psychosis, such as hallucinations or delusions. The symptoms can interfere with everyday activities, relationships, and work or school responsibilities. Some people may also experience stigma related to their symptoms, which can keep them from seeking the help they need.

• #43 Psychiatry.org – What Are Bipolar Disorders?

  https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders

  Bipolar disorder is a category that includes three main diagnoses: bipolar I, bipolar II, and cyclothymic disorder. […] Bipolar disorder commonly runs in families: 80 to 90 percent of individuals with bipolar disorder have a relative with bipolar disorder or depression. Environmental factors such as stress, sleep disruption, and drugs and alcohol may trigger mood episodes in vulnerable people. Though the specific causes of bipolar disorder are unclear, there are both biological factors, including a family history of mood disorders, psychotic disorders, and substance misuse, and environmental factors that increase the risk for bipolar disorder. The average age of onset is in the mid-20s. […] People with bipolar I disorder frequently have other mental disorders such as anxiety disorders, substance use disorders, and/or attention-deficit/hyperactivity disorder (ADHD). The risk of suicide is significantly higher among people with bipolar I disorder than among the general population.

• #44 Bipolar Disorder (Manic Depression): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9294-bipolar-disorder

  The symptoms of depressive episodes in bipolar disorder are the same as those of major depression. They include overwhelming sadness, low energy and fatigue, lack of motivation, feelings of hopelessness or worthlessness, loss of enjoyment of things that were once pleasurable for you, difficulty concentrating and making decisions, uncontrollable crying, irritability, increased need for sleep, insomnia or excessive sleep, a change in appetite, causing weight loss or gain, and thoughts of death or suicide (suicidal ideation). […] The prognosis for bipolar disorder is often poor unless it’s properly treated. Many people with bipolar disorder who receive appropriate treatment can live fulfilling and productive lives. Bipolar disorder results in approximately a nine-year reduction in expected life span, and as many as 1 in 5 people with bipolar disorder commit suicide. An estimated 60% of all people with bipolar disorder have drug or alcohol dependence.

• #45 Bipolar disorder – Wikipedia

  https://en.wikipedia.org/wiki/Bipolar_disorder

  Symptoms of the depressive phase of bipolar disorder include persistent feelings of sadness, irritability or anger, loss of interest in previously enjoyed activities, excessive or inappropriate guilt, hopelessness, sleeping too much or not enough, changes in appetite or weight, fatigue, problems concentrating, self-loathing or feelings of worthlessness, and thoughts of death or suicide. […] In bipolar disorder, a mixed state is an episode during which symptoms of both mania and depression occur simultaneously. […] Individuals experiencing a mixed state may have manic symptoms such as grandiose thoughts while simultaneously experiencing depressive symptoms such as excessive guilt or feeling suicidal. […] The diagnosis of bipolar disorder can be complicated by coexisting (comorbid) psychiatric conditions including obsessive-compulsive disorder, substance-use disorder, eating disorders, attention deficit hyperactivity disorder, social phobia, premenstrual syndrome (including premenstrual dysphoric disorder), or panic disorder.

• #46 Bipolar in Young Adults Treatment | Newport Institute

  https://www.newportinstitute.com/programs/bipolar/

  Researchers believe that bipolar disorder may be caused by a combination of environmental, genetic, and neurological factors. […] Women have a higher risk than men of developing bipolar II. Hence, depressive bipolar disorder symptoms in females are more common. In addition, women have an increased risk of rapid cycling between episodes, and they more frequently experience mixed episodes episodes with both depressive and manic symptoms. […] 40% of adults with bipolar type I and 20% of those with bipolar type II also experience a substance abuse disorder during their lifetime.

• #47 Bipolar disorder and aging: Does it get worse as you age?

  https://www.medicalnewstoday.com/articles/does-bipolar-disorder-get-worse-with-age

  People may also experience cognitive dysfunction, memory issues, and an increased incidence of dementia in old age. […] Bipolar disorder symptoms can vary as individuals age and may worsen for some. For example, older individuals may experience more frequent and severe episodes, with more time in a depressive phase.

• #48 Bipolar disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961

  Bipolar disorder is a lifelong condition, with treatment directed to manage symptoms. […] Depending on your needs, treatment may include: Medicines. Often, you’ll need to start taking medicines right away to balance your moods. […] If you don’t keep taking your medicine, your symptoms could come back, or minor mood changes could turn into full-blown mania or depression. […] The main treatments for bipolar disorder include medicines and talk therapy, also known as psychotherapy, to control symptoms. […] Several medicines are used to treat bipolar disorder. The types and doses of medicines prescribed are based on your symptoms. […] Mood-stabilizing medicines help control manic or hypomanic episodes. They also may help depressive bouts. […] Antipsychotic medicines have mood-stabilizing properties, and many have been approved by the U.S. Food and Drug Administration for manic or hypomanic episodes or maintenance treatment.

• #49 Bipolar disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961

  Your healthcare professional may cautiously add an antidepressant to manage depression. But an antidepressant sometimes can cause a manic or hypomanic episode. […] Talk therapy, also called psychotherapy, is a vital part of bipolar disorder treatment. […] Learning about bipolar disorder, also known as psychoeducation, can help you and your loved ones know more about the condition. […] Generally, treatment includes: Medicines. There’s less research on the safety and effectiveness of bipolar medicines in children than in adults, so healthcare professionals often decide on treatment based on adult research. […] Talk therapy, also known as psychotherapy, can help children and teens manage their routines, cope better, handle learning difficulties, make social problems better, and make family bonds and communication stronger.

• #50 End-Stage Bipolar Disorder: Symptoms & Progression

  https://avisarecovery.com/blog/what-is-end-stage-bipolar-disorder-recognizing-the-signs-and-symptoms/

  End-Stage Bipolar Disorder: Constant, severe symptoms that no longer respond to traditional treatments. Life expectancy is reduced by approximately 12 to 14 years in people with bipolar disorder, with a 1.6-fold to 2-fold increase in cardiovascular mortality. […] When bipolar depression reaches its most severe form, symptoms become overwhelming and can include: Persistent, severe depression that does not improve with standard treatments. Extreme mood instability, with rapid cycling between depressive and manic states. Loss of touch with reality, including hallucinations or delusions. Complete withdrawal from life, avoiding friends, family, and responsibilities. Suicidal thoughts or self-harm, often occurring frequently and intensely. Inability to function, even in basic daily tasks like eating or sleeping.

• #51 Bipolar disorder in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/488

  Bipolar disorder requires an individualised long-term management plan that includes maintenance medication(s), adjunctive psychosocial therapies, careful monitoring for any treatment-emergent complications, and promotion of a healthy lifestyle including sleep hygiene, exercise, and stress management.

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