Of the 5.7 million American adults who have bipolar disorder, the onset typically develops in late adolescence or early adulthood. However, a smaller percentage of people have their first symptoms during childhood, while others develop them late in life. Unlike disorders that subside, bipolar disorder is a long-term illness that must be carefully managed throughout the person's life.

Types of Bipolar Disorder

Bipolar disorder is a mental health condition in which periods of mania alternate with periods of depression. Mild cases of bipolar disorder can often go undiagnosed, with symptoms being mistaken for normal mood swings. Bipolar disorder is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. There are three main classifications of bipolar disorder:

• Bipolar I disorder (mania with or without major depression)
• Bipolar II disorder (hypomania [mild mania] with major depression)
• Cyclothymic disorder (hypomania with mild depression)

Bipolar disorder causes dramatic mood swings, from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression. Some of the signs and symptoms of mania, or a manic episode, include:

• Increased energy, activity and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, can't concentrate well
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol and sleeping medications
• Provocative, intrusive or aggressive behavior
• Denial that anything is wrong

A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences it and may even be associated with higher functioning and enhanced productivity. Thus even when family and friends learn to recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong because he or she feels great. Without proper treatment, however, hypomania can become severe mania that will eventually switch to depression.

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