Early in the progression of the disorder, stress may trigger episodes of depression and mania. However, as the illness progresses, mood changes are not necessarily related to a specific stressful event.
Bipolar disorder causes alternating periods of both depression and mania. The extreme mood changes may come on suddenly or slowly over months. Men tend to suffer from more manic episodes, while women tend to suffer from more depressive episodes.
A person who has bipolar I experiences episodes of depression along with at least one manic episode. Depression may not be triggered by a stressful life event. You may not be able to identify why you started feeling sad, tired, or indecisive. The depression may last for a short time or for months. You may then go back to feeling normal for a time, or you may go right into a manic episode. During mania, you will feel less need to sleep, will have high energy, and will sometimes feel irritable. Mania can also cause you to feel invincible, which can lead to dangerous behaviors (such as driving too fast or spending too much money).
A person who has bipolar II experiences depression just as in bipolar I. However, the episodes of mania are far less severe (hypomania). Bipolar II is more common in women and possibly more common during the period right after a woman has had a baby (postpartum period).
Mixed bipolar disorder
In mixed bipolar disorder, episodes of depression and mania rapidly alternate throughout the day for at least one week. Symptoms include sadness, euphoria, and irritability throughout the day. Other symptoms can include agitation, lack of sleep, appetite changes, and possibly, thoughts of suicide. This makes the disorder challenging to treat and very frustrating for the person and those around the person to deal with. Mixed bipolar disorder can lead to hospitalization if daily functioning becomes impaired.
Rapid-cycling bipolar disorder
A person who has rapid-cycling bipolar disorder experiences at least four episodes of depression, mania, or both within a 12-month period. You may go directly from an episode of depression to an episode of mania, or you may have a short time lapse between the two moods. The mood swings are the same as with other bipolar subtypes. The frequency with which the mood swings occur distinguishes rapid-cycling bipolar disorder from other bipolar subtypes.
What Increases Your Risk
Bipolar disorder can be passed down through families (genetic risk). If anyone in your family has been diagnosed with bipolar disorder, your risk of developing bipolar disorder is increased.
A stressful life event can trigger an episode of bipolar symptoms to return (relapse) early in the course of the illness. However, once you have had bipolar disorder for a long time (later in the progression of the disorder), stressful events may not necessarily trigger a relapse.
If you have had more than one or two episodes of depression or mania in the past, you will likely experience an increase in the number of mood episodes you have in the future.
Your risk of entering into either a depressive or manic episode is increased if you do not take your medications as prescribed by your doctor. Some people think if they are feeling better, they can discontinue their medication therapy. Discontinuing medications can cause you to lapse into an episode of depression or mania.
Alcohol or drug use or abuse puts you at a high risk for having a relapse of mood disturbances