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Bipolar disorder is a psychiatric illness  characterized by extreme swings in mood, from highs (mania) to lows (depression). Therefore it used to be referred to as manic-depressive disorder. The condition affects roughly 2.3 million Americans, or about 1.2 percent of the population, according to the National Alliance on Mental Illness (NAMI). It is the sixth leading cause of disability worldwide.

The cause and risk factors of bipolar disorder are not completely understood. However, the condition appears to be strongly associated with genes since it can run in families. Individuals who have relatives with a history of a mood disorder have a greater risk of developing bipolar disorder. Imbalance in the brain biochemicals called neurotransmitters, which convey messages between the nerves, also appears to play a major role. Too many or too few neurotransmitters are believed to cause alterations in mood.

Episodes of bipolar disorder may last from days to months and usually require life-long treatment. They generally follow a pattern for a particular patient, but may become more frequent as the patient ages.

Symptoms of bipolar disorder generally remain the same from one episode to the next in a patient, but they may get worse or better. Symptoms of mania include euphoria, increased self-esteem, rapid speech, racing thoughts, excessive irritability, increased energy, and decreased need for sleep. Symptoms of depression include sadness, loss of interest in activities, fatigue and thoughts of death. Psychotic features (e.g., hallucinations, delusions) may also occur.

Bipolar disorder is frequently misdiagnosed because people who are manic tend not to seek treatment. When treatment is sought during a depressive episode, the condition may be be mistaken for major depressive disorder.

The diagnosis of bipolar disorder involves a mental health evaluation. This evaluation includes a complete history of symptoms, including when they started, their duration and their severity. Diagnosis also includes ruling out other causes that may mimic symptoms of bipolar disorder, such as substance abuse or thyroid disorders.

Bipolar disorder may be difficult to diagnose in children because symptoms are often similar to those of other conditions (e.g., attention deficit hyperactivity disorder [ADHD]). In addition, children with bipolar disorder often do not fully meet established criteria for the condition.

There is no known way to prevent or cure bipolar disorder. However, effective treatments are available which substantially reduce the number and severity of episodes for most people.