Bipolar disorder (BD), previously known as manic depression, is a mental disorder characterized by periods of depression and of abnormally elevated mood that each last from days to weeks, and in some cases months. If the elevated mood is severe or associated with psychosis, it is called mania; if it does not significantly affect functioning, it is called hypomania. During mania, an individual behaves or feels abnormally energetic, happy, or irritable, and often makes impulsive decisions with little regard for the consequences. There is usually sleep disturbance during manic phases. During periods of depression, the individual may experience crying, have a negative outlook, and demonstrate poor eye contact. Over a period of 20 years, 6% of those with BD died by suicide, with about one-third attempting suicide in their lifetime. Among those with BD, 40–50% overall and 78% of adolescents engaged in self-harm.
While the causes of this mood disorder are not clearly understood, genetic and environmental factors are thought to play a role. Genetic factors may account for up to 70–90% of the risk of developing BD. Environmental risks include a history of child abuse and long-term stress. 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. It is classified as cyclothymia if there are hypomanic episodes with periods of depression that do not meet the criteria for major depressive episodes.If these symptoms are due to drugs or medical problems, they are not diagnosed as BD.