<unk> , previously known as manic depression, is a mood<unk>  characterized by periods of depression and periods of abnormally-elevated happiness that last from days to weeks each. If the elevated mood is severe or associated with psychosis, it is called mania; if it is less severe, it is called hypomania. During mania, an individual behaves or feels abnormally energetic, happy or irritable, and they often make impulsive decisions with little regard for the consequences. There is usually also a reduced need for sleep during manic phases. During periods of depression, the individual may experience crying and have a negative outlook on life and poor eye contact with others. The risk of suicide is high; over a period of 20 years, 6% of those with<unk>  died by suicide, while 30–40% engaged in self-harm. Other mental health issues, such as anxiety<unk> s and substance use<unk> s, are commonly associated with<unk> . While the causes of<unk>  are not clearly understood, both genetic and environmental factors are thought to play a role. Many genes, each with small effects, may contribute to the development of the<unk> . Genetic factors account for about 70–90% of the risk of developing<unk> . Environmental risk factors include a history of childhood abuse and long-term stress. The condition is classified as<unk>  I<unk>  if there has been at least one manic episode, with or without depressive episodes, and as<unk>  II<unk>  if there has been at least one hypomanic episode (but no full manic episodes) and one major depressive episode. If these symptoms are due to drugs or medical problems, they are not diagnosed as<unk> . Other conditions that have overlapping symptoms with<unk>  include attention deficit hyperactivity<unk> , personality<unk> s, schizophrenia, and substance use<unk>  as well as many other medical conditions. Medical testing is not required for a diagnosis, though blood tests or medical imaging can rule out other problems. Mood stabilizers—lithium and certain anticonvulsants such as valproate and carbamazepine as well as atypical antipsychotics such as aripiprazole—are the mainstay of long-term pharmacologic relapse prevention. Antipsychotics are additionally given during acute manic episodes as well as in cases where mood stabilizers are poorly tolerated or ineffective. In patients where compliance is of concern, long-acting injectable formulations are available. There is some evidence that psychotherapy improves the course of this<unk> . The use of antidepressants in depressive episodes is controversial: they can be effective but have been implicated in triggering manic episodes. The treatment of depressive episodes, therefore, is often difficult. Electroconvulsive therapy (ECT) is effective in acute manic and depressive episodes, especially with psychosis or catatonia. Admission to a psychiatric hospital may be required if a person is a risk to themselves or others; involuntary treatment is sometimes necessary if the affected person refuses treatment.<unk>  occurs in approximately 1% of the global population. In the United States, about 3% are estimated to be affected at some point in their life; rates appear to be similar in females and males. Symptoms most commonly begin between the ages of 20 and 25 years old; an earlier onset in life is associated with a worse prognosis. Interest in functioning in the assessment of patients with<unk>  is growing, with an emphasis on specific domains such as work, education, social life, family, and cognition. Around one-quarter to one-third of people with<unk>  have financial, social or work-related problems due to the illness.<unk>  is among the top 20 causes of disability worldwide and leads to substantial costs for society. Due to lifestyle choices and the side effects of medications, the risk of death from natural causes such as coronary heart disease in people with<unk>  is twice that of the general population.
Bipolar disorder
Substance use disorder
Major depressive disorder
Attention deficit hyperactivity disorder
Bipolar I disorder
Schizophrenia
Major depressive episode
Personality disorder