Bipolar depression, also known as bipolar disorder, manic depression and manic-depressive illness, is a form of a depressive illness in which mania and depression alternate. It is a disorder that affects over 2 million (1.2 percent) Americans and usually begins during adolescence (American Medical Association [AMA], 1998). It is often not recognized as a serious disorder, but in many cases it causes difficulty in occupational, educational, social life, and other important functioning. .
A person who has bipolar disorder swings between two extreme emotional poles- depression and mania. During the depression phase, the person will have the same symptoms as people with severe depression (AMA, 1998). Although the shifts of mood have nothing to do with daily activities, the symptoms may prevent the person from functioning normally. However, the All About Bipolar Disorder webpage (1995-2000), says that "increased stress and inadequate coping mechanisms to deal with that stress may also contribute to the disorder's manifestation." The cycles of mood shifts vary greatly in frequency and length. Some people may have several bouts of mania or depression in a row, some have them simultaneously and some have mania without depression (AMA, 1998). In some cases people never experience euphoria during mania, but go directly to a dysphoric state where their energy is boosted so they feel pressured in an uncomfortable state of mind. In other cases bipolar can have a triphasic characteristic, where there is a brief period of depression, then a sudden swing into mania, then depression will set in again for a few weeks (Mondimore, 1995). Some may have mixed mood states. "In mixed mood states (also referred to as dysphoric mania) pronounced symptoms of both depression and mania either co-exist or alternate during different periods of the day." (Daly, p.1157, 1997). However, typical bipolar patients alternate mania and depression with euthymania (normal mood) in between the two (Gorman, 1998).