context: Bipolar disorder, sometimes called manic depression, is a mental health disorder that is distinguished by dramatic changes in a person's mood and energy, from the elated highs of mania to the lows of depression. Bipolar disorder affects all ages, genders, and ethnicities, and usually has its onset in late adolescence or young adulthood. We know that genetics can play a role in the vulnerability to bipolar disorder, as researchers have traced the incidence of bipolar disorder among generations of families. While bipolar disorder cannot be prevented, it's important to be aware of early warning signs of an impending episode of bipolar depression or bipolar mania. Early recognition of bipolar warning signs and seeing your doctor regularly can allow you to monitor your mood and medications and keep illness from escalating. In fact, although treating bipolar disorder moods is critical, there is a convincing case supported by scientific studies that the prevention of further mood episodes should be the greatest goal. Symptoms of bipolar disorder can fall between two extreme mood states: Bipolar depression, which includes feelings of being sad, hopeless, helpless, and worthless Bipolar mania, which includes feelings of elation and exuberance coupled with increased energy and activity and little need for sleep In addition, people with bipolar disorder can have manic episodes that occur simultaneously with depressive symptoms, or vice versa. When a manic or depressive episode simultaneously includes symptoms of the opposite pole, that episode is said to have "mixed features." Symptoms of the depressive phase of bipolar disorder may consist of the following: Depressed mood and low self-esteem Excessive crying spells Low energy levels and an apathetic view of life Sadness, loneliness, helplessness, feelings of guilt Slow speech, fatigue, and poor coordination and concentration Insomnia or oversleeping Thoughts of suicide or dying Changes in appetite (overeating/not eating) Unexplainable body aches and pains Lack of interest or pleasure in usual activities Euphoria or irritability Excessive talking; racing thoughts Inflated self-esteem Unusual energy; less need for sleep Impulsiveness, a reckless pursuit of gratification -- shopping sprees, impetuous travel, more and sometimes promiscuous sex, high-risk business investments, fast driving Hallucinations and or delusions (psychotic features such as these may be involved in about one out of every two of cases of bipolar mania) Bipolar disorder is treated with medications to stabilize mood. If the mood stabilizers do not fully manage the symptoms, other medications may be added to help calm the mania or ease the depression. Along with mood stabilizers, psychotherapy is recommended to help the patient develop appropriate and workable coping strategies to deal with everyday stressors and to increase medication compliance. Different types of talk therapy options are available to help those with bipolar disorder prevent or cope with a mood episode: Individual counseling: This is a one-on-one session with a professional therapist with experience in bipolar disorders in which the patient's problem areas are addressed. The session may include help accepting the diagnosis, education about bipolar moods, ways to identify warning signs, and intervention strategies to manage stress. Family counseling: Bipolar disorder extends beyond the patient and can affect the entire family. Families are frequently involved in outpatient therapy as they receive education about bipolar disorder and work with the therapist and patient to learn how to recognize early warnings of an impending manic or depressive episode. Group counseling: Group sessions allow for the sharing of feelings and the development of effective coping strategies. The give-and-take at group sessions can be the most productive way to change the way you think about bipolar disorder and improve coping skills as you face life's challenges. There is no cure for bipolar disorder, but through behavior therapy and the right combination of mood stabilizers and other bipolar medicines, most people with bipolar disorder can live normal, productive lives. That said, bipolar disorder is a lifelong mental illness that has a great risk of recurrent episodes. Taking prescribed medications and keeping doctor appointments are crucial to self-managing bipolar disorder and preventing serious episodes. In addition, there are support groups available for patients and their family members to help them talk openly and learn how to support someone with bipolar disorder. Ongoing encouragement and support are needed after a person starts treatment. In fact, there are findings showing that the availability of social support systems increases the chances of employment in patients with bipolar disorder compared with those patients without support.