Bipolar I Basics

 

What is bipolar I disorder?

Bipolar I disorder is a condition that causes periods of severe changes in your mood, activity levels, energy, and ability to carry out everyday tasks. These changes are commonly called “mood episodes.”

Although you may feel like you’re the only one if it’s happening to you, there are millions of Americans affected by bipolar disorder each year.

While anyone can develop bipolar I disorder, it often starts in the late teen or early adult years and it lasts a lifetime. Children and older adults may develop bipolar I disorder as well.

Medical researchers believe that it can result from many factors, including an imbalance of certain chemicals in the brain called neurotransmitters, which may be too high or too low.

DID YOU KNOW ?

Bipolar I disorder often runs in families. If you have a family history of bipolar I disorder, be sure to let your healthcare provider know.

 

What are the symptoms?

Bipolar I disorder can cause unpredictable high and low mood swings, also known as manic and depressive episodes.

It’s impossible to predict how long mood episodes may last. You might be severely depressed for a brief or extended period of time before entering into a manic episode. Mania could last anywhere from days to months as well. You may even experience manic and depressive symptoms at the same time, which is known as a mixed episode.

Read on to learn more about the range of symptoms people with bipolar I disorder may experience.

Symptoms spectrum

Select a mood state below to see common symptoms.

Chart for bipolar I disorder symptoms spectrum.Chart for bipolar I disorder symptoms spectrum.Chart for bipolar I disorder symptoms spectrum.

DEPRESSIVE SYMPTOMS

Commonly referred to as the “lows,” depressive symptoms include:

Feeling very down or sad Feeling worried and empty Sleeping too much or too little Feeling tired or slowed down Changes in appetite or weight Having little to no interest or pleasure in your hobbies
Having trouble concentrating Thinking about death or suicide Feeling like you can’t enjoy anything Forgetting things a lot Having trouble sleeping

MIXED EPISODES

Mixed episodes occur when highs and lows are experienced at the same time.
For example, you may be having a mixed episode if you’re:

Having trouble concentrating Having too much energy while feeling very sad Behaving impulsively
Thinking about death or suicide Feeling exhausted but overly anxious Feeling jumpy or wired
Feeling like you can't enjoy anything   Feeling like your thoughts are coming very fast
Forgetting things a lot Being talkative while pessimistic Becoming more active than usual
Having trouble sleeping Behaving impulsively while feeling exhausted Having higher than usual energy levels

MANIC SYMPTOMS

Commonly referred to as the “highs,” manic symptoms include:

Behaving impulsively Feeling jumpy or wired Feeling like your thoughts are coming very fast Becoming more active than usual Having higher than usual energy levels
Being agitated, irritable, or touchy Not feeling tired or needing little sleep Talking really fast about a lot of different things Thinking you can do a lot of things at once Feeling overconfident in your abilities
Depressive Symptoms spectrum-img
Mixed Episodes spectrum-img
Manic Symptoms spectrum-img
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Do these symptoms sound familiar?

Complete this questionnaire and share the results with your healthcare provider.

 

What can trigger bipolar I episodes?

When you have bipolar I, it can seem like your mood episodes are random.

But both depressive and manic episodes are often triggered by something. Being aware of your triggers or warning signs can help you in managing your mood episodes.

Common triggers for bipolar I disorder may include:

  • Sleep deprivation
  • Medications
  • Seasonal changes
  • Substance abuse
  • Stress

Some triggers, such as stress, you can control or manage, while others you may not. Be sure to discuss your triggers with your doctor.

 

How is it diagnosed?

Bipolar I can go unrecognized for years by not only those who suffer with it, but by family, friends, and even healthcare providers. Manic symptoms are reported less often than depressive ones for most people with bipolar I, so healthcare providers may only see, and therefore treat, symptoms of depression instead of bipolar I disorder.

The first step: If you think you may have bipolar I, talk with a doctor. They can complete a physical exam to rule out other conditions.

Why this matters: People with bipolar disorder often have other health problems including substance abuse, anxiety disorders, thyroid disease, heart disease, and obesity. These conditions can have similar symptoms to bipolar I, which can complicate the diagnosis of bipolar I disorder.

Bipolar I depression is different

Bipolar refers to the opposite ends (the poles) of the emotional spectrum—lows (depression) and the highs (mania).  On top of the deep, unshakeable sadness or emptiness felt by patients with Major Depressive Disorder (MDD), patients with bipolar I also experience manic episodes. Treatments for MDD may not be effective for patients with bipolar I disorder, so it’s important to get the right diagnosis.

 

How is it treated?

The most effective treatment plan for bipolar I often includes a combination of medication, talk therapy, support groups, and improving overall health and wellness.

However, the cornerstone of every treatment plan is medication and finding the right one for you could take some time. Some people may require more than one medication to experience relief.

Your healthcare provider will start the process by evaluating your symptoms and treatments. So, it’s critical to share all the symptoms you’re experiencing now or have experienced in the past, as well as the medications you’re taking now or have taken in the past.

It’s difficult to be patient when bipolar I affects your life

Maybe you've already tried a lot of solutions. You want to get your bipolar I under control, and so does your doctor.

If you are experiencing symptoms like extreme highs and lows of your mood, let your doctor know. Ask if VRAYLAR may help.

Additional Resources:

Customize a doctor discussion guide.
Customize A Doctor Discussion Guide
Download My Mood Tracker.
Download My Mood Tracker
Take the “Could I Have Bipolar I?” quiz.
Take the “Could I Have Bipolar I?” quiz

 

IMPORTANT RISK INFORMATION AND INDICATION

What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.

Antidepressants may increase suicidal thoughts or actions in some children and young adults within the first few months of treatment and when the dose is changed. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.

    VRAYLAR may cause serious side effects, including:

    • Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death
    • Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS
    • Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR
    • Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing dose of VRAYLAR
    • Problems with your metabolism, such as:
      • High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity
      • Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment
      • Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment
    • Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR
    • Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position
    • Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries
    • Seizures (convulsions)
    • Impaired judgment, thinking, and motor skills: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy
    • Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water
    • Difficulty swallowing that can cause food or liquid to get into your lungs

    Who should not take VRAYLAR?

    Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face or throat).

    What should I tell my healthcare provider before taking VRAYLAR?

    Tell your healthcare provider about any medical conditions and if you:

    • have or have had heart problems or a stroke
    • have or have had low or high blood pressure
    • have or have had diabetes or high blood sugar in you or your family
    • have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol
    • have or have had seizures (convulsions)
    • have or have had kidney or liver problems
    • have or have had low white blood cell count
    • are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or
      http://www.womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/
    • are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR

    Tell your healthcare provider about all medicines that you take, including prescriptions, over-the-counter medicines, vitamins, and supplements. VRAYLAR may affect the way other medicines work, and other medicines may affect how VRAYLAR works. Do not start or stop any medicines while taking VRAYLAR without talking to your healthcare provider.

    What are the most common side effects of VRAYLAR?

    • The most common side effects were difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, and indigestion.

    These are not all possible side effects of VRAYLAR.

    INDICATION AND USAGE

    VRAYLAR is approved in adults to treat depressive episodes (bipolar depression) and for the short-term treatment of manic or mixed episodes that happen with bipolar I disorder.

    Please see the full Prescribing Information, including Boxed Warnings, and Medication Guide.


    *Depending on insurance coverage, eligible patients may pay as little as $15 for each of up to twelve (12) prescription fills. In such instances, eligible patients who have not previously registered for a VRAYLAR® (cariprazine) savings card may pay as little as $0 for their first two (2) 30-day fills. Eligible patients whose insurer does not cover VRAYLAR® (cariprazine) or where coverage restrictions have not been satisfied may pay as little as $75 per 30-day supply for each of up to twelve (12) prescription fills. Check with your pharmacist for your copay discounts. Maximum savings limit applies; patient out-of-pocket expenses may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state health care programs. Please see https://www.allergansavingscard.com/vraylar for Program Terms, Conditions, and Eligibility Criteria.

IMPORTANT RISK INFORMATION AND INDICATION

More collapse Less collapse

What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.

Antidepressants may increase suicidal thoughts or actions in some children and young adults within the first few months of treatment and when the dose is changed. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.

    VRAYLAR may cause serious side effects, including:

    • Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death
    • Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS
    • Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR
    • Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing dose of VRAYLAR
    • Problems with your metabolism, such as:
      • High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity
      • Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment
      • Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment
    • Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR
    • Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position
    • Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries
    • Seizures (convulsions)
    • Impaired judgment, thinking, and motor skills: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy
    • Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water
    • Difficulty swallowing that can cause food or liquid to get into your lungs

    Who should not take VRAYLAR?

    Do not take VRAYLAR if you are allergic to any of its ingredients. Get emergency medical help if you are having an allergic reaction (eg, rash, itching, hives, swelling of the tongue, lip, face or throat).

    What should I tell my healthcare provider before taking VRAYLAR?

    Tell your healthcare provider about any medical conditions and if you:

    • have or have had heart problems or a stroke
    • have or have had low or high blood pressure
    • have or have had diabetes or high blood sugar in you or your family
    • have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol
    • have or have had seizures (convulsions)
    • have or have had kidney or liver problems
    • have or have had low white blood cell count
    • are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or
      http://www.womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/
    • are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR

    Tell your healthcare provider about all medicines that you take, including prescriptions, over-the-counter medicines, vitamins, and supplements. VRAYLAR may affect the way other medicines work, and other medicines may affect how VRAYLAR works. Do not start or stop any medicines while taking VRAYLAR without talking to your healthcare provider.

    What are the most common side effects of VRAYLAR?

    • The most common side effects were difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, and indigestion.

    These are not all possible side effects of VRAYLAR.

    INDICATION AND USAGE

    VRAYLAR is approved in adults to treat depressive episodes (bipolar depression) and for the short-term treatment of manic or mixed episodes that happen with bipolar I disorder.

    Please see the full Prescribing Information, including Boxed Warnings, and Medication Guide.


    *Depending on insurance coverage, eligible patients may pay as little as $15 for each of up to twelve (12) prescription fills. In such instances, eligible patients who have not previously registered for a VRAYLAR® (cariprazine) savings card may pay as little as $0 for their first two (2) 30-day fills. Eligible patients whose insurer does not cover VRAYLAR® (cariprazine) or where coverage restrictions have not been satisfied may pay as little as $75 per 30-day supply for each of up to twelve (12) prescription fills. Check with your pharmacist for your copay discounts. Maximum savings limit applies; patient out-of-pocket expenses may vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state health care programs. Please see https://www.allergansavingscard.com/vraylar for Program Terms, Conditions, and Eligibility Criteria.