Bipolar I, also known as manic depressive disorder, is a mental illness. In order to be diagnosed with bipolar, a person must experience a manic episode. Mania is characterized by abnormally high or "up" feelings accompanied by abnormal behavior. The person with bipolar disorder will often cycle between episodes of mania and depression, hence the name manic depression. Sometimes the 'down' episodes are characterized by feelings so low that the person may seek to cause self-injury. Bipolar disorder afflicts approximately 2.5 million people, most of whom are still quite young (in their teens and 20s) when they experience the onset of symptoms of bipolar disorder. Only rarely is someone diagnosed with bipolar disorder in later adulthood (after 50). For the person living with the disorder, episodes of mania and depression may be separated by long periods when they feel steady and "normal." In a manic stage, or period of abnormally elevated mood, an individual might exhibit the following behaviors: \tInability to stay with a single thought or idea and instead fly from one to the next \tLoud and rapid speech \tHyperactivity \tSeverely interrupted sleep patterns \tIrrationally high self-image \tRisky behaviors such as over-spending, gambling, hypersexuality or sex with risky partners, or substance abuse The periods of depression mirror those of a person with regular depression and are characterized by: \tLow energy \tLoss of pleasure \tFeelings of guilt \tFeelings of worthlessness \tThoughts of suicide For someone with bipolar, depression may become so intense that the sufferer is willing to inflict self-harm in order to escape or relieve his emotions. These self-mutilating acts (cutting, hair pulling, excessive scratching or head-banging) are dangerous in the moment and can leave lasting emotional scars. In the same way a person may choose to go for a long run or bike ride because they are feeling uptight, someone with bipolar may seek release from their negative feelings. Instead of using healthy coping mechanisms, they may seek relief through acts of self-injury. Though it is a coping mechanism, it is one that is unhealthy and even dangerous. Other unhealthy coping mechanisms may include abuse of alcohol or drugs. A person living with bipolar disorder may at times consider suicide. In fact, 25-50 percent of people with bipolar attempt suicide, though far fewer actually succeed. Actions of self-injury are not to be equated with being suicidal. Some experts believe that the person engaged in self-injury may be seeking to self-medicate. Unfortunately, these behaviors are rarely isolated occurrences. Rather they are often repeated, sometimes in methodical and regular patterns. In some cases, a person may impulsively attempt to find relief through acts of self-injury that are not part of a regular pattern. Either way, it is crucial that the person seek out the professional support they need. Physicians have a range of medications to address mood disorders and therapists can help sufferers learn new ways to cope with stress. With help, managing the highs and lows can feel like extensions of the symptom-free periods in between.