Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and abnormally elevated moods. 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. Individuals often make impulsive decisions with little regard for the consequences. There is usually a reduced need for sleep during manic phases. During periods of depression, individuals may experience crying, 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 people died by suicide, while 30-40% engaged in self-harm. Other mental health issues, such as anxiety disorders and substance use disorders, are commonly associated with bipolar disorder.