Bipolar Disorder
Bipolar disorder is a mood disorder that can cause emotional extremes: the lows of depression and the highs of mania. For many people, bipolar disorder can disrupt everyday activities, like work, school, parenting, and self-care. Getting a diagnosis from a trained mental health clinician is an important step in obtaining treatment.
What is bipolar disorder?
People with bipolar disorder experience extreme emotional states that can last from days to weeks. These emotional or mood states can be categorized as manic or depressive. During a manic state, someone with bipolar disorder might feel unusually energetic or euphoric. In a depressive state, they might feel tired, lethargic, and sad.
Mood changes are normal. If you feel sad one day and happy the next, that doesn’t necessarily mean that you have a mood disorder. The mood changes of bipolar disorder are characterized by their intensity and long-lasting nature.
What causes bipolar disorder?
Bipolar disorder seems to have a strong genetic component (Goes, 2016). This doesn’t mean you’re guaranteed to develop bipolar disorder. It just means there’s a greater risk.
Your early experiences may also be a factor. Bipolar disorder may be linked to childhood trauma (Brietzke et al., 2012).
Symptoms of bipolar disorder
People with bipolar disorder experience mood symptoms at opposite ends of the spectrum. On one end, mania brings euphoria, elevated mood, and heightened energy. On the other, depression lowers motivation, saps energy, and dampens mood.
Mania and hypomania
A manic episode usually involves some combination of the following:
- Elevated mood
- High energy
- Decreased need for sleep
- Racing thoughts
- Psychotic symptoms, such as hallucinations or delusions
- Increased creativity
- Talkativeness
- Increased risk-taking or spending
- Irritability
- Distractibility
Hypomania is a milder form of mania. It generally lasts for a shorter period of time and doesn’t majorly affect your ability to function, complete work, or take care of yourself.
Depression
Depression can be experienced as a combination of symptoms that can include:
- Depressed mood
- Loss of motivation
- Feelings of worthlessness
- Difficulty thinking and making decisions
- Loss of enjoyment of usual activities
- Insomnia or hypersomnia (increased need for sleep)
- Fatigue
Other symptoms
Many people with bipolar disorder find that their mood symptoms interfere with their ability to complete daily activities. Even mild disruptions can make life significantly harder, especially if you have a high-stress job or care for a child or family member.
Disruptions in functioning can be one of the earliest and most reliable signs that your symptoms may require clinical help to manage.
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Types of bipolar disorder
The Diagnostic and Statistical Manual of Mental Disorders, (DSM) classifies bipolar disorder as four main subtypes: bipolar 1, bipolar 2, cyclothymia, and substance- or medication-induced bipolar disorder. While these subtypes differ in significant ways, they all can cause a person to cycle through mania or hypomania and depression.
Bipolar 1
To be diagnosed with bipolar 1 disorder, you must have experienced at least one episode of “elevated, expansive, or irritable” mood mania along with behavior or energy that is “persistently goal-directed” and lasts at least one week (American Psychiatric Association, 2013). These symptoms must represent a departure from your usual mood and activity.
Bipolar 2
According to DSM, bipolar 2 disorder is distinguished from bipolar 1 by the presence of hypomania and the absence of mania (American Psychiatric Association, 2013). Hypomanic episodes are less severe than manic episodes and do not affect your functioning to the same degree.
Cyclothymia
Cyclothymia is a mood disorder that is different from bipolar disorder and somewhat rare by comparison. People with cyclothymia experience periods of hypomania and depression that do not meet the full criteria for bipolar 1 or 2 disorder.
Substance/medication-induced bipolar and related disorders
This disorder involves persistent mood disturbances brought on by the use of a prescribed medication or recreational substances, like cocaine or amphetamines.
Can children and teens have bipolar disorder?
Yes, although the diagnosis criteria for these ages are different from adults.
How is bipolar disorder diagnosed?
A therapist will typically use a structured interview to assess your mood symptoms. They may ask questions about your psychiatric history, family history, current symptoms, lifestyle, work, and family. Some therapists will use standardized questionnaires to rate your symptoms.
Treatments for bipolar disorder
Bipolar disorder can be managed with therapy, medication, or both. The type of treatment will depend on your symptoms and your individual preferences.
Therapy
Therapy for bipolar disorder often involves learning to recognize when you’re entering a manic/hypomanic or depressive state. Your clinician will help you develop strategies to cope with these mood changes.
The clinician may also help you deal with some of the social effects of having a mood disorder. Many people develop shame or stigma around their symptoms. They may face intrusive questions and unwanted advice from people who don’t fully understand what they’re going through. A therapist can help you bolster your self-esteem, reframe feelings of worthlessness, and fend off hurtful comments from others.
Medication
Medication can be an effective treatment for bipolar and related disorders. Your clinician can provide you with information about the types of medication available.
When to seek emergency help
If you are having a psychiatric or medical emergency, please call 911 or go to the nearest emergency department. To reach the Suicide and Crisis Lifeline, please call or text 988.
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Brietzke, E., Sant’anna, M. K., Jackowski, A., Grassi-Oliveira, R., Bucker, J., Zugman, A., Mansur, R. B., & Bressan, R. A. (2012). Impact of childhood stress on psychopathology. Revista Brasileira De Psiquiatria, 34(4), 480–488. https://doi.org/10.1016/j.rbp.2012.04.009
- Goes, F. S. (2016). Genetics of bipolar disorder. Psychiatric Clinics of North America, 39(1), 139–155. https://doi.org/10.1016/j.psc.2015.10.004
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