Depression & BipolarSelf-Image & Self-Harm

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Bipolar Disorder

Have you ever described your moods or feelings as an “emotional roller coaster?” Most people experience periods of emotional highs followed by lows at some time in their lives. Different people might experience these mood changes while watching a dramatic movie, or maybe during a life event that evokes both positive and negative emotions. But when these mood swings from high to low and low to high are extreme, sudden, long-lasting, or persistent, they might indicate bipolar disorder, a severe mental health condition.


What is Bipolar Disorder?

The American Psychiatric Association (APA) defines bipolar disorder as “any of a group of mood disorders in which symptoms of mania and depression alternate.” A serious mental illness, bipolar disorder was previously known as manic-depressive illness or manic depression because it is characterized by both manic episodes and periods of depression. Manic episodes, or “mania,” are the emotional highs, while depressive episodes are the lows. Some people living with bipolar disorder will experience symptoms of mania and depression at the same time.

While an emotional high for most people might include feelings of happiness, excitement, contentedness, or passion, these emotions are amplified and elevated during a period of mania. During the manic phase of bipolar disorder, a person will experience euphoria as well as irritability. They may feel abnormally energized, and be so confident that they participate in reckless behavior. They may even suffer symptoms of psychosis, including delusions and hallucinations. Hypomania is a less severe form of mania.  

In general, people experiencing a low mood usually feel down or sad, but will return to a healthy mood fairly quickly. With bipolar disorder, though, a person’s depressed mood is long-lasting and extreme. They may feel emptiness, hopelessness, and worthlessness. In fact, one of the most dangerous complications of bipolar disorder is the risk of suicide.

Because bipolar disorder symptoms are so intense and unusual, they usually interfere significantly with the person’s ability to lead a productive life. The National Institute of Mental Health (NIMH) notes that bipolar disorder affects and “unusually” shifts “mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.”

As with many mental health conditions, there is no single cause for bipolar disorder. Some research suggests that genetics, or a family history of bipolar disorder or schizophrenia, may increase a person’s risk for the condition. Other research attributes the development of bipolar disorder to a person’s brain structure or functioning. Still, others blame environmental factors as causes of bipolar disorder, including the death of a close family member or loved one, childhood abuse, long-term stress, or substance abuse.

How common is Bipolar Disorder?

Bipolar disorder is a common mental disorder. As many as 2.6% of the general population of the United States, or more than five million people, suffer from some form of bipolar disorder. Although bipolar disorder symptoms may appear in childhood, onset most often occurs in late adolescence or early adulthood.  

Common Symptoms of Bipolar Disorder

According to the NIMH, people with bipolar disorder “experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behavior — often without recognizing their likely harmful or undesirable effects.” Some people may experience these periods, known as mood episodes, for weeks, months, or even years. During these episodes, symptoms will last every day for most of the day.

Individuals with bipolar disorder may also experience a series of the same mood episode, whether that’s a depressed state, hypomanic episode, or a manic episode, before their mood changes to another state. Still, others will experience rapid cycling, which involves experiencing more than four distinct depressive or manic episodes during a one-year period. Women are more likely than men to experience rapid cycling. Women also experience more prolonged periods of depression than men.

Psychologists, counselors, and other mental health professionals divide the signs and symptoms of bipolar disorder into those for mania and those for depression.

Manic symptoms include:

  • Feeling high, elated, or euphoric for an extended period
  • Feeling jumpy, wired, touchy, or remaining in an irritable mood
  • Experiencing racing thoughts and talking very fast
  • Having a decreased need for sleep and feeling constantly restless
  • Being overly confident or powerful
  • Participating in risky behaviors like reckless sex or exorbitant spending

Depressive symptoms include:

  • Feeling extremely low, empty, sad, or hopeless for an extended period
  • Experiencing a lack of energy or motivation
  • Having trouble falling or staying asleep or sleeping too much
  • Speaking slowly or having difficulty concentrating
  • Experiencing a loss of interest in hobbies or previously enjoyable activities
  • Crying uncontrollably
  • Having thoughts of death or contemplating suicide 

Types of Bipolar Disorder

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) designates three specific subtypes of bipolar disorder.

Bipolar I disorder: The DSM-5 defines Bipolar I as a manic-depressive illness that can exist both with and without episodes of psychosis. With Bipolar I, episodes of mania are differentiated from a healthy mood, are unlike the person’s usual behavior, are present most of the day and last at least one week. Depressive episodes are not required for a diagnosis by a mental health professional. 

Bipolar II disorder: The more common form of bipolar disorder, Bipolar II is characterized by both manic and depressive symptoms. Manic episodes of Bipolar II are less severe than those of Bipolar I, which mental health professionals refer to as hypomanic episodes. If hypomanic symptoms aren’t treated, they can escalate into acute mania or major depression.

Cyclothymic disorder: Cyclothymic disorder, or cyclothymia, is less frequent and less severe than either Bipolar I or Bipolar II. With cyclothymic disorder, a person’s mood changes are similar to those of the other disorders but less extreme. A person with cyclothymic disorder may be able to function without medication or other treatment. Still, over time their symptoms may escalate to warrant a diagnosis of Bipolar I or Bipolar II.

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Do I have Bipolar Disorder?

It can sometimes be difficult for physicians to diagnose bipolar disorder, and even harder for you to recognize the symptoms — especially if you don’t have symptoms of severe mania or if you have hypomania. Mood states are considered hypomanic episodes if the mood lasts at least four consecutive days and is present most of the day, every day. During these mood states, three or more symptoms of mania must be present.

In addition, patients must have had a major depressive episode that results in a depressed state and loss of interest in a healthy lifestyle and activities. To be considered a major depressive episode according to the DSM-5, five or more symptoms of a depressive episode must be experienced within a two-week period.

Bipolar disorder symptoms can be easily misdiagnosed as another mental health condition. This is particularly true of other diagnoses that also involve changes in mood like anxiety disorder, schizophrenia, major depressive disorder (also called unipolar depression), or attention deficit hyperactivity disorder (ADHD). 

However, your medical or mental health professional can differentiate bipolar disorder from regular mood swings by discussing whether your moods are triggered by an event or situation, or for no apparent reason. They will also ask about the severity or intensity of your symptoms and how long they last before making a diagnosis of a type of bipolar disorder.

Treatment of Bipolar Disorder

Although bipolar disorder is a lifelong mental condition, it can be stabilized with treatment options, including medication, psychotherapy, or a combination of both. There are also some things you can do on your own to combat your bipolar disorder symptoms.

Medication: Medications are the primary and most effective treatment for bipolar disorder. Depending on the patient’s symptoms, a psychiatrist or primary care physician may prescribe antidepressants, mood stabilizers (lithium, for example), atypical antipsychotics (also known as “second generation” antipsychotics), or a combination of medications as part of a comprehensive treatment plan. Healthcare professionals may also recommend or prescribe other medications to treat symptoms of anxiety or insomnia.

Psychotherapy: Also known as talk therapy, psychotherapy involves working with a psychologist, therapist, social worker, psychiatrist, or counselor to identify and change specific thoughts, emotions, and behaviors. A psychotherapy treatment plan may include psychoeducation or cognitive behavioral therapy (CBT). Other therapies that have proven effective in treating patients with bipolar disorder are family-focused therapy (FFT) and interpersonal and social rhythm therapy (IPSRT), which helps patients establish consistent routines and find ways to avoid and overcome stressors.

Self-therapy options: You can supplement and enhance your professional treatment for bipolar disorder with a few simple self-care techniques. First, try to participate in regular aerobic exercise like walking, jogging, swimming, or cycling to alleviate depression and anxiety symptoms and promote better sleep. You can also keep a life chart, journal, or other record of your daily moods, mood symptoms, sleep patterns, and treatments. Sharing this data with your healthcare provider or therapist can help with your long-term treatment.

Common Barriers to Bipolar Disorder Treatment

Bipolar disorder is a severe mental illness with symptoms that can severely impact your daily life and overall well-being. However, with medication, therapy, and some lifestyle changes, you can manage your bipolar disorder symptoms and enjoy a full and satisfying life.

As with any illness, your first step is to seek treatment from a qualified professional without hesitation. Don’t let things like a perceived stigma of mental illness or the hassle of scheduling an appointment keep you from getting better. Some people worry about finding the “right” therapist — someone whose race, gender, ethnicity, sexual orientation, experience, or specialty matches their preferences.

If these are the potential barriers between you and a great therapist, consider WithTherapy, a matching service that uses science to pair you with a personalized shortlist of therapists. You’ll start by finding therapists who are available when and where you are. Then you’ll be able to narrow down your list with preferences like what you think would be helpful for your treatment. When you find a great match, you can schedule an appointment with him or her immediately, directly through the WithTherapy website.

Find a Therapist for Bipolar Disorder

If you’re experiencing major depressive episodes, mania, or other symptoms of bipolar disorder, visit WithTherapy today.

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