What is Bipolar Disorder?

Bipolar disorder is perhaps one of the least understood and most stigmatized mental illnesses today. People often use the term “bipolar” to describe something that changes quickly, such as the weather. Some even use the word to describe someone whose mood changes throughout the day. However, all of these uses of the word “bipolar” feed into the myths about the disease.

Like depression, bipolar disorder is an illness that patients and loved ones should treat seriously. It’s also called manic-depressive illness. This term comes from the fact that patients have large swings in their moods, energy, and ability to complete daily tasks.

Cyclothymic Disorder

Some patients experience manic and depressive episodes, but do not have severe enough symptoms to qualify for a bipolar diagnosis. For example, the episodes may not be long enough or they may not have enough of them per year to have bipolar disorder.

Patients like this may have cyclothymic disorder. Behavioral health professionals can treat such people with many of the same techniques as they do with the other two types of manic-depressive illnesses listed below.

Bipolar 1 vs 2

Behavioral health professionals generally recognize two different types of this condition: bipolar I and bipolar II.

Patients with bipolar I have manic episodes that either last at least one week and depressive episodes that last at least two weeks. Someone may have bipolar I if the episodes are shorter but have such severe symptoms that the person must go into emergency care.

People with bipolar II (also written as “bipolar 2”) have the same patterns of episodes. However, the mania and depression do not last as long as they do with bipolar I. Symptoms of bipolar II tend to be less severe than bipolar I, although there’s no doubt that both can cause distress.


Bipolar Symptoms

People with bipolar disorder have manic episodes in which their energy levels soar, and their mood is generally happy. These episodes can be dangerous because patients can stop caring about family, friends, finances, and other important things in their lives.

One of the more common bipolar disorder symptoms are experiences of depressive episodes. During these times, people may not have the energy to complete daily tasks. In some cases, their moods sink so low that they have suicidal thoughts.

Manic and depressive episodes are not a few moments or hours, as some popular cultural would portray. For people with certain types of bipolar disorder, these episodes last about two weeks on average.

Manic Symptoms

  • Above-average energy levels
  • Feeling elated
  • Difficulty sleeping
  • Irritability
  • Racing thoughts
  • Risky behavior, such as spending recklessly

Depressive Symptoms

  • Hopelessness
  • Low energy levels
  • Too much or too little sleep
  • Over or under eating
  • Fatigue
  • Feeling “empty”
  • Unable to enjoy favorite activities
  • Thoughts about suicide

Is There a Bipolar Test?

Physical tests, such as blood work and scans, do not help behavioral health professionals in diagnosing bipolar disorder. Instead, psychiatrists and therapists may ask patients about the patterns in their moods. They are not looking for moment-to-moment moods swings. Instead, they look for how long a person may be in a manic or depressive state.

Sometimes, this process involves filling out a survey on pen and paper. Some patients find this easier than expressing their concerns out loud. The questionnaire can then guide the discussion between a patient and a counselor.

Patients should prepare for their therapist to ask detailed questions and pause to take thorough notes, especially in the initial assessment. This is a fairly non-stressful process. Patients will be able to ask to slow down if a particular topic is too difficult to explore at that time.

Comorbid Conditions

Behavioral health professionals may also evaluate patients for other disorders. Some illnesses often coexist with bipolar disorder, including psychosis, anxiety, ADHD, and substance abuse. Mental health professionals may also want to rule out different types of depression.

Evaluation for any of these illnesses will be much like that for bipolar disorder. Patients may need to complete questionnaires to let professionals know how often they have specific symptoms. With a clear picture of the patient’s mental health, the medical team can devise a personalized strategy.


Bipolar Disorder Treatment Options

Like other mental illnesses, the treatment for bipolar disorder can be medication, talk therapy, or a combination of both. Depending on the severity of the symptoms, behavioral health professionals may recommend residential treatment or other bipolar disorder treatment options.

Talk Therapy

Several types of therapies can be useful in bipolar treatment. Cognitive Behavioral Therapy (CBT) helps patients notice their triggers and regulate their emotions accordingly. Unlike with anxiety attacks, CBT is often not enough of its own for bipolar patients.

Counselors may also utilize family-focused therapy, in which the patient’s immediate support system learns about bipolar disorder and how to help. This strategy often goes hand-in-hand with psychoeducation, which allows patients to know more about their conditions.

Interpersonal and Social Rhythm Therapy (IPSRT) is another popular type of therapy for bipolar disorder. With this technique, patients learn how their biology, moods, and social interactions all work together. Mental health professionals give patients strategies to work with these forces to stabilize moods.

Medication Options

It can take time for patients to find the right combination of medication. Generally, psychiatrists use three classifications to treat bipolar disorder:

  • Antidepressants
  • Mood stabilizers
  • Antipsychotics

In some cases, sleep aids may be necessary as well. Even when other symptoms remain under control, people with bipolar disorder can struggle with sleep.

Additional Bipolar Treatment Options

When someone has extreme bipolar disorder symptoms, and no other treatments have worked, doctors may recommend Electroconvulsive Therapy (ECT). This procedure can cause some side effects, including confusion and loss of memory. Professionals limit the use of ECT until the risks of not finding an effective treatment outweigh the risks of ECT.

Life charts may be part of treatment plans for patients with varying severity of bipolar symptoms. With these charts, patients log their symptoms, medications taken and life events. Their care teams can then find patterns in the charts and recommend strategies for improvement.


How Common is Bipolar Disorder?

2.6 percent of the adult population in the United States suffers from bipolar disorder. This may seem like a low number at first glance, but it makes up about 5.7 million people. If one has 100 friends, family members, and colleagues, there’s a good chance that two or three of these people have the condition.

The numbers regarding children and teenagers with bipolar disorder is less clear. Members of the behavioral health community still debate over the diagnostic criterion for patients at these ages. Some estimates show that 750,000 children and teens may have the disorder without a diagnosis.


Risk Factors for Bipolar Disorder

Certain people are more at risk for developing bipolar disorder, although almost anyone can have it. For example, people with certain gene variants seem to be more likely to have the disease. Similarly, bipolar disorder tends to run in families.

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