Bipolar Disorder: Everything You Need to Know
2.8 percent of U.S adults live with bipolar disorder. Some of them have episodes several times a year; others experience them rarely. Attacks may last for days or weeks. Unfortunately, this condition has no cure.
A common misconception is that this disorder is just about having mood swings. The truth is, it is a severe mental condition that can affect one’s quality of life. There is plenty to know about bipolar disorder, including available treatment options that help manage the symptoms.
What Is Bipolar Disorder?
Bipolar disorder is a mental health condition characterized by unusual shifts in mood, energy, activity levels, and concentration. Everyone has ups and downs, but with bipolar disorder, these changes are severe.
The changes range from episodes of extreme highs called mania to extreme lows called depression. Unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they may interfere with relationships, productivity at work, and daily activities.
What Are the Causes and Triggers of Bipolar Disorder?
There is no apparent cause of bipolar disorder. It results from a combination of genetic and environmental causes. Certain factors may trigger episodes in people who are predisposed to the condition.
Is bipolar disorder hereditary? Yes, it is. You are more likely to develop this condition if someone in your immediate family has it. The risk is higher if either your parents or your twin has the disease.
It is clear that more than one gene is involved. Researchers are yet to determine the particular genes responsible for the disorder. However, not everyone with an inherited vulnerability develops the disease. Therefore, genes are not the only cause.
Abnormalities in Brain Structure and Functioning
Some studies indicate that the brain structure and functioning of people with bipolar disorder are different from that of people who have no mental illnesses.
However, there is not enough information about these differences to inform diagnosis. Therefore, health care providers base their diagnosis on a patient’s symptoms and history rather than brain imaging.
Research indicates that external factors can trigger episodes of mania or depression. Environmental influences may also make existing symptoms worse. Some of the most common environmental triggers are:
Stressful life events can trigger the disorder in someone with a genetic vulnerability. Such events involve drastic changes such as losing a loved one, going away to college, losing a job, or moving. Positive life events such as getting married can also trigger an episode.
Substance abuse alone cannot cause bipolar disorder. However, it can trigger an episode or worsen the progression of symptoms. Drugs such as cocaine, amphetamines, or ecstasy can trigger mania. Alcohol can trigger depression.
Manic episodes are expected during the summer. Depressive episodes are typical during fall, winter, and spring.
Not getting enough sleep can trigger a manic episode. The quality of sleep is also essential. Restless nights can worsen symptoms and make extreme behavior more likely.
What Are the Different Types of Bipolar Disorder?
According to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM), there are three main types of bipolar disorder based on the nature and severity of symptoms.
It is the classic form of this disorder and was originally referred to as “manic depression.” One may experience a sudden, extreme shift in moods, and their behavior may escalate quickly.
Individuals with this type of disorder experience episodes of severe mania. A diagnosis of bipolar I mean that you have experienced at least one manic episode that lasts longer than one week.
90% of people with this disorder also experience periods of depression. Without treatment, manic episodes last 3-6 months, and depressive episodes last 6-12 months.
Individuals with this type of disorder experience a less severe form of mania called hypomania. A diagnosis of bipolar II means you often experience major depressive episodes. Instead of mania, you experience a less extreme episode called hypomania.
Hypomania often becomes worse without treatment and may result in severe mania or depression.
Individuals with this type of disorder have symptoms that do not meet the diagnostic requirements for hypomania or depression. They experience mild symptoms that last for 1-2 years.
What Are Signs and Symptoms of Bipolar Disorder?
Bipolar disorder is typically diagnosed in late adolescence or early adulthood. Symptoms can appear in children, pregnant women, or after childbirth.
A manic episode does not always turn someone into a maniac. In this state, a person may feel extreme highs and engage in risky behavior. However, it does not automatically mean a person is violent or dangerous.
During a manic episode, one may:
- Feel euphoria (extreme highs)
- Feel irritable or touchy
- Feel jumpy or wired
- Have a decreased need for sleep
- Have loss of appetite
- Talk very fast about a lot of different things
- Have racing thoughts
- Think they can do a lot of things at once
- Engage in risky behavior such as reckless sex, excessive drinking, and impulsive spending
- Feel like they are extremely powerful, talented, or important.
Depressive episodes occur more in individuals with Bipolar II disorder. Because during such attacks, one tends to keep to themselves, it may be difficult for others to notice the symptoms.
During a depressive episode, one may:
- Feel extreme anxiety or hopelessness
- Feel slowed down or restless
- Have trouble falling asleep or waking up
- Experience increased appetite and weight gain
- Talk slowly or feel like they have nothing to say
- Have difficulty concentrating or making decisions
- Feel sluggish and unable to do the simple tasks
- Experience apathy or indifference to all activities
- Have decreased or absent sex drive
- Think about death or suicide
Hypomanic episodes involve the same, but less extreme, symptoms as manic episodes. However, one’s functioning is not impaired. One may also have periods with no symptoms, making the condition harder to diagnose.
During a hypomanic episode, one may:
- Have increased energy
- Have decreased need for sleep
- Function normally despite the symptoms
Treatment of Bipolar Disorder
To diagnose bipolar disorder, a doctor or other health care provider may do a physical exam and lab tests to identify any medical problem that could cause your symptoms. Your doctor may refer you to a psychiatrist if there is sufficient reason to believe you may have the condition.
Only a psychiatrist should make a formal diagnosis and guide treatment that is directed at managing symptoms. Bipolar disorder is treated through a combination of medication and psychotherapy. It requires long-term treatment to prevent relapse and stay symptom-free.
Treatment of the condition is highly individualized. It depends on the types and severity of symptoms one experiences. It may include different types of medications:
- Mood stabilizers, such as lithium
- Anticonvulsants to stabilize mood swings
- Antidepressants to alleviate depressive symptoms
Electroconvulsive therapy is an alternative treatment option if you don’t get better with medications. It is effective in relieving severe mania or depression.
Psychotherapy can be effective for bipolar patients as an adjunctive treatment alongside medication. An experienced therapist can help you learn skills to effectively cope with bipolar symptoms in a non-judgmental environment.
Cognitive-behavioral therapy (CBT) is the dominant technique used to treat bipolar disorder. It is based on the premise that mood problems can be resolved by changing dysfunctional interpretations of stressful life events.
Interpersonal and social rhythm therapy may also be used to treat this condition. It focuses on regulating basic daily habits to help symptom management. This mode of treatment focuses on daily routines such as sleeping, eating, and exercising.
Therapy sessions may involve the individual and their family members. It creates a supportive environment by teaching people how to help their loved ones.
Psychotherapy offers several benefits to people with bipolar disorder, including:
- A safe place to talk about how the illness is impacting them and their families
- Objective third party monitoring of their mood and potential for self-harm
- Coping mechanisms to navigate work and social situations
- Motivation to maintain and adjust medication routines
When to See a Doctor
Despite the extreme mood swings, people with this condition often don’t realize when they need help. They are not aware that their emotional instability disrupts their lives and those of their loved ones.
It is possible to enjoy the euphoria and bursts of productivity that come with manic or hypomanic episodes. However, high episodes are followed by an emotional crash that leaves one depressed and worn out. So, it is crucial to seek medical attention regardless of which symptoms one feels at the moment.
If you experience extreme mood swings and other symptoms associated with this condition, it is best to see a doctor right away. Getting treatment from a mental health professional is the only way to manage symptoms and live a better life.
Living with Bipolar Disorder
Like many mental health conditions, bipolar disorder is associated with societal stigma. People may make hurtful comments or discriminate based on what they think they know about the illness. Stigma makes it hard to seek treatment and cope with the condition.
Know that stigma develops due to a lack of knowledge. Usually, the best way to fight stigma is by sharing facts about the condition. Connecting with other people who have the disorder can help you cope and consistently seek treatment.
When it comes to managing a relationship while living with this condition, honesty is the best policy. Because episodes can impact your partner, it is important to be open about your situation.
Consider sharing these facts to help your partner better understand the disorder:
- When you were diagnosed
- What to expect during manic episodes
- What to expect during depressive episodes
- How they can be helpful to you
- When you need medical attention
People living with mental health conditions can have healthy relationships. One of the best ways to make a relationship successful is by sticking with your treatment. Treatment helps manage symptoms and reduce the severity of your disorder.
Online therapy is an excellent tool for developing coping mechanisms. Speaking with a licensed counselor can help you manage relationships while living with bipolar disorder and seek help when necessary.
When to Get Emergency Help
If you, or anyone you know, have suicidal ideation, get emergency help immediately. You can confide in a trusted friend to help you contact emergency services. Calling 911, a local emergency number, or a suicide hotline guarantees a quick response. If you can, head to the nearest hospital emergency room.