Understanding Bipolar Disorder

Bipolar disorder is a mental illness characterized by extreme shifts in mood and energy. Formerly known as "manic depression," this disorder causes individuals to cycle between two emotional states: mania or hypomania (the "highs") and depression (the "lows"). The term "bipolar" reflects these two opposite "poles" of emotion.

While individuals with bipolar disorder may experience periods of more balanced moods between episodes, some may experience symptoms of mania and depression simultaneously. These "mixed" episodes, while not always severe enough for a full bipolar disorder diagnosis, are sometimes referred to as "depression with mixed features."

Symptoms of Bipolar Disorder

Symptoms of bipolar disorder vary depending on the type of episode a person is experiencing. For instance, manic episodes often involve abnormally high self-confidence, while depressive episodes are associated with low self-esteem. However, some common signs can be present regardless of whether someone is experiencing mania or depression:

• Extreme mood swings

• Difficulty concentrating or making decisions

• Insomnia or decreased need for sleep

• Changes in appetite

Manic Symptoms

During a manic episode, individuals with bipolar disorder may feel extremely confident and energized. They might act impulsively or engage in risky behaviors, and in some cases, experience hallucinations. Hypomania, a less intense form of mania, doesn't typically involve delusions or reckless risk-taking. Symptoms of mania can include:

• Feeling overly happy or excited

• High energy levels

• Rapid speech

• Poor decision-making

• Increased sexual desire

• Risky or impulsive behaviors

• Sudden, intense irritability

Depressive Symptoms

Individuals experiencing a depressive episode within bipolar disorder often exhibit symptoms similar to those of major (or "clinical") depression. A therapist can help determine if symptoms indicate clinical depression or a bipolar depressive episode. Common depressive symptoms include:

• Sadness, emptiness, or hopelessness

• Loss of interest in previously enjoyed activities

• Low energy levels

• Slow speech

• Low sexual desire

• Anxiety or restlessness

• Suicidal thoughts (suicidal ideation)

Bipolar Disorder in Children and Teens

Diagnosing bipolar disorder in children and teens can be challenging. Many of the symptoms can overlap with other mental health conditions, such as attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD). It's also important to remember that mood swings are common during puberty. If you suspect your child or teen may have bipolar disorder, it's crucial to seek professional help from their doctor and/or a licensed therapist.

Types of Bipolar Disorder

There are several types of bipolar disorder:

• Bipolar I: Characterized by manic and depressive episodes. Manic episodes last at least a week or require hospitalization, while depressive episodes last at least two weeks. This type often presents with the most extreme symptoms. Individuals with bipolar I may also experience depression with mixed features.

• Bipolar II:  Individuals experience hypomanic and depressive episodes but do not experience full-blown manic episodes.

• Cyclothymic Disorder: Characterized by hypomanic and depressive symptoms that persist for at least two years (one year for children and teens). These symptoms may not be severe enough to meet the criteria for hypomania or major depression.

What Causes Bipolar Disorder?

The exact cause of bipolar disorder is not fully understood, but several risk factors are believed to contribute:

• Biochemistry: Research suggests a possible link between bipolar disorder and chemical imbalances in the brain, though further investigation is needed.

• Genetics:  A family history of bipolar disorder may increase the risk of developing the condition.

• Triggers:  Certain factors, such as substance use, physical illness, trauma, and sleep disturbances, can trigger bipolar symptoms in individuals with a genetic or biological predisposition.

Is Bipolar Disorder Hereditary?

While genetics play a role in bipolar disorder, they are not the sole determinant. Someone can be diagnosed with bipolar disorder even without a family history. While the risk may be higher if a family member has been diagnosed, it's not guaranteed.

Strategies for Management and Treatment

Treatment for bipolar disorder typically involves a combination of medication, psychotherapy, and lifestyle changes:

• Medical Therapy: Mood stabilizers, antidepressants, antipsychotic medications, and other medications can be effective. Your psychiatrist may also prescribe medications for anxiety or sleep issues. In severe cases, electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may be considered.

• Psychotherapy:  Therapists utilize various methods, such as cognitive behavioral therapy (CBT) and interpersonal and social rhythm therapy (IPSRT), to help individuals manage their condition.

• Lifestyle Changes:  These changes can support treatment but are not a substitute for professional care. Recommended lifestyle changes include:

  • Maintaining a regular daily routine

  • Getting adequate sleep, eating regularly, and exercising

  • Avoiding alcohol and drugs

  • Engaging in hobbies

  • Keeping a mood journal

  • Cultivating healthy relationships

"Am I Bipolar?"

If you are experiencing symptoms of bipolar disorder, it's essential to consult with a healthcare professional. Only a licensed professional can provide a formal diagnosis.

• See your primary care doctor:  Your doctor can perform tests to rule out other medical conditions and can provide a referral to a specialist.

• Speak with a therapist: A therapist can evaluate your symptoms and provide a diagnosis and treatment plan.

Whether diagnosed with bipolar disorder or another condition, a therapist can offer support and treatment to help you improve your mental health.