The more you know about bipolar disorder, the better prepared you will be.
Whether you have been diagnosed with bipolar disorder yourself or know someone who has, start here to understand the condition and those living with it.
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So, what exactly is Bipolar Disorder?
Bipolar disorder is a chronic mood disorder.
In other words, this lifelong mental health condition affects the mood state of the individual.
A ‘mood state’ is what you feel at any given time.
Unlike the general population, bipolar individuals experience extreme mood states and disturbing mood swings.
Bipolar disorder also affects energy, activity & stamina levels.
Bipolar individuals experience two distinct mood states:
i) Mania: In a manic mood state, the individual can experience, among others, symptoms such as irritability, grandiosity, substance and/or alcohol use or dependence and hypersexuality and risky sexual behavior.
Distractibility, inability to go to sleep (insomnia) or a lessened need for sleep, fast or racing thoughts/flight of ideas, overactivity or unusually goal-directed behavior, overtalkativeness, and thoughtless, reckless or impulsive behavior are classic signs of the manic state.
ii) Depression: During depressive episodes, the individual can experience a wide range of symptoms, including irritability to hopelessness and delusions to contemplation of suicide.
Changes in sleep patterns (sleeping in more often than usual), a general loss of interest, feelings of guilt or worthlessness, low energy levels, a decreased ability to concentrate, appetite changes (usually increased), slowed thoughts and physical movements, and suicidal ideation or recurrent thoughts of death are classic signs of the depressive state.
A manic or depressive episode can last, on average, from 3 to 6 months.
The average frequency of a BD episode is 2 or 3 years.
What are the various types of Bipolar Disorder?
Depending on the symptoms, severity and other factors, the condition can be diagnosed as Bipolar I Disorder, Bipolar II Disorder, Bipolar NOS (Not otherwise specified), Mixed Bipolar Disorder, or Rapid-cycling Bipolar Disorder.
Bipolar I Disorder
This type is marked by at least one manic episode, which can be severe and dangerous. Moreover, a manic episode is generally preceded or followed by hypomania (a mild to moderate form of mania) or major depression.
Psychosis—hallucinations and delusions—can also result.
Bipolar I Disorder affects males and females equally.
Bipolar II Disorder
This type of the condition is marked by at least one major depressive episode and at least one hypomanic episode. The individual does not experience any manic episodes.
This type of the condition affects twice as many females as males.
Bipolar NOS (Not otherwise specified)
This type of bipolar disorder is marked by short-duration manic, hypomanic or mixed episodes.
These symptoms are generally not seen in the previous two types.
Mixed Bipolar Disorder
In this type, symptoms of mania and depression occur together, i.e., the individual experiences both mood states (mania and depression) at the same time.
Rapid-cycling Bipolar Disorder
Not all bipolar individuals experience a period of normality between episodes.
Those diagnosed with the rapid-cycling type of the condition experience manic and depressive mood states which immediately follow each other.
The mood state of rapid-cycling bipolar individuals swings from one extreme to another without any respite in between.
Regardless of the type of bipolar disorder, the mood states or feelings of the typical bipolar individual are likely to be chronically severe.
Therefore, their perceptions and thoughts about their environment and themselves are likely to be severe, too.
In turn, their perceptions and thoughts can undermine their mood state even further at any given time.
The good news?
Even those diagnosed with the most severe form of the condition can experience substantial mood state stability and symptomatic relief with treatment.
What causes Bipolar Disorder?
Although the root cause(s) behind the condition remains unidentified, bipolar disorder in both adolescents and adults is subject to several risk factors:
• Family history of mania or recurrent depression
• History of elated, excited or irritable mood or extraverted/impulsive traits
• Melancholic features during a depressive episode
Melancholic features include slowing of thoughts and physical movements; loss of interest and ability to find pleasure in previously pleasurable activities; a non-reactive mood; excessive sleepiness or oversleeping; mood changes throughout the day; and psychosis (hallucinations and delusions).
Bipolar disorder—or a condition like it—can also be triggered or worsened by substance and/or alcohol use or dependence, stroke, and certain medical conditions, including those affecting the central nervous system.
What are the conditions that co-occur with Bipolar Disorder?
Substance and/or alcohol use or dependence, anxiety disorders, attention deficit hyperactivity disorder, eating disorders, thyroid problems, psychosis (hallucinations and delusions), and migraine attacks can co-occur in both Bipolar I and II individuals.
How is Bipolar Disorder treated?
Besides early detection, accurate diagnosis is critical in the effective treatment of bipolar disorder.
An individual who is eventually diagnosed with the condition may initially seek medical advice for symptoms often associated with depression.
In fact, as many as 4 out of 10 bipolar individuals are likely to be misdiagnosed with major depressive disorder or clinical depression.
The same bipolar individual is unlikely to seek help for symptoms of mania.
This is simply because bipolar individuals in general need help to seek proper help.
Nevertheless, long-term treatment of bipolar disorder is likely to involve a combination of drug & psychosocial interventions.
Along with a mood stabilizer(s), anticonvulsant(s) may also be prescribed, especially if the symptoms are severe.
An antidepressant(s) may also be needed to avoid slipping into mania or hypomania, or from developing the rapid-cycling type of the condition.
If required, a sedative may also be prescribed to promote better sleep, but only over the short term.
The bipolar individual may also have to take thyroid pills for a co-occurring thyroid condition or to counter the side-effects of a bipolar disorder drug.
In general, the treatment plan over the lifetime of the bipolar individual is likely to be modified intermittently to ensure the effective management of the condition.
The bipolar individual may also benefit from psychosocial interventions.
They may be advised cognitive behavioral therapy, interpersonal & social rhythm therapy, psychoeducation and/or some other psychosocial intervention(s).
Because the condition is marked by symptoms that can be deeply disturbing and distressing, the immediate family of the bipolar individual can benefit from psychoeducation, family therapy and/or some other psychosocial intervention(s).
If medication and psychosocial interventions are ineffective or a medical condition prohibits medication, electroconvulsive therapy (ECT) may be the best treatment option.
The bipolar individual may otherwise require hospitalization.
A word about bipolar disorder and suicide
Anyone who even talks about suicide should be taken seriously.
Some bipolar individuals do become suicidal.
The risk appears to be higher during the initial stages of a depressive, rapid-cycling or mixed bipolar episode.
Suicidal thoughts or tendencies and actual attempts can all also be triggered or made worse by the stigma attached to mental health conditions such as bipolar disorder and those living with it.
However, the risk of death by suicide can be decreased by recognizing the condition for what it is: a chronic, debilitating & potentially life-threatening mood disorder .
Moreover, learning to recognize and manage its symptoms before they get out of hand can also help.
Above all, unless otherwise instructed a bipolar individual must never stop taking their medication, even if they feel normal.
The bipolar individual may also be advised some form of psychotherapy to help them deal with suicidal thoughts or tendencies, if any.
Some signs and symptoms that may accompany suicidal feelings
• Talking about feeling suicidal or wanting to die
• Feeling hopeless, helpless, or like a burden to others
• Abusing alcohol or drugs
• Putting affairs in order (organizing finances or giving away possessions to prepare for one’s death)
• Writing a suicide note
• Deliberately endangering life and limb
If you are feeling suicidal or know someone who is . . .
1. Call a doctor, emergency room or 911 right now for help.
2. Make sure not be alone or to leave the suicidal person alone.
3. Stay or keep the suicidal person away from large amounts of medication, weapons or other potentially dangerous items and environments.
NOTE: Not all suicide attempts are carefully planned. Some attempts can be impulsive acts. Either way, suicidal thoughts and tendencies are symptoms of a treatable condition and YOU can overcome them!
You can otherwise contact the National Alliance on Mental Illness:
1-800-950-NAMI (6264) from Mon–Fri: 10 a.m.–6 p.m.
Text ‘NAMI’ to 741741
Email info@nami.org