Bipolar Disorder

What is Bipolar Disorder?

Bipolar disorder, also called manic depression, is a mental health condition that causes people to have extreme mood swings. Instead of the usual ups and downs, bipolar disorder involves distinct periods of the following:

• Elevated mood: This can manifest as mania, a state of intense euphoria, energy, irritability or hypomania (a less severe form of mania).
• Depressed mood: These are periods of low mood, sadness, hopelessness and a loss of interest in activities.

These feelings go beyond regular mood changes. They affect how much energy a person has, how much they sleep, what they do each day, how well they can think and how they behave. The frequency and duration of these manic and depressive episodes varies considerably among individuals. Some have infrequent episodes, while others experience them more often.

Is Bipolar a Personality Disorder?

No, personality disorders are about having inflexible and unhealthy personality traits that disrupt your life. Bipolar disorder, on the other hand, is defined by changes in mood.

Facts about Bipolar Disorder

• Bipolar disorder is a lifelong condition.
• It's estimated approximately 2% of adults have bipolar disorder.
• In most cases, bipolar disorder develops before the age of 25.
• People with bipolar disorder are at a higher risk for other health conditions.

What’s the Difference Between Borderline Personality Disorder vs. Bipolar?

While both cause problems with managing emotions, bipolar disorder and borderline personality disorder are different. Bipolar disorder involves mood episodes of mania/hypomania and depression. Borderline personality disorder involves instability in relationships, how you see yourself and your feelings.

Bipolar Disorder Causes

The exact causes of bipolar disorder are unclear, but research suggests genetics play a role.

Bipolar Disorder Signs and Symptoms

Hypomania or Mania

Hypomania involves milder manic-like symptoms, where individuals feel very good and productive. They can often function well socially and at work. However, family and friends might notice unusual mood swings and increased energy. A hypomanic episode can be followed by severe depression.

Mania is a more severe form of hypomania but shares similar symptoms: increased energy, elevated/irritable mood, less sleep, rapid speech, racing thoughts, distractibility and poor judgment. Mania disrupts life more and may include psychosis (when a person loses connection with reality and experiences delusions or hallucinations). Other symptoms include:

• Feeling overly confident or adventurous
• Feeling very happy and excited (euphoric)
• High-risk behavior
• Inflated self-esteem
• Paranoia
• Saying or doing things that are rude, inappropriate or out of the norm

Depression

The major depressive episodes in bipolar disorder have the same symptoms as major depression, including:

• Avoiding seeing, or spending time, with others
• Change in appetite
• Deep sadness
• Excessive sleep
• Extreme tiredness
• Frequent crying
• Hopelessness
• Lack of interest in activities
• Low confidence
• Thoughts of death, suicide or harming yourself
• Trouble concentrating

Types of Bipolar Disorder

• Bipolar I disorder: The main requirement for diagnosing bipolar I disorder is that a person had at least one manic episode. This means a period of at least one week with abnormally and persistently high or irritable mood and increased energy. The person may also have had episodes of hypomania or major depression.
• Bipolar II disorder: An individual had at least one hypomanic episode and major depressive episode but no manic episodes. A hypomanic episode is a period of at least four days with abnormally high or irritable mood and increased energy.
• Cyclothymic disorder: Individuals have ongoing mood swings of hypomania and mild depression for two years or more. Although periods of normal mood may occur, they last fewer than eight weeks.
• Other specified and unspecified bipolar and related disorders: If someone experiences clinically significant elevated mood episodes but doesn't meet the specific criteria for bipolar I, bipolar II or cyclothymia (chronic mood disorder with alternating mild depression and hypomania), they’re classified as having other specified or unspecified bipolar disorder.

Rapid Cycling Bipolar

If you have bipolar I or II disorder and experience four or more mood episodes (depressive, manic, hypomanic or mixed) within a year, it's called "rapid cycling." This involves switching between mania/hypomania and depression with periods of stability in between. These episodes can last for months, weeks or days.

Rapid cycling isn’t considered a separate bipolar disorder type.

The Difference in Bipolar Disorder Symptoms in Women vs. Men

Some studies show bipolar disorder affects women and men differently. Women tend to develop it later in life and are more likely to experience seasonal mood patterns, depression, mixed mania and rapid cycling. Bipolar II disorder is also more common in women.

Additionally, women with bipolar disorder often have other health issues, like thyroid problems, migraines, obesity and anxiety, which can make recovery harder. Men, however, are more prone to substance use disorders.

Does Bipolar Disorder Get Worse with Age?

Evidence suggests as people with bipolar disorder get older, they experience more frequent episodes that are depressive more often than manic. They may also develop cognitive issues. Additionally, some people find medications that used to work well become less effective.

How to Treat Bipolar Disorder

There’s no cure for bipolar disorder, but with appropriate treatment and support, people diagnosed with the condition live fulfilling lives.

A careful psychiatric evaluation is necessary for an accurate bipolar disorder assessment.

Medication is also a cornerstone for bipolar disorder treatment, including:

• Mood stabilizers — lithium, divalproex and lamotrigine — help even out mood swings.
• Antipsychotics may be used to treat mania or depression. Some help with mood stabilization.
• Antidepressants treat depressive episodes. They should be used with caution and in partnership with mood stabilizers.

What’s prescribed depends on the phase of the disorder (mania, depression or maintenance).

Different types of bipolar disorder therapies are also recommended, including cognitive behavioral therapy (CBT) and interpersonal and social rhythm therapy (IPSRT) to help with condition management.

Talk to your doctor if you, or someone you love, is struggling with their mental health. Primary care providers serve as a good starting point and can refer you to the appropriate mental health professionals.