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Bipolar Disorder
Bipolar disorder is a mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience
What is Bipolar Disorder?
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). One becomes depressed and may feel sad or hopeless and lose interest or pleasure in most activities. Then their mood shifts to mania or hypomania (less extreme than mania), and may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.
From the DSM-5
What causes Bipolar Disorder?
Risk Factors
The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:
- Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
- Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:
- Having a first-degree relative, such as a parent or sibling, with bipolar disorder
- Periods of high stress, such as the death of a loved one or other traumatic event
- Drug or alcohol abuse
How to Recognize Bipolar Disorder
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
Know the Facts
46 million people around the world, including 2.8% of the U.S. population, have bipolar disorder.
More than 90% of individuals who have a single manic episode go on to have future episodes. About 60-70% of manic or hypomanic episodes occur before or after a major depressive episode.
Intensive psychotherapy, when used as an adjunctive treatment to medication, can significantly enhance a person’s chances for recovering. A research study found that 64% of 293 participants in an intensive psychotherapy program became well.
Common Forms of Bipolar Disorder
Bipolar I Disorder
Bipolar I Disorder is an illness in which people have experienced one or more episodes of mania. Most people diagnosed with bipolar I will have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with bipolar I, a person’s manic episodes must last at least seven days or be so severe that hospitalization is required.
Bipolar II Disorder
Many adults with ADHD also have depression, bipolar disorder or another mood disorder.
Cyclothymic Disorder or Cyclothymia
Cyclothymic Disorder or Cyclothymia is a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood, but these periods last less than eight weeks.
Treatment Options
Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse. The primary treatments for bipolar disorder include medications and counseling (psychotherapy) to control symptoms, and also may include education and support groups. Bipolar disorder is a lifelong condition.
Treatment is directed at managing symptoms. Depending on your needs, treatment may include:
Psychotherapy
Psychotherapy is a vital part of bipolar disorder treatment and can be provided in individual, family or group settings. Several types of therapy may be helpful. These include:
- Cognitive behavioral therapy (CBT). The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. CBT can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.
- Psychoeducation. Learning about bipolar disorder (psychoeducation) can help you and your loved ones understand the condition. Knowing what's going on can help you get the best support, identify issues, make a plan to prevent relapse and stick with treatment
- Family-focused therapy. Family support and communication can help you stick with your treatment plan and help you and your loved ones recognize and manage warning signs of mood swings.
Medications
Often, you'll need to start taking medications to balance your moods right away. A number of medications are used to treat bipolar disorder. The types and doses of medications prescribed are based on your particular symptoms. Medications may include: Mood stabilizers, Antipsychotics, Antidepressants, Antidepressant-antipsychotic, Anti-anxiety medications.
Continued Treatment
Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.
Hospitalization
Your doctor may recommend hospitalization if you're behaving dangerously, you feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you're having a manic or major depressive episode.
Lifestyle Changes
There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening. If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:
From the Mayo Clinic
Pay attention to warning signs.
Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel you're falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.
Take your medications exactly as directed.
You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.
Avoid drugs and alcohol.
Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
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