Bipolar disorder is one of the most misunderstood mental health conditions, often reduced to stereotypes about moodiness or unpredictability. In reality, it is a serious and complex condition that affects millions worldwide, influencing their emotions, energy levels, and daily lives. While the mood swings in bipolar disorder can feel overwhelming, understanding the condition—its symptoms, types, causes, and treatments—can make a significant difference.
What Is Bipolar Disorder?
Bipolar disorder, previously called manic-depressive illness, is a brain condition that causes significant changes in mood, activity levels, and energy. These mood swings aren’t the typical ups and downs everyone experiences. They are intense, can last for days to weeks, and often interfere with daily functioning.
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), bipolar disorder is classified as a mood disorder and involves distinct episodes of mania, hypomania, and depression.
Types of Bipolar Disorder
The DSM-5 outlines several types of bipolar disorder based on the severity and pattern of episodes:
Bipolar I Disorder
- Defined by at least one manic episode that lasts at least 7 days or requires hospitalization.
- Depressive episodes typically occur as well, lasting at least 2 weeks, but a depressive episode is not required for diagnosis.
Bipolar II Disorder
- Characterized by at least one hypomanic episode (less severe than mania) and one major depressive episode.
- Individuals with Bipolar II do not experience full manic episodes.
Cyclothymic Disorder (Cyclothymia)
- Involves periods of hypomanic and depressive symptoms for at least 2 years (1 year in children or adolescents).
- Symptoms do not meet the full criteria for hypomanic or major depressive episodes.
Symptoms of Bipolar Disorder
The symptoms of bipolar disorder vary depending on the phase—manic, hypomanic, or depressive.
Manic Episode Symptoms
A manic episode involves an elevated, expansive, or irritable mood lasting at least 1 week (or less if hospitalization is required). Three or more of the following symptoms must be present & four if the mood is irritable (because irritability alone might not be as strong an indicator of mania compared to an elevated or expansive mood):
- Inflated self-esteem or grandiosity.
- Decreased need for sleep (e.g., feeling rested after 3 hours of sleep).
- More talkative than usual or pressured speech.
- Racing thoughts or flight of ideas.
- Distractibility.
- Increased goal-directed activity (socially, at work, or sexually) or physical restlessness.
- Engaging in risky behaviors, such as reckless spending or unsafe sexual activity.
Manic episodes can lead to severe consequences, such as financial ruin or legal issues, due to poor judgment and the “high” of it all.
Hypomanic Episode Symptoms
Hypomania is similar to mania but less severe. It lasts at least 4 consecutive days and doesn’t significantly disrupt functioning.
Major Depressive Episode Symptoms
A depressive episode involves a persistent sad or empty mood for at least 2 weeks, along with at least five of the following symptoms:
- Feeling sad, hopeless, or empty most of the day.
- Loss of interest or pleasure in almost all activities.
- Significant weight changes or changes in appetite.
- Difficulty sleeping (insomnia) or oversleeping.
- Fatigue or lack of energy.
- Feelings of worthlessness or excessive guilt.
- Trouble concentrating or making decisions.
- Thoughts of death or suicide.
In bipolar depression, the episodes may feel more intense than in unipolar (regular) depression, as one may feel a sense of sudden “loss” of energy.
Causes of Bipolar Disorder
While the exact cause of bipolar disorder isn’t fully understood, researchers believe it arises from a combination of genetic, biological, and environmental factors:
Genetics
- Bipolar disorder often runs in families. If a parent or sibling has the disorder, the risk of developing it is higher. However, no single gene has been identified as the cause.
Brain Structure and Function
- Brain imaging studies show differences in the size and activity of certain brain structures in people with bipolar disorder.
- Neurotransmitters like dopamine and serotonin, which regulate mood, may function abnormally.
Environmental Triggers
- Stressful life events, trauma, or major changes (like a breakup, job loss, or childbirth) can trigger episodes in vulnerable individuals.
Diagnosis of Bipolar Disorder
Diagnosing bipolar disorder requires a thorough evaluation by a mental health professional. This includes:
- A detailed clinical interview about symptoms, mood changes, and family history.
- Mood tracking to identify patterns over time.
- Ruling out other medical conditions like thyroid disorders or substance use, which can mimic bipolar symptoms.
The key to diagnosis is understanding the pattern of mood episodes. And please remember, self-diagnosis isn’t recommended & is never enough, as the condition can be complex and easily mistaken for depression, anxiety, or other disorders.
Treatment of Bipolar Disorder
Bipolar disorder is a lifelong condition, but effective treatments help individuals manage symptoms and lead productive lives.
- Medications
Medications are the cornerstone of bipolar disorder treatment. They may include:
- Mood Stabilizers:
- Lithium is one of the most commonly prescribed and effective treatments for preventing manic and depressive episodes.
- Anticonvulsants:
- Medications like valproate or lamotrigine are also used as mood stabilizers.
- Antipsychotics:
- Atypical antipsychotics like quetiapine or olanzapine help with mood stabilization, especially in manic or mixed episodes.
- Antidepressants:
- These may be used cautiously alongside mood stabilizers to avoid triggering mania.
2. Psychotherapy
Therapy helps individuals understand their condition, develop coping strategies, and maintain stability. Common approaches include:
- Cognitive Behavioral Therapy (CBT) helps individuals with bipolar disorder identify and manage unhelpful thought patterns that can trigger mood episodes. It also teaches coping strategies to navigate challenges and maintain emotional balance. Research shows that CBT is often used as second in line after/ along with medication and yields impressive results.
- Interpersonal and Social Rhythm Therapy (IPSRT) helps stabilize daily routines, such as sleep and meal times, to regulate biological rhythms. It also strengthens interpersonal relationships to reduce stress and prevent mood episodes.
- Family-Focused Therapy educates family members and improves communication and support.
3. Lifestyle Changes
Adopting healthy habits can reduce the risk of mood episodes:
- Maintaining a consistent sleep schedule.
- Regular exercise to improve mood.
- Avoiding drugs and alcohol.
- Managing stress through mindfulness or meditation.
4. Support Networks
Support groups, whether in-person or online, provide a sense of community and shared experiences. Having understanding friends and family is equally crucial.
5. Hospitalization
In severe cases, such as during a manic episode with psychosis or a depressive episode with suicidal thoughts, hospitalization may be necessary for safety and stabilization.
Bipolar disorder is a complex but manageable condition. With the right combination of medication, therapy, and lifestyle changes, many individuals find stability and success. Understanding the types, symptoms, and treatments is key to reducing stigma and supporting those affected. If you or someone you know shows symptoms of bipolar disorder, seeking help from a mental health professional is the first step toward recovery.
Mental health matters, and help is always available. If you’re looking for counselling or psychotherapy, please book a session online using our calendar.
