Bipolar disorder affects 2.8% of adults in the US. It is a serious, yet treatable, mood disorder. It’s important for us to gain a greater understanding of bipolar disorder and treatment options so that people who have it can live fulfilling lives without stigma. 

What is Bipolar Disorder?

Bipolar disorder is a chronic mood disorder characterized by drastic shifts in mood, energy levels, and concentration. It used to be referred to as manic-depressive disorder or manic depression. 

Bipolar disorder not only affects a person’s moods, it can also affect their ability to:

• Think clearly
• Focus and complete tasks
• Sleep well
• Maintain energy levels

Bipolar disorder is similar to many mental health disorders such as depression and anxiety in the way it takes a toll on your cognitive abilities and executive function. They also share many symptoms.

Symptoms of Bipolar Disorder

Like all mental health disorders, the symptoms of bipolar disorder and their severity are different for everyone. They can also change throughout a person’s life. It’s a lifelong disorder and people can go through seasons of more and less severe symptoms, and sometimes, no symptoms at all.

Bipolar disorder is identified by manic, depressive, and hypomanic episodes of intense emotions and behaviors. Typically, the behavior during these episodes is out of character for that person.

Most people with bipolar disorder experience two manic and depressive episodes each year. Experiencing four or more episodes per year is referred to as rapid cycling. 

Mania

Manic episodes are times of intense ups. These episodes are usually defined by feeling:

• Incredibly energized
• Exhilarated
• Confident
• Abnormally irritable

Behaviorally, mania is seen in a few ways:

• Increased activity
• Less focus
• Racing thoughts and speech
• Impulsivity
• Reckless behavior
• Sleep disruptions

Manic episodes can disrupt work, school, and relationships. On rare occasions, severe mania can lead to psychosis such as delusions or hallucinations. 

Depression

Depressive episodes are the opposite. They are extreme down periods that align with symptoms of major depressive disorder.

In a depressive episode, a person will feel: 

• Intense melancholy
• Empty
• Hopeless
• Worthless 

Depressive symptoms can cause people to lose all interest in things they used to enjoy, they may sleep too much, be restless, have a loss of energy.

Episodes of depression also lead to problems in work or school, social settings, and in relationships.

Mixed Episodes

Sometimes, people with bipolar disorders experience symptoms of both mania and depression at the same time. This is called a mixed episode. A person may feel incredibly energized while at the same time feeling hollow and empty. 

Hypomania 

Hypomania is a milder form of mania with less severe symptoms. It doesn’t necessarily interfere with someone’s day to day life. During a hypomanic episode, most people can still perform at work and in social situations without much difficulty.

Causes of Bipolar Disorder

We don’t entirely know what causes bipolar disorder, or that it can even be boiled down into one single factor.

Research has found that brain structure and function of people with bipolar disorder differs slightly from the brain of someone unaffected by the disorder. There are physical differences, chemical imbalances, and brain activity that is dysregulated when compared to a typical brain. 

This information is not currently used for diagnosis, treatment, or prevention, but may eventually help in these areas and provide more understanding of the disorder.

Environmental factors may also play a role in developing or triggering bipolar episodes. Stress, trauma, and disrupted sleep patterns can all increase the risk of experiencing bipolar episodes. 

Drug and alcohol misuse can also be a risk factor in making a person more vulnerable to episodes associated with bipolar disorder.

Is Bipolar Disorder Genetic?

Genetics and family history are also thought to have influence on a person’s likelihood to develop a bipolar disorder. If you have a closely related family member who is affected by bipolar disorder, you are more likely to be diagnosed with it as well. Researchers are still trying to discover which genes are specifically involved. 

Types of Bipolar Disorder

Because of the varying levels of manic and depressive episodes, medical professionals have broken down bipolar disorder into several subtypes. The difference between these subtypes has to do with the symptoms someone experiences, the severity of those symptoms, the duration of them, and their pattern.

Bipolar I Disorder 

People with bipolar I disorder experience extremely high highs. Bipolar I is characterized by the experience of one or more episodes of mania in between euthymia (baseline mood) and depressive episodes. 

In order to be diagnosed with bipolar I, a person must have experienced either: 

• At least one manic episode that lasted seven days or more
• At least one manic episode that required hospitalization 

While someone with bipolar I can experience both mania and depression, depressive episodes are not required for a doctor to make this diagnosis. Sometimes people bounce between manic and hypomanic states. It is also possible for someone with bipolar I to experience mixed episodes. 

Bipolar II Disorder 

Bipolar II disorder is characterized more by extreme depressive episodes. Individuals suffering from bipolar II will flux between depression and hypomania.

While someone with bipolar I won’t experience the extreme mania as someone with bipolar I, they will experience much more severe depressive episodes. These depressive episodes are often severe enough to be considered major depressive disorder.

Cyclothymic Disorder 

Cyclothymic disorder is the diagnosis used for people with chronic mood instability that doesn't quite meet the criteria for bipolar I or II. Someone with cyclothymic disorder will have mood swings that are either not as severe, not as frequent, or not long enough to be classified as bipolar I or II. 

A person with cyclothymia still experiences episodes of hypomania and depression, but they are brief. To be diagnosed with cyclothymic disorder, a person has to have been experiencing these recurring highs and lows for at least two years. 

Other Specified and Unspecified Disorders

Some people still experience abnormal mood shifts significant enough to be clinically acknowledged but still not meet the diagnostic criteria of bipolar I, II, or cyclothymia. This type of abnormal mood shifting gets classified as either other specified or unspecified bipolar disorders.

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How is Bipolar Disorder Diagnosed?

Bipolar disorder is tested for and diagnosed similarly to other mental health disorders like depression or anxiety. A doctor will ask a list of questions regarding thoughts, feelings, or behaviors.

In order to be diagnosed with bipolar disorder, someone must have experienced a manic and depressive episode. Because different people experience different lengths and severities of these episodes, a doctor may ask about a specific time frame of these episodes, usually six months. They'll also ask about family history of bipolar disorder, as there is a strong genetic component to developing it.

Part of the mental health assessment also involves ruling out other disorders, such as schizophrenia, depression, and bipolar disorder. They may also perform physical exams to rule out anything that can cause symptoms that mimic bipolar disorder, including hyperthyroidism.

Treatment for Bipolar Disorder

Bipolar disorder is a serious mental health disorder that should be addressed with professional treatment. Those who have it can manage symptoms and lead happy and healthy lives.

A professional can diagnose the disorder and find the right treatment options that work best for each individual. Bipolar disorders are often accompanied by other mental health issues that may also need treatment. 

Therapy for Bipolar Disorder

Talk therapy is beneficial in a lot of ways. It can help someone with bipolar disorder:

• Come to terms with their diagnosis
• Learn to recognize signs of an oncoming episode
• Develop healthier coping mechanisms for symptoms
• Learn about lifestyle habits that can alleviate the severity of symptoms 

Regularly seeing a therapist can help hold you accountable in sticking with your treatment plan and managing the stressors.

Once you find a treatment plan that works for you, it is important to stick with it even in times you feel good and “normal.” Stopping treatment may trigger an episode or increase the severity of one. 

The top therapies for treating bipolar disorder are:

• Cognitive behavioral therapy
• Dialectical behavioral therapy
• Interpersonal and social rhythm therapy

Also called CBT, cognitive behavioral therapy is the gold standard for taking control of our emotions and actions. It helps clients tie together thoughts, feelings, and actions. When someone with bipolar disorder understands why they’re doing something, feeling a certain way, or thinking about something, they can change those processes.

Dialectical behavioral therapy, or DBT, was originally developed to treat borderline personality disorder, but it has been proven effective to treat many things. DBT is based around improving emotional regulation. When someone understands their emotions, they can accept them and move on.

Also based around improving emotional regulation, interpersonal and social rhythm therapy helps people stay balanced with daily routines. ISRT therapists believe that a lot of stress stems from disruptions to your daily routine, also called your social rhythm. These stressors can lead to a manic or depressive episode. 

ISRT helps those with bipolar create social rhythms that can help stabilize their mood, and better cope with disruptions that cause distress.

Medications for Bipolar Disorder

Treatment plans for bipolar disorders often require a combination of both medication and therapy.

Common medications include:

• Antidepressants
• Mood stabilizes
• Antipsychotics 

It may take some trial and error to find the right medications for each person.

Inner Balance Counseling Is Here for You  

At Inner Balance Counseling, you can connect with an experienced therapist who will help you get a handle on your bipolar disorder. 

Our therapists specialize in trauma therapy, CBT and DBT. We have the experience to help you regulate your emotions, and own your thoughts without any judgment or stigmas.

No matter what battles you face, you have the power to create the life you dream of. Let us help you get there.

Reach out today to get started!