What Is Bipolar Disorder?

Bipolar disorder is a type of mental illness that causes drastic changes in a person’s mood, energy levels, train of thought, and overall ability to function in their day-to-day life. It is marked by manic periods where an individual is extremely energized and perceivably happy or extremely irritable, along with significant episodes of depression.

It is also known as manic depression. Like other mental health conditions, bipolar disorder impacts an individual’s ability to manage simple everyday tasks, such as attending work, school, or even maintaining social connections. 

What Is Bipolar Disorder?

In life, we all experience a range of emotions, including joy, sadness, anger, and fear, but tend to do it in response to a pertinent life event. When a person persistently experiences significant highs and lows of emotions that interfere with life, they may be suffering from something more serious—such as bipolar disorder.

Bipolar disorder is much more common than most people think. In fact, an estimated 4.4% of U.S. adults will experience a bipolar or related disorder at some point in their lifetime, and an estimated 2.8% of U.S. adults will experience the condition in the last year alone, according to the National Institute of Mental Health.

It tends to crop up during adulthood, with the majority of patients first showing symptoms around age 25, according to the National Alliance on Mental Illness. 

Types

There are three main types of bipolar disorder and all three involve many of the same symptoms, involving mood changes and fluctuations in energy and activity levels. Here’s a look at each type and how they differ. 

Bipolar I Disorder

This is the most well-known type of bipolar disorder and is defined by severe manic episodes that last at least a single week (or seven days). The manic episodes may be severe enough to require hospitalization. The same tends to be true for the depressive episodes, which need to be present for at least a two-week period in order for this diagnosis to be made. 

Bipolar II Disorder

This type of bipolar disorder is defined by depressive and hypomanic episodes. Episodes of hypomania have features of mania but are not as intense as the manic episodes that are seen in bipolar I disorder. 

Cyclothymic Disorder

Also known as cyclothymia, this type of bipolar disorder is marked by periods of hypomanic symptoms alternating with depressive symptoms over a period lasting longer than two years.

The key feature of this type of bipolar disorder is that the symptoms of both the highs and lows don’t meet the diagnostic requirements to be considered a true episode of either hypomania or major depression. 

Symptoms

These are the most common signs and symptoms associated with a manic episode of bipolar disorder, according to the National Institutes of Mental Health (NIMH):

• Feeling “high” or “elated” 
• Feeling irritable or touchy
• Feeling “jumpy” or “wired”
• Feeling less tired or in need of less sleep
• Decreased appetite
• Talking very fast about several different topics
• Feeling as though your mind is racing
• Thinking one can manage multiple tasks at once
• Indulging in risky behavior that shows poor judgment
• Feeling unusually important, talented, or powerful

These are the most common signs and symptoms associated with a depressive episode of bipolar disorder, according to the NIMH:

• Feeling very sad, “down,” empty, worried, or hopeless
• Feeling slowed down or restless
• Having difficulty falling asleep or sleeping too much
• Waking up too early in the morning
• Experiencing increased appetite and weight gain
• Talking very slowly and feeling like you have nothing to say 
• Feeling forgetful
• Having difficulty focusing or making decisions
• Feeling incapable of performing even simple tasks
• Having little interest in things that used to bring you joy
• Having suicidal thoughts or thinking about death

Causes

While scientists are still in search of the causes of bipolar disorder, research has shown that certain factors may play a role:

• Genetics: If your parents or one of your siblings suffers from bipolar disorder, you have an increased risk of also developing the disorder. It is important to note, however, that the majority of individuals with a close family relative who has the disease do not go onto develop it. 
• Stress: In certain cases, a stressful event, such as losing a loved one, coping with a severe illness, experiencing a divorce, or struggling with finances, can trigger an episode of bipolar disorder, be it manic or depressive.  
• Brain structure: While bipolar disorder cannot be diagnosed with a brain scan alone, some research suggests that there are differences in the average size or activation of some of the brain structures in patients suffering from bipolar disorder.

Diagnosis

In order to reach a diagnosis, your healthcare provider will likely start by performing a physical exam and certain lab tests.

Although bipolar disorder cannot be seen on a blood test or through a body scan, these tests can help your healthcare provider rule out other conditions that may have similar features, including thyroid disease.

Your healthcare provider will likely refer you to a mental health professional,  such as a psychologist or psychiatrist, who will use the Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition, Text Revision (DSM-5-TR) to determine your diagnosis and which type of bipolar disorder you might be suffering from based on your symptoms.

To be diagnosed with a manic episode, you must have experienced the associated symptoms for at least one week or have been hospitalized for them. In order to be diagnosed with a major depressive episode, you must have been experiencing the symptoms for at least two full weeks.

Treatment

There are several ways mental healthcare professionals choose to treat bipolar disorder, and what might be right for someone see might not necessarily work best for you. 

Psychotherapy

Also known as talk therapy, this type of treatment involves talking with a mental health professional about your symptoms and what you are experiencing.

Types of psychotherapy include cognitive-behavioral therapy (CBT), family-focused therapy, interpersonal and social rhythm therapy (IPSRT), and psychoeducation.

Medications

Bipolar illness generally requires a mental health professional to prescribe certain medications to help you manage your symptoms, such as mood stabilizers (such as lithium), antipsychotic medications, anti-anxiety medications and, although less common, antidepressants.

Hospitalization and Day Treatment Programs

During periods of more extreme symptoms or if there are safety concerns, hospitalization may be necessary.

If inpatient hospitalization is not required, your healthcare professional may recommend that you attend a day treatment program that is specifically designed to provide you with the more intensive support and counseling you need to cope with your condition. 

Coping

You don’t have to feel alone as you navigate your life with bipolar disorder. Here are some practical ways of coping: 

• Be patient. Know that it will take time for your symptoms to dissipate and for you to start feeling more like your old self. With a consistent treatment plan in place, however, you can experience significant improvements in your symptoms. 
• Maintain communication with your healthcare provider. During treatment, it’s vital that you stay in close contact with your healthcare provider, as your treatment plan might need to be modified over time. 
• Take your medication as instructed. If you are on a treatment plan that involves taking medication, it’s important that you follow all of the instructors and take the dose recommended to you by your healthcare provider. If you feel the need to change your medication, discuss this with your healthcare provider first. 
• Know when to seek emergency help. If you think you may be in a position to harm yourself or someone else, call 911 or your local emergency number ASAP.