What is Bipolar Disorder?
Bipolar disorder is a mental illness in which patients experience periods of mania followed by episodes of depression. It is also a form of depression. The disorder is one of the least understood and most stigmatized mental illnesses today.
While many people use the term “bipolar” to describe situations that change quickly, this is not how the disorder works. Furthermore, the cavalier use of the word further alienates the people who need treatment. The swings in a person’s mood must continue over a long time, and the symptoms are severe enough to impact the patient’s quality of life.
Cyclothymic Disorder
The diagnostic criteria for bipolar disorder set a high bar. As such, some people experience mania and depression, yet fail to meet the standards for a bipolar diagnosis. These patients may have shorter or fewer episodes.
Behavioral health professionals diagnose such patients with cyclothymic disorder. Psychiatrists and therapists use the same techniques for patients with this disorder as patients with the two types of bipolar disorder.
Bipolar 1 vs 2
The mental health community recognized two distinct types of bipolar disorder: bipolar I and bipolar II. (Some people write it as bipolar 1 and bipolar 2.)
Bipolar I is the most extreme version. Manic periods last for at least a week and depressive periods go on for two weeks or longer. Some people with bipolar I experience shorter bouts of both but have such severe symptoms that they require hospitalization.
Patients who have bipolar II have shorter episodes and less severe symptoms. This fact should not take away from the fact that people with bipolar II experience distress and deserve treatment.
Signs of Bipolar Disorder
Mania and depression are the two distinctive characteristics of bipolar disorder. Patients experience different symptoms during each type of episode.
During manic episodes, patients feel elated and have plenty of energy. While this may seem great at first, the mania can cause patients to take risks they otherwise would not tolerate. It can make people feel invincible, stop caring about relationships, and buy things they cannot afford.
The depressive episodes present with low energy levels and feelings of hopelessness. Patients may feel unable to get out of bed, much less live their daily lives. In some cases, depressive episodes cause suicidal thoughts.
Neither the manic nor the depressive episode last a few hours, as some myths suggest. The symptoms can last days or weeks, depending on the type of bipolar.
Manic Symptoms
- Elevated energy levels
- Risky behavior, such as gambling
- Thoughts that seem to race through the mind
- Trouble falling asleep
- Elation, as though nothing can stop the patient
- Irritability with those who try to stop them
Depressive Symptoms
- Decreased energy levels
- Feelings of hopelessness
- Feelings of emptiness
- Sleeping too much or too little
- Changes in appetite
- Fatigue
- Uninterested in things that used to bring them joy
- Thoughts of suicide
Is There a Bipolar Test?
Mental health professionals cannot use physical tests like blood draws and CAT scans to determine if a patient has bipolar disorder. Instead, they examine the patterns of a person’s symptoms.
Often, professionals use clinically proven surveys on pen and paper to understand the patient’s history. Some people find it easier to answer questions this way than to talk about their symptoms out loud.
During the initial assessment, counselors ask personal questions and take detailed notes. While this can feel invasive, it is a necessary part of the diagnosis and eventually getting help. Patients should know that the therapists will meet them with compassion.
Comorbid Conditions
Patients with bipolar disorder often also live with ADHD, anxiety, psychosis, and substance abuse. As such, mental health professionals screen patients for these disorders when they diagnose someone with bipolar disorder.
Tests for these disorders go much the same way as the ones for bipolar. Patients answer questions and talk about their symptoms. These evaluations help professional understand the patient’s full mental health picture and devise personalized treatment plans.
Bipolar Disorder Treatment Options
As with many mental health disorders, successful treatments for bipolar disorder include talk therapy, medication, or some combination of these methods. In some severe cases, patients need residential treatment or other options to keep them safe.
Talk Therapy
Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy (IPSRT), and family-focused therapy can all help patients with bipolar disorder feel relief.
In CBT, patients uncover what triggers their symptoms. Then, they learn to recognize these stimuli and respond in different ways. While CBT can help, it is often not enough for patients with bipolar disorder.
IPSRT teaches patients about the interactions between biology, social interactions, and their moods. They then use this knowledge to find new ways to stabilize their moods.
When patients and their support systems attend sessions together, counselors can use family-focused therapy. The professional teaches the patient and loved ones about the disorder, strategies for coping. This helps keep patients safe and healthy between visits with their mental health teams.
Medication Options
Certain medications can help patients stabilize their moods, but it can take time to find the right combination. Psychiatrists can use antidepressants, mood stabilizers, antipsychotics, and sleep aids to help.
Additional Bipolar Treatment Options
Although conventional treatments work for many patients with bipolar disorder, some patients may not respond well to medication and need more than talk therapy. In these cases, patients may need Electroconvulsive Therapy (ECT). This method can cause confusion and loss of memory in some patients. Like with all medical treatments, doctors only recommend ECT when the potential benefits outweigh the risks.
Life charts present another alternative treatment plan for patients with bipolar disorder. Patients use specialized charts to log their medications, what happened during each day, and what symptoms they experience. Their counselors and psychiatrists can then look over the charts to identify significant patterns. These insights allow the team to recommend more personalized treatments.
How Common is Bipolar Disorder?
Best estimates report that 2.6 percent of American adults live with bipolar disorder, which equals about 5.7 million people. It’s less clear how many children and teenagers suffer from this disorder because mental health professionals disagree on the diagnostic criterion for minors. Some experts believe that about 750,000 children and teenagers in the United States have undiagnosed bipolar disorder.
Risk Factors for Bipolar Disorder
While there is not a single known cause of bipolar disorder, some people tend to be more likely to develop the illness than others. Bipolar disorder seems to have genetic links. People with immediate family members who have bipolar disorder are significantly more likely to develop it than their peers.