Bipolar disorder is a type of mental illness characterized by extreme changes in mood and disposition. Symptoms include a highly elated mood called mania, coupled with episodes of acute depression. Bipolar disorder is also known as manic depression or bipolar disease. People diagnosed with bipolar disorder may experience difficulties coping with the challenges of everyday life, like completing tasks at school or work, or maintaining meaningful relationships with their family and friends. While there’s no cure for bipolar disorder, there are a number of treatment options available that can help manage and mitigate the symptoms.
Bipolar Disorder Facts
Bipolar disorder is a rather common brain disorder. As of this writing, 2.8% of U.S. adults — approximately 5 million people — have been diagnosed with bipolar disorder. People with bipolar disorder generally begin to display symptoms around 25 years old. Depression caused by bipolar disorder can last upwards of two weeks, while a manic episode can last for several days or even weeks. Some people with bipolar disorder experience episodes of mood changes several times a year, while others may experience them very rarely.
Bipolar Disorder Symptoms
There are three main symptoms that frequently occur with bipolar disorder: mania, hypomania, and depression.
While experiencing mania, a person diagnosed with bipolar disorder may feel an extreme emotional high. They feel excited, impulsive, euphoric and bursting with energy. During manic episodes, they may also engage in reckless behavior such as:
- impulsive spending sprees
- risky, unprotected sex
- illicit drug use
Hypomania is generally associated with bipolar II disorder. It is very similar to mania, but it’s not nearly as severe. Unlike mania, hypomania may not result in difficulties at work, at school or in personal relationships. However, people with hypomania still experience drastic changes in their mood and disposition.
During an episode of depression, individuals suffering from bipolar disorder may experience:
- deep sadness
- loss of energy
- lack of interest in activities they once enjoyed
- periods of too little or too much sleep
- suicidal thoughts
Although it’s not a particularly rare mental health condition, bipolar disorder can be difficult to diagnose due to the variety of symptoms. See below for details about the symptoms that frequently occur during both the high and low periods.
Bipolar Disorder Symptoms in Women
Men and women are diagnosed with bipolar disorder in relatively equal numbers. However, the main symptoms of bipolar disorder may be different between men and women. In many cases, a woman with bipolar disorder is more likely to:
- be diagnosed later in life, generally in her 20’s or early 30’s
- experience milder episodes of mania
- experience more depressive episodes relative to manic episodes
- experience 4 or more episodes of mania and depression each year
- experience other health conditions, including thyroid disease, obesity and migraines
- experience a higher risk of alcohol dependency / abuse
Women diagnosed with bipolar disorder may also relapse more often than men. It is believed that this is caused by hormonal changes related to menstruation, pregnancy or menopause. If you’re a woman and you suspect you may have bipolar disorder, it’s important for you to speak with your health care provider as soon as possible.
Bipolar Disorder Symptoms in Men
Men and women both experience symptoms of bipolar disorder, but men may experience those symptoms differently than women. Men with bipolar disorder are more likely to:
- be diagnosed earlier in life
- experience more severe episodes, particularly manic episodes
- experience substance abuse issues
- act out during manic episodes
Additionally, men diagnosed with bipolar disorder are far less likely than women to seek medical care and they’re far more likely to die by suicide.
Types of Bipolar Disorder
There are three main types of bipolar disorder: Bipolar I, Bipolar II and Cyclothymia.
Bipolar I is defined by the appearance of at least one manic episode. Individuals diagnosed with Bipolar I may experience hypomanic or major depressive episodes before and after the appearance of a manic episode. This type of bipolar disorder affects men and women in equal proportion.
Individuals diagnosed with Bipolar II experience one major depressive episode that lasts a minimum of two weeks. They also have at least one hypomanic episode that lasts up to 4 days. This type of bipolar disorder is thought to be more common in women than in men.
Individuals with cyclothymia experience episodes of both hypomania and depression. However, these symptoms are shorter and less severe than the mania and depression caused by Bipolar I or Bipolar II. Most individuals suffering from this condition only experience a month or two at a time where their moods are considered stable.
Bipolar Disorder in Children
Diagnosing bipolar disorder in children is highly controversial, primarily because children don’t display the same bipolar disorder symptoms as adults. Their moods and behaviors may also differ from the standards physicians use to diagnose bipolar disorder in adults. Many bipolar disorder symptoms witnessed in children overlap with symptoms from a range of childhood health disorders, such as attention deficit hyperactivity disorder (ADHD).
However, in recent years, physicians and mental health professionals have come to recognize the condition in children with greater frequency. An accurate diagnosis can help children get treatment they need, but attaining a clear diagnosis may take weeks or even months of testing and observation. Children will likely need to seek special care from a professional trained to assist children with mental health issues.
As is the case with adults, children diagnosed with bipolar disorder experience episodes of elevated mood. They can appear very happy and exhibit signs of excitable behavior. These periods are then followed by bouts of depression. While all children experience mood changes, changes caused by bipolar disorder are considerably more pronounced and they’re usually more extreme than a child’s typical change in mood and disposition.
Manic Symptoms in Children
Symptoms of a manic episode in children caused by bipolar disorder often include:
- acting silly and feeling overly happy
- speaking fast and rapidly changing subjects
- having difficulty focusing or concentrating
- taking unnecessary risks or experimenting with risky behaviors
- having a short temper that quickly leads to outbursts of anger
- having trouble sleeping and not feeling tired after sleep loss
Depressive Symptoms in Children
Symptoms of a depressive episode caused by bipolar disorder in children can include:
- lethergy or acting very sad
- sleeping too much or too little
- low energy for normal activities or showing signs of disinterest in general activities
- complaining about not feeling well, including frequent headaches or stomach aches
- experiencing feelings of low self esteem, worthlessness or guilt
- eating too much or too little
- experiencing thoughts about death and suicide
Some of the behavioral issues you may witness in your child could be the result of another condition. ADHD and other behavior disorders can occur in children with bipolar disorder. As always, consult with your child’s physician to document your child’s unusual behaviors, which can help lead to a proper diagnosis.
Bipolar Disorder in Teenagers
Angst-filled behavior comes as no surprise to the average parent of a teenager. The changes in hormones and the life changes that come with puberty, can make even the most well-behaved teenager appear upset or overly emotional from time to time. However, these changes in mood and disposition may be the result of a more serious condition, such as bipolar disorder.
A diagnosis of bipolar disorder is most common during the late teens and early adult years. For teenagers, the most common symptoms of a manic episode include:
- being very happy
- acting out or misbehaving
- participating in risky behaviors
- abusing alcohol and illicit substances
- thinking about sex more than usual
- becoming overly sexual or sexually active
- difficulty sleeping but showing few signs of fatigue
- having a very short temper and explosive outbursts
- having trouble staying focused or being easily distracted
For teenagers, the most common symptoms of a depressive episode include:
- sleeping too much or too little
- eating too much or too little
- feeling extremely sad and showing little excitability
- withdrawing from activities, family and friends
- experiencing thoughts about death and suicide
Bipolar Disorder and Depression
Individuals with bipolar disorder can have experience two opposite extremes: up and down. To be diagnosed with bipolar, an individual must experience a period of mania or hypomania. People generally feel “up” in this phase of the disorder, and they may feel highly energized and excitable.
Many people with bipolar disorder will also experience a major depressive episode, or a “down” mood. When experiencing a “down” change in mood, they may feel lethargic, unmotivated and terribly sad. However, not everyone diagnosed with bipolar disorder feel “down” enough to be labeled depressed. For some people, a normal mood may feel like depression because of the extreme “high” they experienced during the manic episode.
While bipolar disorder can cause people to experience symptoms of depression, it’s not the same as a formal diagnosis of depression. Bipolar disorder can cause extreme highs and lows, but clinical depression precipitates moods and emotions that are frequently down.
Causes of Bipolar Disorder
Bipolar disorder is an extremely common mental health disorder, but it remains a bit of a mystery to doctors and researchers. It’s not yet clear what causes some people to develop the condition and not others. Possible causes of bipolar disorder include:
If a parent or sibling has been diagnosed with bipolar disorder, you have a higher likelihood of developing the condition. However, it’s important to acknowledge that most people with a family history of bipolar disorder do not develop it.
An individual’s brain structure may increase their risk for the disease. Abnormalities in the structure or functions of your brain may increase your risk for bipolar disorder.
It’s not just what’s in your body that can increase your likelihood of developing bipolar disorder. External, environmental factors may contribute to a diagnosis. These factors can include:
- extreme stress
- traumatic experiences
- physical illness
Is Bipolar Disorder Hereditary?
Bipolar disorder can indeed be passed from a parent to their child. Recent research has identified a strong genetic link in people with bipolar disorder. If you have a relative with bipolar disorder, your chances of developing it are 4-6 times higher than individuals without a family history of the condition. However, it’s important to note that this doesn’t mean everyone with relatives who have been diagnosed with the disorder will develop it. Additionally, not everyone with bipolar disorder has a family history of the disease. That said, genetics appear to play a considerable role in the incidence of bipolar disorder. If you have a family member with bipolar disorder, please discuss this matter with your physician.
Bipolar Disorder Diagnosis
A bipolar disorder I diagnosis involves one or more manic episodes, or mixed (manic and depressive) episodes. It can also include a major depressive episode. A diagnosis of bipolar II involves one or more major depressive episodes and at least one episode of hypomania.
To be diagnosed with a manic episode, one must experience bipolar symptoms that last for a minimum of 1 week, or any symptom or symptoms which require hospitalization. An individual must experience symptoms all day every day to meet this criteria. On the other hand, major depressive episodes must last for at least 2 weeks.
Bipolar disorder is difficult to diagnose because mood swings can vary day to day. It’s even more difficult to diagnose in children and teenagers, as this age group experiences more changes in mood, behavior and energy levels than the general population.
Bipolar disorder becomes progressively worse if left untreated. Episodes may happen more frequently or become more extreme over time. However, if an individual receives treatment for bipolar disorder in a timely manner, it’s entirely possible to lead a healthy, productive and meaningful life.
Bipolar Disorder Symptoms Test
A single test result doesn’t qualify as a bipolar disorder diagnosis. Instead, a physician will administer several tests and exams to arrive at a positive diagnosis. These test may include some or all of the following:
Your doctor will likely perform a full physical exam, including blood or urine tests to rule out other possible causes of symptoms.
Your doctor may refer you to a mental health professional such as a psychologist or a psychiatrist. These mental health professionals diagnose and treat mental health conditions such as bipolar disorder. During the visit, they will evaluate your mental health in an effort to identify signs of bipolar disorder.
If your doctor suspects that behavioral changes are the result of a mood disorder like bipolar, they may ask you to keep track of your moods in a journal. Your doctor may also suggest tracking and recording your eating and sleeping patterns.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an outline of symptoms for various mental health disorders. A physician can follow this outline to confirm or deny a bipolar diagnosis.
Bipolar Disorder Treatment Options
There are several proven treatments available for bipolar disorder. These treatments include medication, counselling and lifestyle changes. Some natural remedies have also proven to be helpful.
Recommended medications may include:
- mood stabilizers, such as lithium (Lithobid)
- antipsychotics, such as olanzapine (Zyprexa)
- antidepressant-antipsychotics, such as fluoxetine-olanzapine (Symbyax)
- benzodiazepines, a type of anti-anxiety medication such as alprazolam (Xanax) may be used for short-term treatment
Recommended forms of psychotherapy may include:
Cognitive Behavioral Therapy
Cognitive behavioral therapy is a type of talk therapy. The patient and the therapist will discuss the possible ways to manage bipolar disorder. They will help the patient understand their thinking patterns and help them come up with positive coping strategies and mechanisms.
Psychoeducation is a type of counselling that helps the patient and their loved ones better understand the disorder. Understanding more about bipolar disorder will help the patient and the people in their life manage it more effectively.
Interpersonal and Social Rhythm Therapy
Interpersonal and social rhythm therapy (IPSRT) focuses on teching the patient to more effectively regulate their daily habits, such as sleeping, eating and exercising.
Additional treatment options may include:
- electroconvulsive therapy (ECT)
- sleep medications
There are also a number of simple steps a patient can take to help manage their bipolar disorder:
- keep a routine for eating and sleeping
- learn to recognize mood swings
- ask a friend or relative to support your treatment plans
- talk to a doctor or licensed healthcare provider
Natural Remedies for Bipolar Disorder
Some natural remedies may be helpful in the treatment and management of bipolar disorder. However, it’s important to speak with your doctor in advance, as some of these treatments could interfere with prescribed medications.
The following herbs and supplements have shown some promise in helping patients stabilize their moods and relieve the symptoms of bipolar disorder:
- Fish oil
- Rhodiola rosea
- S-adenosylmethionine (SAMe)
Several other minerals and vitamins may also reduce the challenging symptoms of bipolar disorder, including the use of medical cannabis (where legal).
Living with Bipolar Disorder
Bipolar disorder is a chronic mental illness, which means a patient will have to develop methods to cope with it for the rest of their life. However, that doesn’t mean they can’t live a happy, healthy and productive life. Treatment can help individuals suffering from bipolar disorder better manage changes in mood and symptoms. In addition to your primary care physician, individuals with bipolar disorder may request a referral to a psychiatrist and/or psychologist. Through talk therapy, these mental health professionals can help patients cope with the symptoms of bipolar disorder that cannot be treated with medication alone. Together with your health care team, individuals with bipolar disorder can explore many ways to maintain a normal, happy, healthy life.