Everything You Need to Know About Bipolar Disorder: Symptoms, Treatment, and Support

What exactly is bipolar disorder? This condition is a brain disorder that causes severe swings in moods. These mood swings may include lows (depression) and highs (mania or hypomania). Bipolar disorder changes a person’s energy, mood, and sleep. Mood episodes can last days or weeks. The good news is that bipolar disorder is manageable with the right treatment and support. 

What Causes Bipolar? 

Bipolar disorder symptoms usually start when a person is in their mid-20s, but they can appear at any time. Researchers aren’t quite sure what causes this disorder but they believe that it’s a combination of factors. 

Genetics 

Bipolar disorder (especially type 1) has a strong genetic component. It is more common in people who have a first-degree relative (such as a parent, child, or sibling) with the condition. However, there are many people who have bipolar and don’t have a close family member with the condition. Therefore, genetics can’t completely explain the risk. 

Hormones 

Recent studies have shown that women going through perimenopause are 112 times more likely to develop bipolar disorder. The hormonal fluctuations that occur during this period may trigger the disorder, especially in women who have a genetic risk. 

Bipolar Disorder Symptoms 

The DSM 5 bipolar criteria include sudden and intense shifts in mood. The mood changes can either result in mania, hypomania or depression. In severe cases, a person may experience suicidal thoughts or behaviors.  Bipolar episode symptoms may include the following:  

• Mania 

Mania is characterized by high levels of energy, creativity, and activity. During mania, a person may feel as though they don’t need to sleep. They will usually have pressured speech and thoughts.  A person caught in the grip of mania may feel powerful or grandiose, like a god. They may be restless and impulsive. This can lead to reckless spending sprees and risky behaviors. Mania can be so severe that involuntary hospitalization is required. 

• Hypomania 

Some people with bipolar don’t experience mania, but have hypomania instead. This is characterized by a slightly elevated mood that is not as intense as with mania. A person may still be able to work or go to school with hypomania. They may have difficulty sleeping nad feel restless. 

• Depression 

During a depressive episode, a person may sleep for long periods of time. They may eat more or less than usual. They may feel hopeless or sad. Things like taking a shower or doing normal daily activities may seem almost impossible. 

• Psychotic Symptoms 

It’s not uncommon for people with severe mania or depression to experience psychotic symptoms, including delusions, hallucinations, and paranoia. According to a study published in the World Journal of Psychiatry, more than 50 percent of people with bipolar disorder experience these symptoms at some point. 

Types of Bipolar 

There are three main types of bipolar disorder: 

• Bipolar 1- To be diagnosed with this type of bipolar, you must have at least one manic episode that lasts at least a week or is so severe that hospitalization is required. A depressive episode is not required for bipolar 1. However, most people with bipolar 1 have depressive episodes as well. 

• Bipolar II - People with bipolar II have experienced a major depressive episode and at least one hypomanic episode, but they have not experienced a full manic episode. 

• Cyclothymic disorder - Cyclothymic disorder is characterized by a chronic unstable mood that lasts at least 2  years. However, the symptoms aren’t as severe as with bipolar 1 or II. It’s a milder form of bipolar. 

How is Bipolar Diagnosed? 

Bipolar disorder is typically diagnosed by a psychiatrist or another mental health professional. They may run diagnostic tests or labs to rule out any medical issues that could be causing the symptoms.  Next, a psychological evaluation is typically performed. The mental health specialist may ask about your symptoms, family history, drug or alcohol use, and other factors. They may also gather collateral information from your family or close friends (with your permission). They will then make a diagnosis based on the information you have provided using the DSM 5 bipolar disorder criteria.  

Bipolar Disorder Treatment 

Both bipolar one and two can be quite debilitating. Fortunately, people with bipolar disorder can live a productive, full life with the right support.   Treatment helps people with bipolar disorder go to school, work, and be productive. However, many people with bipolar disorder stop taking their medications or drop out of treatment.  If this happens, symptoms can return. It’s important to talk to your treatment team if you are experiencing side effects or other issues. 

Medications 

Medication is typically the first-line treatment for bipolar disorder. Medications may consist of: 

• Mood stabilizers - Lithium (Lithobid, Eskalith), valproic acid (Depakene) and divalproex sodium (Depakote). 

• Antipsychotics - Quetiapine (Seroquel), aripiprazole (Abilify), and olanzapine (Zyprexa). 

• Benzodiazepines - These may be used to help with anxiety and sleep. 

Therapy 

Along with medications, it is a good idea to participate in counseling for bipolar disorder. Talk therapy can help you identify strategies to better manage your symptoms and cope with the disorder. 

Electroconvulsive Therapy (ECT)

ECT is sometimes used to treat bipolar disorder that doesn’t respond to other treatments. During ECT, a person is given general anesthesia. Then, electrical currents are sent through the brain to induce a seizure. This changes the balance of neurotransmitters in the brain. ECT is also used to help treat catatonia, which can sometimes occur with bipolar disorder. 

Learn the truth about ECT.

Self-Care 

Self-care is important with bipolar disorder. It can help you better manage symptoms. 

• Physical movement. Exercise boosts your mood. Studies have shown that people with bipolar who exercise have fewer mood episodes and fewer hospitalizations. 

• Regular sleep schedule. Getting enough sleep when you are living with bipolar disorder is really important. Poor sleep can trigger manic episodes. Create a relaxing sleep routine that starts about an hour before bedtime. Things you can include in your sleep routine include bedtime yoga, journaling, or deep breathing. 

• Rely on others for help. It’s okay to rely on someone for help. You can’t face bipolar alone. It’s important to find a community, whether that’s family members or a place of worship. 

• Join a bipolar disorder group. It’s important to connect with others who get what you are going through. You can look on Facebook or online for a support group. The Depression and Bipolar Support Alliance has both in-person and online support groups. 

• Always take suicidal thoughts seriously. To get immediate support, call or text the Suicide and Crisis Lifeline at 988. 

Final Thoughts 

Bipolar disorder is a lifelong condition. Having a solid treatment team is important for anyone living with bipolar. Paying attention to your sleep, exercise, and overall mental health can also help.