We all experience ups and downs in our lives. Many people’s moods will shift when significant life events happen or for other common reasons, but overall their moods will stay on the same level throughout their lives and they’ll be able to maintain emotional stability without much trouble.
This is not the case for more than 3.3 million (1.7%) American adults who suffer from bipolar disorder every year. According to a Harvard Medical School Study an estimated 4.4% of U.S. adults experience bipolar disorder at some time in their lives.
Bipolar disorder (manic depression) is a mental health condition known to cause extreme mood swings marked by emotional highs (mania) and lows (depression). The depression brings on sadness or hopelessness, and those suffering depression lose interest in most activities that previously gave them pleasure. Then, the mood will shift into mania and they feel full of energy, euphoric, and can even be irritable. The shift between these states (also known as mood swings) can affect behavior, the ability to think clearly, judgment, sleep, energy, and even how one participates in activities. Mood swings can occur rarely or multiple times a year.
What Is Bipolar Disorder?
The term bipolar is often used loosely in conversation. Bipolar disorder is often used to refer to a person who is highly emotional. However, the reality for people who suffer from bipolar disorder means that they experience extended periods of mood and energy that shift between being excessively high and potentially irritable to a state of sadness and hopelessness. They also have periods of time during which their emotional state appears normal.
Beginning in adolescence or early adulthood, bipolar disorder continues throughout life. Many sufferers are never diagnosed, or they are diagnosed later in life and suffer needlessly for years. Bipolar disorder is stressful and disruptive not only for those who have the disease but also for everyone in their lives, from family to friends and even employers.
Currently, there is not a cure for the disease. Individuals with bipolar disorder can lead normal lives with treatment, however. A treatment plan that includes medication, therapy, healthy lifestyle, and support gives bipolar sufferers the opportunity to be in successful relationships and have productive, fulfilling lives.
What Causes Bipolar Disorder?
Bipolar disorder does not appear to have a specific genetic link. Researchers have discovered that there is a range of factors that interact to potentially cause this disorder. It also seems to run in families. Let’s take a look at some of the factors that may be causative:
- Genetic factors – There may be a genetic component to bipolar disorder. It seems to be more prevalent when there is a family member with the condition.
- Biological traits – Patients with bipolar disorder often show physical changes in their brains, but the exact link remains unclear.
- Brain-chemical imbalances – Neurotransmitter imbalances play a key role in many mood disorders, including bipolar disorder.
- Hormonal problems – Hormonal imbalances may trigger or cause bipolar disorder.
- Environmental factors – Abuse, mental stress, a “significant loss,” or other traumatic events can contribute to or trigger bipolar disorder.
What Are The Symptoms Of Bipolar Disorder?
Bipolar disorder is not easily recognized or diagnosed. One of the main issues in diagnosing bipolar disorder is that sufferers can be in denial of having any problem. When a person is in a manic phase or episode, they have high energy levels which may feel good for them. It’s the accompanying symptoms of unrealistic ideas and impulsive behavior that is often reckless that brings on reason for concern. This can also mimic other illnesses or issues, like poor work or school performance and substance abuse.
Symptoms vary from person to person and depend on mood. Sometimes it is easy to see the mood swings; manic states and depressive states can last for long periods of time. Sufferers may even have months of stable moods in between these episodes. On the other end of the spectrum, some people may spend years in a high or low mood. They can even be in what is known as a “mixed state” when the manic and depressive states coincide together. You may notice the person being negative but very energetic. When you see some of the behaviors listed below, it may be time to consider an evaluation.
Manic State — Symptoms may include:
- Engaging in risky behavior
- Impaired judgment
- Feeling “wired”
- Being distracted or bored
- Missing work or school, or underperforming
- Thinking you can “do anything”
- Believing nothing is wrong
- Being extremely forthcoming
- A feeling of being on top of the world, exhilarated, or euphoric
- Excessive self-confidence (inflated sense of self-esteem or self-importance)
- Excessive rapid talking (pressurized speech, jumping from one topic to another)
- Rapid thoughts
- Bizarre ideas (may be acted upon)
Typical behaviors may include: squandering money, abusing illegal drugs/alcohol, and taking part in dangerous activities or even a higher libido leading to promiscuity.
Depressive State — Symptoms may include:
- Feelings of gloom, despair, or hopelessness
- Extreme sadness
- Insomnia, difficulty sleeping
- Anxiety about trivial things
- Pain or physical issues (that does not respond to treatment)
- Feeling that everything that goes wrong is their fault
- Changes in eating patterns
- Weight loss or gain
- Extreme tiredness or fatigue
- Inability to enjoy activities
- Low attention span (difficulty remembering)
- Easily irritated
- Lack of desire to go to school or work
In severe cases, these individuals may consider ending their life, and they may take action on those thoughts.
Psychosis can occur in either the manic or the depressive state when the person is unable to differentiate between reality and fantasy. Symptoms of psychosis may include delusions (false but strongly-felt beliefs) and hallucinations (hearing or seeing things that are not there). Note that children and teenagers with bipolar disorder tend to have temper tantrums, rapid mood shifts, aggressive outbursts, anger, and reckless behavior.
How Is Bipolar Disease Diagnosed?
Bipolar disorder diagnosis involves the expertise of a psychiatrist or psychologist, who base the diagnosis on criteria set out in the Diagnostic and Statistical Manual, fifth edition (DSM-5). Other healthcare professionals may have observed signs of the condition, but the diagnosis must happen by a licensed mental health professional. The doctor may carry out a physical examination and some diagnostic tests, including blood and urine tests. The patient must meet certain criteria for both mania and depression, including an elevated or irritable mood and “persistently increased activity or energy levels.” These must have lasted at least 7 days, or less if symptoms were severe enough to need hospitalization. Often times supporting information from family members, colleagues, teachers, and friends can help with the confirmation of the diagnosis.
There are 3 broad types of bipolar disorder and each person who is diagnosed is placed in one of the following categories.
Bipolar I Disorder: Being diagnosed in this category means there has been at least one manic episode and the person has had a prior major depressive episode. The doctor has also ruled out schizophrenia, delusional disorder, and other psychotic disorders.
Bipolar II Disorder: These patients have experienced one or more depressive episodes and at least one hypomanic episode (the hypomanic state is less severe than the manic one). They may have experienced a mixed state where they felt depressed but also restless. The hypomanic state includes sleeping less than normal and being competitive, outgoing, and energetic. The person is fully functioning which is not the case with full manic episodes.
Cyclothymia: This diagnosis involves episodes of low-level depression that alternate with periods of hypomania. The DSM-V classifies it separately from bipolar disorder because the mood changes are less dramatic.
A diagnosis of bipolar disorder is a lifelong disorder. The person may enter a period of stability or remission, but they will always have this diagnosis.
What Are The Treatment Options For Bipolar Disorder?
Bipolar disorder requires managing both manic symptoms (impulsive behavior, excessive irritability, and anxiety) along with depressive symptoms (low mood, poor appetite, and emotional indifference). A combination of medication, therapy, lifestyle changes, and support from family, friends, and peers may help individuals with bipolar disorder to stabilize their mood and live productive lives.
Unfortunately, there aren’t many complementary or alternative medicine (CAM) options available for bipolar patients. There are a few non-prescription supplements that may help to alleviate depression which is where many bipolar patients spend a good amount of time. The key thing to remember is that just because CAM therapies exist doesn’t mean that someone with bipolar disorder should stop taking their antidepressants. These alternative therapies are meant to be supportive and help people diagnosed with bipolar disorder lead fuller lives.
- Medication: Common medications used are lithium, anticonvulsants, and mood stabilizers. Alternative medications used include antipsychotics, benzodiazepines, and beta-blockers. The right medication regimen takes time to figure out, so patience and regular follow up with therapists is a necessary part of this process.
- Therapy: Group and individual therapy are supportive in bipolar disorder. Depending on the symptoms, therapies tried are Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and family-focused therapies.
- Lifestyle changes: Healthy lifestyle changes are an important part of recovery. Regular sleep schedules, elimination of alcohol, caffeine, and similar substances, and regular exercise along with meditation, mind-body practices, and spirituality are considered.
- Support: Support groups for learning coping skills, feeling accepted, and avoiding social isolation can be very effective.
The goal of treatment is to minimize the length and frequency of manic and depressive episodes. Therapy teams work with patients to decrease the severity of symptoms, working towards providing them with tools to have a productive life. It is important to seek treatment for this disorder as episodes of mania or depression can last for up to a year. When patients seek treatment options, they can see improvement in as little as 4 months.