Health and Safety

Everything You Need to Know About Bipolar Disorder

By Cristiano Antonino

Bipolar disorder is a mental health condition marked by extreme shifts in mood

Key symptoms include:

  • episodes of mania, or an extremely elevated mood
  • episodes of depression, or a low mood

Older terms for bipolar disorder include manic depression and bipolar disease.

Although bipolar disorder doesn’t have a cure, many effective treatments are available

These treatment options can help you learn to manage mood episodes, which can improve not only your symptoms, but also your overall quality of life.

Types of bipolar disorder

There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia.

Bipolar I

Bipolar I is defined by the appearance of at least one manic episode.

You may experience hypomanic episodes, which are less severe than manic episodes, or major depressive episodes before and after the manic episode.

This type of bipolar disorder affects people of all sexes equally.

Bipolar II

People with bipolar II experience one major depressive episode that lasts at least 2 weeks.

They also have at least 1 hypomanic episode that lasts about 4 days.

According to a 2017 reviewTrusted Source, this type of bipolar disorder may be more common in women.

Cyclothymia

People with cyclothymia have episodes of hypomania and depression.

These episodes involve symptoms that are shorter and less severe than the mania and depression caused by bipolar I or bipolar II disorder.

Most people with this condition only experience no mood symptoms for 1 or 2 months at a time.

Your doctor can explain more about what kind of bipolar disorder you have when discussing your diagnosis.

Some people experience distinct mood symptoms that resemble but don’t quite align with these three types.

If that’s the case for you, you might get a diagnosis of:

  • other specified bipolar and related disorders
  • unspecified bipolar and related disorders
  • Learn more about the types of bipolar disorder.

Bipolar disorder symptoms

To receive a diagnosis of bipolar disorder, you must experience at least one period of mania or hypomania.

These both involve feelings of excitement, impulsivity, and high energy, but hypomania is considered less severe than mania.

Mania symptoms can affect your day-to-day life, leading to problems at work or home.

Hypomania symptoms typically don’t.

Some people with bipolar disorder also experience major depressive episodes, or “down” moods.

These three main symptoms — mania, hypomania, and depression — are the main features of bipolar disorder.

Different types of bipolar disorder involve different combinations of these symptoms

Bipolar I symptoms

A diagnosis of bipolar I disorder requires:

  • at least 1 episode of mania that lasts at least 1 week
  • symptoms that affect daily function
  • symptoms that don’t relate to another medical or mental health condition or substance use

You could also experience symptoms of psychosis, or both mania and depression (known as mixed features).

These symptoms can have more impact on your life.

If you do have them, it’s worth reaching out for professional support as soon as possible (more on this later).

While you don’t need to experience episodes of hypomania or depression to receive a bipolar I diagnosis, many people with bipolar I do report these symptoms.

Bipolar II symptoms

A diagnosis of bipolar II requires:

  • at least 1 episode of hypomania that lasts 4 days or longer and involves 3 or more symptoms of hypomania
  • hypomania-related changes in mood and usual function that others can notice, though these may not necessarily affect your daily life
  • at least 1 episode of major depression that lasts 2 weeks or longer
  • at least 1 episode of major depression, involving 5 or more key depression symptoms that have a significant impact on your day-to-day life
  • symptoms that don’t relate to another medical or mental health condition or substance use

Bipolar II can also involve symptoms of psychosis, but only during an episode of depression.

You could also experience mixed mood episodes, which means you’ll have symptoms of depression and hypomania at the same time.

With bipolar II, though, you won’t experience mania. If you have a manic episode, you’ll receive a diagnosis of bipolar I.

Cyclothymia symptoms

A diagnosis of cyclothymia requires:

  • periods of hypomanic symptoms and periods of depression symptoms, off and on, over 2 years or longer (1 year for children and adolescents)
  • symptoms that never meet full criteria for an episode of hypomania or depression
  • symptoms that are present for at least half of the 2 years and never absent for longer than 2 months at a time
  • symptoms that don’t relate to another medical or mental health condition or substance use
  • symptoms that cause significant distress and affect daily life

Fluctuating mood symptoms characterize cyclothymia.

These symptoms may be less severe than those of bipolar I or II.

Still, they tend to last longer, so you’ll generally have less time when you experience no symptoms.

Hypomania may not have a big impact on your daily life.

Depression, on the other hand, often leads to more serious distress and affects day-to-day function, even if your symptoms don’t qualify for a major depressive episode.

If you do ever experience enough symptoms to meet the criteria for a hypomanic or depressive episode, your diagnosis will likely change to another type of bipolar disorder or major depression, depending on your symptoms.

Mania and hypomania

An episode of mania often involves an emotional high.

You might feel excited, impulsive, euphoric, and full of energy.

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You might also feel jumpy or notice your thoughts seem to race.

Some people also experience hallucinations and other symptoms of psychosis.

Manic episodes can involve behavior that’s more impulsive than usual, often because you feel invincible or untouchable.

Commonly cited examples of this kind of behavior include:

  • having sex without using a barrier method
  • using alcohol and drugs, or using them more than usual
  • going on spending sprees

But impulsiveness and risk taking can show up in plenty of other ways, too.

Maybe you:

  • quit your job abruptly
  • take off on a road trip by yourself without telling anyone
  • make a big investment on a whim
  • drive much faster than usual, well above the speed limit
  • participate in extreme sports you wouldn’t ordinarily consider

Hypomania, generally associated with bipolar II, involves many of the same symptoms, though they’re less severe.

Unlike mania, hypomania often doesn’t lead to trouble at work or school, or in your relationships.

Episodes of hypomania don’t involve psychosis. They typically won’t last as long as episodes of mania or require inpatient care.

With hypomania, you might feel very productive and energized, but you may not notice other changes in your mood.

People who don’t know you well may not, either.

Those closest to you, however, will usually pick up on your shifting mood and energy levels.

Major depressive episodes

A “down” change in mood can leave you feeling lethargic, unmotivated, and sad.

Bipolar-related episodes of major depression will involve at least five of these symptoms:

  • a lasting low mood, marked by deep sadness, hopelessness, or feelings of emptiness
  • loss of energy
  • a sense of feeling slower than usual or persistent restlessness
  • lack of interest in activities you once enjoyed
  • periods of too little or too much sleep
  • a sense of guilt or worthlessness
  • trouble with concentrating, focusing, and making decisions
  • thoughts of death, dying, or suicide
  • changes in appetite or weight

Not everyone with bipolar disorder experiences major depressive episodes, though many people do.

Depending on your type of bipolar, you might experience only a few symptoms of depression, not the full five needed for a major episode.

It’s also worth noting that sometimes, but not always, the euphoria of mania can feel enjoyable.

Once you get treatment for mania, the symptom-free mood you experience might feel more like a “down” shift, or a period of depression, than a more typical mood state.

While bipolar can cause a depressed mood, bipolar disorder and depression have one major difference.

With bipolar, you might have “up” and “down” mood states.

With depression, though, your mood and emotions might remain “down” until you get treatment.

Bipolar disorder treatment

Several treatments can help you manage bipolar disorder symptoms.

These include medications, counseling, and lifestyle changes. Some natural remedies can also have benefits.

Medications

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 used for short-term treatment

Psychotherapy

Recommended therapy approaches may include:

  • Cognitive behavioral therapy
  • Cognitive behavioral therapy (CBT) is a type of talk therapy that helps you identify and address unhelpful thoughts and change unwanted patterns of behavior.

Therapy offers a safe space to discuss ways to manage your symptoms. Your therapist can also offer support with:

  • understanding thought patterns
  • reframing distressing emotions
  • learning and practicing more helpful coping strategies

Get tips on finding the right therapist.

Psychoeducation

Psychoeducation is a therapeutic approach centered around helping you learn about a condition and its treatment.

This knowledge can go a long way toward helping you and the supportive people in your life recognize early mood symptoms and manage them more effectively.

Interpersonal and social rhythm therapy

Interpersonal and social rhythm therapy focuses on regulating daily habits, such as sleeping, eating, and exercising.

Balancing these everyday basics could lead to fewer mood episodes and less severe symptoms.

Other options

Other approaches that can help ease symptoms include:

  • electroconvulsive therapy
  • sleep medications
  • supplements
  • acupuncture

Bibliographic resources:

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Source:

Health Line

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