Bipolar disorders are classified as mood disorders which include characteristics of extreme mood shifts – highs and lows -- including depressive symptoms and manic episodes separated by relatively normal periods of mood.
Because of the existence of co-occurring disorders, bipolar disorder is often misdiagnosed or mistreated. According to the National Institute of Mental Health, nearly 6 million adult Americans suffer from bipolar disorders, with the median age of onset being 25 years old, although children and teens do suffer from symptoms as well.
Additionally, more than two-thirds of people diagnosed with bipolar disorders have a relative with similar symptoms and characteristics.
People with bipolar symptoms are at a greater risk of suicide if left untreated.
Bipolar Disorder, also called to as manic-depressive illness, is a serious mental condition characterized by intense and unusual mood swings between emotional highs and lows. The highs and lows experienced by individuals with bipolar disorder are significantly more severe than the emotional highs and lows people without the condition go through on a day to day basis. Their mood swings also usually bring about extreme changes in energy, activity, sleep, and behavior. These unusually intense periods of emotional volatility are referred to as “mood episodes”, and they last anywhere from seven to fourteen days. Each mood episode represents a marked change in a person’s usual behavior, and they can inhibit people’s ability to lead normal lives. Bipolar disorder is a lifelong illness, and it cannot be cured. However, through prolonged and closely monitored treatment, those with bipolar disorder can learn to control their mood swings, and lead stable, productive, and successful lives.
According to the Depression and Bipolar Support Alliance , more than five and a half million Americans are affected by bipolar disorder every year. Most individuals that suffer from bipolar disorder develop the condition in their late teens or early twenties, but it can occur at any age. Diagnoses for bipolar disorder are made using the Diagnostic and Statistical Manual of Mental Disorders (DSM) , and in order to be diagnosed, a person’s symptoms must represent a major change from their usual mood or behavior.
The fluctuations between the emotionally “high” episodes (manic or hypomanic mood episodes) and emotionally “low” (depressive mood episodes) make it difficult for individuals with bipolarism and their families to recognize their symptoms. They may be able identify singular symptoms, but they are not always able to recognize the larger underlying issue. Consequently, some people with bipolar disorder will suffer for years before being properly diagnosed and treated.
The longer the condition goes untreated, the more severe the symptoms become. Bipolar symptoms can result in damaged relationships with friends and family, poor work or academic performance, and in some cases even suicide. This fact helps emphasize the importance of treatment and the severity of the condition, because it shows that bipolar disorder does not get better on its own. Getting the proper treatment is the only way to ensure that bipolar individuals get their symptoms under control.
The underlying cause of bipolar disorder is unknown, but there are a number of risk factors to be aware of. The most prominent risk factors are genetics, brain structure, and brain functioning. Individuals with a first degree relative, namely a parent or sibling, with the condition are more susceptible to developing the condition. In regards to brain structure and functioning, and MRI study found that adults with bipolar disorder have smaller prefrontal cortices with smaller functional capacities than people without the condition. The prefrontal cortex is a cerebral cortex covering a portion of the brain’s frontal lobe, and is responsible in constructing complex cognitive behavior, personality expression, decision making, and moderating social behavior. Interestingly, the prefrontal cortex develops during late adolescence, which may help explain why more than 50% of bipolar diagnoses occur before the age of twenty-five.
Mood episodes are the distinct periods in which individuals experience intense emotional states along with unusual sleep habits, activity levels, thoughts, and/or behavior. Each episode denotes a drastic alteration from a person’s typical mood or behavior. During an episode, people will experience symptoms for the majority of the day and bipolar individuals usually experience multiple episodes. The DSM delineated four particular types of mood episodes: manic episodes, hypomanic episodes, depressive episodes, and mixed episodes.
Mania and hypomania are two different types of mood episodes, but manifest the same symptoms. Hypomania is simply a mild form of mania. Mania is noticeably more severe, posits more problems in daily activity, and can even induce psychosis. It is important to note that without proper treatment, hypomanic episodes can develop into severe mania or depression. In order for an individual to experience a manic or hypomanic episode, they must exhibit three or more of the following symptoms:
It’s common for bipolar individuals to enjoy the euphoric feelings and increased productivity attributed with manic and hypomanic episodes, but is important to remember that they’re impermanent. Both hypomanic and manic episodes result in an emotional crash that leave individuals feeling depressed and worn out.
Major depressive episodes (MDE) are the antithesis of manic episodes. During a depressive episodes, individuals become much more reserved and tend to isolate themselves. It’s common for depressive symptoms to become severe enough to disrupt their daily lives, and make the most routine tasks difficult. When someone is going through a MDE, they will experience five or more of the following nine symptoms for two or more weeks:
People with bipolar disorder are more likely to seek out help amidst a depressive episode, which is why bipolar disorder is sometimes misdiagnosed as major depressive disorder . So, it’s extremely important to have your physician conduct a close examination of your previous medical history in order to prevent this from happening.
A mixed mood episode , or mixed state, is a manifestation of manic and depressive symptoms simultaneously. During a mixed state, individuals are likely to be more irritable than normal, have trouble sleeping, and experience a drastically changed appetite. The National Institute of Mental Health noted that, “People in a mixed state may feel very sad and hopeless while at the same time feel extremely energized.” Thus, a mixed mood episode can be characterized by emotional uncertainty or confliction.
People with particularly severe mood episodes may develop symptoms of psychosis . Psychosis affects a person’s ability to know what’s real and what is not in addition to their thoughts and emotions. The psychotic symptoms an individual exhibits will reflect their particular mood extremity. When a person is experiencing psychotic symptoms during a manic episode, they may believe that they’re rich and famous or have special powers like invincibility. Conversely, psychotic symptoms during a depressive episode include the belief that they’ve committed a crime, the belief that they’ve lost all of their money, or that their life has been ruined in some way or another. As a result, bipolar individuals with psychotic symptoms can be misdiagnosed with schizophrenia.
There are four primary types of bipolar disorder, and physicians use the DSM to determine the particular form of the disorder an individual has. In order to be diagnosed, their symptoms must represent a marked change from their usual mood or behavior.
There is also a severe form of bipolar disorder called Rapid-Cycling Bipolar Disorder which occurs when a person has four or more episodes of major depression, mania, hypomania, or mixed states over the course of a single year. Rapid cycling can occur at any point within the course of the disorder, and will come and go depending on the individual’s treatment. This particular form of bipolar disorder is more common in women and those with bipolar II disorder. It has also been documented that rapid cycling occurs in individuals that experience their first mood episodes in their mid to late teens, which is earlier than most diagnoses.
It is also important that bipolar II disorder is not a milder form of bipolar I disorder. They are completely separate diagnoses. The manic episodes of bipolar I disorder can be more severe, but individuals with bipolar II disorder can be depressed for longer periods, and are more susceptible to rapid cycling bipolar disorder.
People with bipolar disorder frequently have other mental or behavioral conditions that contribute to their bipolar disorder. Some of the most common cohabitational ailments include:
Substance abuse problems are the most common cohabitational sickness, and they’re also the biggest complication attributed with bipolar individuals’ stability. Some people attempt treating their disorder by “drowning their sorrows” in alcohol or recreational drugs. But, this often triggers or prolongs their symptoms and the manic behavioral complications lead them to excessive indulgences. Other common complications with bipolar disorder include but are not limited to:
There is no way to prevent the development of bipolar disorder, but seeking out treatment at the onset of symptoms can prevent conditions from worsening. Proper treatment helps all bipolar individuals gain better control of their mood swings and behavioral symptoms.
Bipolar disorder may be treated with medication, psychotherapy, or a combination of medication and psychotherapy. The most effective forms of treatment typically include a steady, prolonged combination of medication and psychotherapy. Additionally, keeping a log of your daily mood symptoms, treatments, sleep patterns, and life events can help individuals and their physicians track and treat their illness most effectively.
Not everyone responds to medications the same way, and there are different medications used to treat different symptoms of bipolar disorder. Individuals may need to try a number of different medications before they find a solution that works best for them. The most commonly prescribed medications for treating bipolar disorder are mood stabilizers, atypical antipsychotics, and antidepressants.
Psychotherapy is commonly prescribed along with medication. Therapy is particularly effective because it provides individuals with a condition and their families with support, education, and guidance. There are a myriad of psychotherapy methods used in treating bipolar disorder, but the most popular methods include:
For more information on bipolar disorders, below are several additional resources to help learn more:
At Clarity Clinic, we have highly trained staff who specialize in diagnosing and treating bipolar disorders. To schedule an appointment, click on one of the specialists below to schedule an initial evaluation to and discuss assessment, diagnosis and treatment options.