What is Bipolar Disorder?

A highly stigmatized disorder, Bipolar Disorder is often misconstrued and its sufferers misunderstood. The term itself has become a fixture in pop culture, causing many to have stereotype ideas about the disorder. Many use the term 'bipolar' loosely, referring to moodiness or difficult personalities, adding to confusion and stigma.

Bipolar Disorder is a mental disorder that patients and their loved ones need to address seriously. Formerly known as manic depressive disorder, bipolar disorder gets its name from the way in which patients swing from manic to depressive states in very polarized ways.   

Cyclothymic Disorder

Someone with a cyclothymic disorder experiences the same swings in mood as someone with bipolar disorder but in a less severe way. Their manic states are only slightly elevated from the norm and their depressions are likewise more mild.  None of their episodes reach the level of those experienced in either bipolar disorder or major depressive disorder. To receive a diagnosis, an adult patient should have these symptoms for 2 years; children and adolescents, 1 year.

Bipolar I vs Bipolar II

In Bipolar I, the patient has mania that runs for at least 7 days and depression that lasts over 14 days.  Bipolar II differs in terms of the 'highs' the patient experiences; in bipolar II, the patient has hypomania, or slightly elevated mood and activity. Depression in Bipolar II can be on par with depression in Bipolar I.

The Symptoms of Bipolar Disorder

The manic episodes in someone with Bipolar I involve soaring energy, rapid, unending speech, high levels of joy or irritability, and episodes of delusion on occasion. A manic episode can put the patient in serious danger and sometimes inpatient treatment is required.  

Depressive episodes come more frequently. A bipolar patient in the throes of a depressive episode may not leave the home or bed, not wash, and even experience suicidal ideation.

These episodes are never a matter of a few hours, as pop culture likes to portray them. A manic episode in a bipolar i patient lasts at least 7 days, while a depressive episode can run over 2 weeks.   

Manic Symptoms

  • Unusually high energy

  • Feelings of extreme elation or irritability

  • Insomnia

  • Rapid thoughts and speech

  • Risk-taking

  • Thoughts of omnipotence or superiority

Depressive Symptoms

  • Feeling hopeless

  • Unusually low energy

  • Excessive sleep or insomnia

  • Binge eating or starving

  • Exhaustion

  • Apathy towards activities that were pleasurable in the past

  • Suicidal ideation

  • Crying jags

  • Inability to concentrate

Is There a Bipolar Test?

There is no physical exam or testing that can reveal bipolar disorder in a patient. Instead, a mental health professional must assess the situation via interviews, questionnaires, or surveys. The diagnosing professional looks for periods of mania and depression that are long in duration.

Conditions that are Comorbid with Bipolar Disorder

Mental health disorders such as ADHD, anxiety, and drug use or alcoholism can sometimes appear in tandem with Bipolar disorder. A mental health professional assessing a patient for bipolar disorder may also look for these or seek to rule out a depressive disorder.

As with bipolar disorder, this diagnostic process typically involves questions and interviews with the patient. The therapist and patient can then develop a system of treatments and interventions based on the diagnosed disorders present.

Treatment for Bipolar Disorder

Treatment can include talk therapy, medication, or even inpatient care. Interventions depend on the specific needs of the patient.

Psychotherapy

There are a number of therapies that can benefit the bipolar patient. These include CBT, Family Focused Therapy, and Interpersonal and Social Rhythm Therapy, or IPSRT. Oftentimes with bipolar disorder, the patient needs medication in addition to talk therapies.  

One therapeutic approach involves psychoeducation, which teaches the patient about the condition, done in tandem with family therapy. The goal is to give the family support unit the tools they need to aid the patient.

In IPRST,  patients focus on how biology and social interaction come together to form the whole person. Tools are built around these concepts to help the patient stabilize their moods during episodes.   

Medication

Mediation options for those with bipolar disorder can include:

  • Antipsychotics

  • Mood stabilizers

  • Anti-anxiety medications

  • Antidepressants

  • Sleep medication (occassionally)

Patients should work closely with their psychiatrist to find the right combination of medications. No one answer is the right fit for all patients.

Additional Bipolar Treatment Options

In severe cases, mental health professionals sometimes recommend Electroconvulsive Therapy (ECT). Given that the side effects of this treatment can include memory loss and confusion, this approach is only used when other interventions are not producing positive results.  

Additional treatments include Repetitive Transcranial Magnetic Stimulation (rTMS) and the use of mood charts to track symptoms and behaviors.  

How Common is Bipolar Disorder?

Bipolar disorder is surprisingly common, affecting around 3 percent of adults in the US. In other words, two or three people out of every 100 suffer from this mental health disorder. The data for children and adolescents is still up for debate, with some estimates suggesting that 750,000 younger Americans suffer from Bipolar disorder.

Risk Factors for Bipolar Disorder

No gene for bipolar disorder has been identified yet. However, most experts agree that those with certain variants in their genes have a higher chance of having the disorder. It has also been shown to run in families.