Understanding Bipolar Disorder

One of the more stigmatized disorders in our culture, bipolar disorder involves severe episodes of depression and periods of mania. The lack of understanding around this disorder can cause hurt and confusion in patients or even aversion to diagnosis.

Sometimes, the term “bipolar” is used casually to refer to someone who is moody. This type of uninformed characterization belittles the true experience of those with bipolar disorder. Those with this disorder experience extended periods of depression and mania that interfere with their ability to conduct normal lives.

Cyclothymic Disorder

The DSM-5 has strict diagnostic criteria for bipolar disorder. As such, those with similar symptoms that do not last for such extended periods of time may fall under another category of diagnosis. These patients may have something known as cyclothymic disorder. Mental health professionals typically take a similar approach to treating cyclothymic disorder as they do to treating bipolar disorder, however.

The Differences between Bipolar 1 & 2

Bipolar disorder comes in two forms: bipolar I and bipolar II.

Bipolar I involves manic periods that last for at least a week and depressive episodes that go on for more than 14 days, making it the more severe of the two. Patients with severe symptoms that do not last as long may still qualify, as such, as bipolar I.

Patients with bipolar II experience milder symptoms that are shorter in duration. While their symptoms may be more mild, bipolar II patients still require support, intervention, and compassion.

The Signs of Bipolar Disorder

Understanding the true symptoms of bipolar disorder can help patient and loved ones alike. The primary characteristic of this disorder is the way in which the patient cycles between mania and depression.

Manic periods are characterized by excessive energy, hyperactivity, and feelings of grandiosity. While this may seem positive, it can actually lead to destructive behaviors. Patients may be unaware of physical risks during this time, as an example, or spend money to excess. Symptoms of bipolar mania can include:

  • Excessive risk taking
  • Excessive energy and insomnia
  • Elation even when sad things happen
  • Getting angry or frustrated with people who try to stop risk-taking behavior
  • Racing thoughts

Depressive periods are characterized by extremely low energy and an absence of emotion. For some patients, this can be so severe that they cannot get out of bed and get on with their day. One of the most dangerous symptoms of depressive episodes is suicidal ideation.

Depressive symptoms include:

  • Suicidal thoughts
  • Limited or no energy
  • Apathy towards loved ones and interests
  • Loss of appetite or excessive appetite
  • Insomnia or sleeping too much
  • Feelings of hopelessness

Can You Test for Bipolar Disorder?

There is no physical test for bipolar disorder. In order to diagnose a patient, a mental health professional must look for a pattern of symptoms in the patient by interviewing the patient. Patients may be asked to complete surveys, as well.

The interview process can feel deeply personal and even invasive for some patients. It is, however, essential for proper diagnosis. Therapists will always demonstrate patience and compassion and withhold judgment.

Conditions that Present with Bipolar Disorder

Bipolar disorder is often comorbid with other mental, behavioral, and emotional disorders. Some conditions that can present with bipolar disorder include:

  • Psychosis
  • Anxiety disorders
  • Substance abuse
  • ADHD

Mental health professionals may screen for these types of disorders during the initial interviews. Getting a full picture of a patient is essential to treating the whole patient.

Treating Bipolar Disorder

As with many mental health disorders, bipolar is often treated with medications, talk therapy, or a combination of both. Sometimes inpatient care is needed when a patient is self-destructive or has suicidal ideation.

Talk Therapy

Talk therapies that help with bipolar disorder include:

  • Cognitive Behavioral Therapy (CBT)
  • Interpersonal and Social Rhythm Therapy (IPSRT)
  • Family-focused therapy

In CBT , patients work to recognize the triggers of their negative behaviors and then develop appropriate coping mechanisms.

IPSRT involves learning about the biological triggers involved in bipolar disorder. Patients the leverage this knowledge to cope with and decrease the power of triggers.

Patients with bipolar disorder can also benefit from family therapy. In these sessions, loved ones can work with the patient and therapist to develop coping strategies. Having a support structure can help patients stay in better shape in the interim between sessions.

Medication for Bipolar Disorder

In some cases, medication can be a helpful supplement to other interventions. The available medications for bipolar disorder include:

  • Mood stabilizers
  • Antidepressants
  • Sleep aids
  • Antipsychotics

Finding the right combination of medications can take a while. Patients will need to work with their therapist on medication management to find the right balance.

ECT for Bipolar Treatment

In cases where patients have a low tolerance for medications, mental health professionals may wish to supplement a patient’s talk therapy with ECT. Electroconvulsive Therapy (ECT) can be beneficial, but it can also come with some risks. Side effects can include heightened confusion and memory loss. A mental health professional will only recommend ECT when its benefits are greater than the risks for the patient.

Bipolar Disorder – The Statistics

According to some estimates, 2.6 percent of the adult population in the United States has bipolar disorder, or about 5.7 million American people. Parsing numbers in children is more difficult, since there is still disagreement in the mental health community around whether or not children should be diagnosed with the disorder. Some estimates say that 750,000 kids and teens in the U.S. are bipolar but do not have a diagnosis.

Bipolar Risk Factors

There is no known cause for bipolar disorder, but research indicates there are certain risk factors involved. For one, research points to a genetic driver for the disorder, since the chance of having this disorder goes up when a close family member has it.