Roughly 2.8% of the US adult population suffers from bipolar disorder – a mental health condition affecting a person’s mood. The condition gets its name from the two distinct phases – or poles – that distinguishes it from other similar conditions. Cycling between a manic episode and a depressive episode, bipolar disorder produces stark shifts in mood that can make it difficult for a person to perform everyday tasks.
Causing serious impairment in a person’s functionality, work, and socialization, bipolar disorder requires prompt treatment. This is especially true if the individual poses a threat to him or herself, or to those around them.
There are four main categories of bipolar disorder. And because each one may manifest differently or may stem from different causes, a proper diagnosis is necessary in order to guarantee appropriate treatment. These categories include:
- Bipolar I disorder – Characterized by a manic episode lasting 7 days, or a severe episode requiring hospitalization. This then comes hand in hand with a depressive episode lasting at least two weeks. It’s also possible for the individual to manifest both depressive and manic symptoms together.
- Bipolar II disorder – This type of bipolar is characterized by a hypomanic episode, which is milder than the full-blown mania that bipolar I cause. Similarly, however, bipolar II also comes with seasons of depression.
- Cyclothymic Disorder – Also called ‘cyclothymia’, this disorder manifests both hypomanic and depressive symptoms over the course of 2 years. The severity of the symptoms however doesn’t qualify for a diagnosis of bipolar I or II.
- Bipolar disorder due to another medical condition – This includes bipolar disorders that are induced by the use of certain drugs and illicit substances. Some conditions are also known to cause manic and depressive symptoms, thus making the bipolar disorder a result of another underlying health problem.
For a person to be diagnosed with bipolar disorder, it’s necessary that they have at least one episode of mania and one episode of depression. The severity of the symptoms will only determine which type of bipolar the person has.
A manic episode is characterized by episodes of elevated mood. In essence, it’s the opposite of depression which is why it’s said that a person with bipolar disorder cycles between the two polar opposites of mood. A manic episode may involve symptoms such as:
- Talkativeness beyond normal for the individual
- Lack of need for sleep or absolute sleeplessness
- Racing thoughts
- Difficulty concentrating
- Increased activity levels and energy
- Psychomotor agitation (i.e. Ticks, tremors, leg shaking, nail biting)
- Inflated self-esteem or a sense of grandiosity
- Engagement in activities that could be potentially harmful or dangerous (i.e. Speeding, spending excessively)
A person in a manic state will seem out of control. Sometimes, they may act out violently and pose a threat to others or themselves. They can also be irritable, difficult to talk to, and they may be unable to perform daily tasks and routines.
To be considered mania, these symptoms have to be present most of the day almost every day for a week. On the other hand, hypomania entails the presence of these symptoms for most of the day for four consecutive days.
Then there’s the other end of the disorder, which is depression. Keep in mind that some patients will have depression for years before developing a manic episode. That’s why many of those with bipolar disorder are misdiagnosed with depressive disorder.
Unlike a manic episode, a depressive episode is characterized by a depressed mood and a loss of interest or pleasure in things and activities that the person previously enjoyed. These symptoms must be present for at least two weeks to qualify as depression:
- Depressed mood for most of the day, almost every day for 2 weeks
- Loss of interest or pleasure in activities and hobbies previously enjoyed
- Weight changes, loss or increase in appetite
- Increased purposeless activity like pacing a room or rocking back and forth
- Decreased energy levels
- Feelings of worthlessness
- Impaired ability to think or focus
- Thoughts of death or attempts of suicide
There are some cases when individuals mistake themselves for bipolar simply because they experience mood swings. And while it’s absolutely normal for most people to go through ups and downs, the marker of bipolar disorder is that its symptoms will interfere with daily functioning.
Research suggests that some people are at a higher risk of developing bipolar disorder than others. This has much to do with their family background, their health, and even the way their brain works.
Some of the risk factors for developing bipolar disorder include:
- Genetics – Individuals with a first degree relative with bipolar disorder are more likely to develop the condition themselves.
- Constant stress – People who have to deal with constant stress and pressure may be more likely to develop a mental health condition especially when confronted with a major trauma.
- Substance abuse – Various drugs and alcohol can alter brain chemistry and induce the symptoms of bipolar disorder among other forms of mental health conditions.
- Injuries and accidents – Certain injuries affecting the brain have been found to cause bipolar disorder. Once such study explored the effects of traumatic brain injury, and how the condition has been linked to the later development of bipolar.
It’s not entirely clear how bipolar disorder affects the brain, but science has shown us that it might have something to do with the different neurotransmitters in our system. Imbalances of these chemicals in the brain lead to the symptoms of bipolar disorder which makes it difficult for a person to regulate their mood.
Presently, it’s understood that during the manic episode, and individual will likely have much higher levels of noradrenaline. And then during the depressive episodes, a person is likely to have much lower levels of the same. But then again, it’s not so one dimensional.
Other neurotransmitters like dopamine and serotonin have also been found to play a role in the pathophysiology of bipolar disorder. Other than that, some studies have found that individuals with bipolar disorder actually have distinct brains that are slightly different from those without the condition.
If a person with bipolar disorder isn’t treated, their symptoms of mania can last for up to 6 months while depression can last up to a year. And because this can cause significant impairment in functioning, it’s imperative that individuals receive prompt medical care and treatment to combat the disorder.
The course of treatment for bipolar disorder typically involves a variety of methods that are used in combination in order to target the various areas of the person’s health. These may include:
- Medications – There are two different types of medications for bipolar disorder. The first is what’s called a mood stabilizer which works to improve and normalize brain chemistry. These medications are taken over a long period of time. Then there are meds that are used to target the symptoms of bipolar disorder as they occur. This helps to manage the severity of the symptoms and the extent to which they interfere with daily functioning.
- Therapy – Various therapy treatments and counseling methods can be used to help individuals identify underlying problems, traumas, and issues that might be causing the mental health condition. This can also help patients develop healthier, more stable relationships which can be vital to the prevention of future episodes.
- Lifestyle management – Engaging in healthy activities like exercise and proper diet can actually significantly reduce the risk for future bipolar disorder episodes. That’s why during treatment, patients are encouraged to find hobbies and healthy activities that they can adopt once they re-enter society.
While it is possible to treat someone with bipolar disorder without having to keep them in a hospital, there are some instances when an individual might have to be admitted. For instance, an individual with an active manic episode might pose a threat through aggression and violent tendencies, requiring the strict observation of medical professionals. On the other hand, an individual in an advanced state of depression might be at risk of suicide, which also calls for a controlled environment.
Bipolar disorder is one of the most problematic mental health conditions, causing the highest level of impairment compared to the range of other similar conditions. Nonetheless, with proper treatment, the mood disorder can be efficiently addressed. Many of those who receive treatment for bipolar disorder will rarely experience severe episodes down the line, allowing them to function, work, and socialize without the condition weighing down on their abilities.