Bipolar disorder, or manic depression, is a mental health condition that results in extreme mood swings and emotional highs and lows (depression).

When patients ask me, “what causes bipolar,” there is no simple answer. Underlying causes or factors can include genetic predisposition or sudden and chronic stressors such as drug/alcohol abuse, financial struggles, losing a friend or family member, or other stressful situations.

With bipolar depression, you might feel sad or hopeless or lose interest in things you used to enjoy. When you experience mood shifts to mania or hypomania, you can feel euphoric, full of energy or irritable. And it’s likely this affects your sleep, energy, behavior, and ability to think clearly.

Bipolar disorder can feel like a lifelong condition, but with treatment, you can manage your mood swings and other symptoms. Usually, it is treated with medication and psychological counseling, or psychotherapy.

Types of bipolar

There are two types of bipolar disorder I treat– bipolar I and bipolar II disorder. Understanding the difference between these two is important when it comes to treatment.

Bipolar I means you’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).

Bipolar II means you’ve had at least one major depressive episode and at least one hypomanic episode, but never a manic episode. When someone experiences a manic episode, they often experience a very extreme exaggerated mood such as intense energy, racing thoughts, or exaggerated behaviors. They might seem more confident, feel like they need less sleep or make impulsive choices. They can even act delusional or experience hallucinations.

And a more mild form of mania is hypomania, where the energy level is higher than normal, but not as extreme.

Depression vs. positive attitudes

A major depressive episode occurs when someone experiences a low mood or persistent feelings of sadness, emptiness or hopelessness. They might be lacking energy, losing interest in normal activities and hobbies, or experience feelings of worthlessness and guilt. Frequent thoughts of suicide or death may even occur.

So, where exactly do positive attitudes come from? And how can someone with bipolar find happiness and positivity again?

I think positivity comes from listening to your body and its needs and forcing time for yourself to help it feel better and/or heal. Even if it’s just 10 minutes, anything can help!

For me, I love listening to podcasts while cleaning or doing laundry to help me escape the world and my own thoughts. And the most important thing I can do for myself is to take breaks from my to-do list and do what my heart needs in that moment.

A break, or time for myself, means it is time that I do not take care of anyone else– a time where I can feed my soul. For someone else, this could look different, but I would just encourage you to take breaks and a time out! To change your attitude you have to work on yourself, know what you need, and listen to your body. I can help you do that with treatment as well.


When I treat a patient dealing with bipolar depression I will refer him/her to get a general physical, medical history review, and a hormone level check. I may also work with and alongside a psychiatrist.

I will work with you on a two-step treatment approach which includes:

  1. Setting up a strong routine

  2. Working through and learning how to recognize your own symptoms

This means knowing what triggers your episodes and managing those triggers. Together we will create a schedule to calm yourself down and write a letter to yourself that you can read if/when you begin feeling manic.

When you come to Southern Pine Counseling, I will help review your bipolar diagnosis and take into account any underlying causes to help tailor treatment to your needs. I can help with stress management and help you find more positivity in your life as you manage bipolar depression.

For more information, or to learn more about treatment, give me a call today!

Or, if you are having suicidal thoughts, please call National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).