What is Bipolar Disorder?

Bipolar disorder is a mental illness that causes extreme shifts in a person’s mood, thoughts, and behavior. People with bipolar disorder experience extreme shifts between euphoric happiness (mania or hyper-mania) and depressive lows in which the sufferer feels sad and hopeless and loses interest in most activities.

The shifts in mood that people with bipolar disorder experience are different from the normal ups and downs that we all experience. The mood swings in bipolar disorder tend to be severe and unpredictable comparable to normal mood shifts. These shifts in overall mental well-being can lead to a variety of other issues including insomnia. Bipolar disorder can also cause social issues and affect a person’s ability to maintain relationships and steady employment. 

Risk Factors

Bipolar disorder often develops in the late teens or early 20s. Extreme changes in lifestyle, energy levels, sleep and behavior are often the early warning signs of a person affected by bipolar disorder.

Scientists aren’t exactly sure what causes bipolar disorder. However, they have identified some things that increase the risk for bipolar, including: 

• Having a parent, sibling, or another close relative with the disorder 
• Alcohol or drug abuse 
• History of head injury 

Signs and Symptoms of Bipolar

Those with bipolar disorder typically experience intense shifts in mood from their “normal” mood. These shifts range from overly excited and euphoric (manic) to sad, depressed, or hopeless (depressive). On occasion, a person may exhibit moods characterized by both mania and depression, which is commonly referred to as a “mixed state.” Bipolar disorder is characterized by the presense of extreme mood swings that include depressive episodes and manic episodes. 

• Depressive episodes – Episodes in which a person feels very sad, anxious, or down. During these periods, the person may find it difficult to get out of bed, work, or do activities that they normally enjoy. They may feel hopeless and have thoughts of suicide. 

• Manic episodes – Periods of extreme elation, happiness, or joy. A person experiencing a manic episode may have a decreased need for sleep, racing thoughts, and pressured speech. During manic episodes, a person may engage in risky behaviors that put them and others at risk for harm, such as driving recklessly. 

Bipolar symptoms may affect a person’s ability to work or go to school. Bipolar disorder can also cause impairments in judgment and thinking, which can lead to legal issues. 

Types of Bipolar Disorder

There are several different types of bipolar disorder. Here are the most common forms: 

1. Bipolar 1 Disorder: To be diagnosed with this type of bipolar, a person must have experienced at least one manic episode. 
2. Bipolar 2 Disorder: This type of bipolar is marked by the presence of at least one depressive episode and one hypomanic episode. This type of bipolar is more common in women. 
3. Cyclothymia: People with cyclothymic disorder have episodes of mild depression or hypomania that are present for at least two years, but aren’t severe enough to meet the requirements of bipolar 1 or bipolar 2. 

Treatments for Bipolar Disorder

Bipolar disorder can’t be cured, but it can be treated effectively with the help of your doctors and mental health professionals. Treatments are generally geared around controlling intense mood shifts.

Since bipolar disorder is a chronic disease, treatments are usually ongoing and may include a combination of medications, counseling, and lifestyle changes. 

Medications

• Mood Stabilizers – Lithium, Depakote, Lamictal, Neurotin, Topamax, and Trileptal are popular choices for treating bipolar disorder.
• Antipsychotics – These are often used to treat symptoms, though generally in correlation with other medications, such as antidepressants. Zyprexa, Abilify, Seroquel, Risperdal and Geodon are often prescribed.
• Antidepressants – Medications like Prozac, Paxil, Zoloft and Wellbutrin are examples of antidepressants that may be prescribed to treat depressive symptoms of bipolar disorder. 

Psychotherapy

Psychotherapy is often used in combination with medication and can be a very effective treatment for bipolar disorder. Common psychotherapy treatments include:

• Cognitive Behavioral Therapy helps those with bipolar disorder learn to change harmful or negative thought patterns that lead to episodes of mania or depressive behavior.
• Family-focused Therapy involves family members and details coping strategies as well as recognizing patterns and onset behavior for episodes.
• Interpersonal and Social Rhythm Therapy helps people affected by bipolar disorder improve their relationships with loved ones as well as learn to manage their daily routines such as sleep and eating schedules.
• Psychoeducation teaches those affected by bipolar disorder how to recognize problem behavior as well as the patterns that lead to episodes. This type of psychotherapy is typically done in a group setting.

Why Work With a Therapist?

Therapy can help a person with bipolar disorder better manage the disease and return to doing the things that they enjoy. It can also help a person learn how to cope with symptoms, improve relationships, and more. 

What to Look for When Finding a Therapist

Finding the right therapist can be daunting. You could try joining a support community for people with bipolar disorder. Ask forum members for recommendations. 

Next, search for therapists who have experience in treating bipolar disorder. It is a good idea to talk to several therapists to determine their treatment approach and whether it will be a good match. Some questions to ask include: 

• What kinds of therapy do you use to treat bipolar disorder? 
• What do you think of medication when it comes to bipolar disorder? 
• How many years of experience do you have in treating bipolar? 

You might also ask if they offer virtual visits if that is something that is important to you. 

Post-Pandemic Update 

The coronavirus pandemic caused increased mental health symptoms for many people, including those with bipolar disorder. One of the most important things post-pandemic is to make sure you are managing stress and getting help for bipolar disorder. There is no cure for bipolar disorder, but treatment can help you manage the symptoms.

References

1. National Institute of Mental Health. (2017). Bipolar Disorder. Retrieved April 23rd, 2019 from https://www.nimh.nih.gov/health/statistics//bipolar-disorder.shtml.
2. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
3. National Institute on Mental Illness. (2019). Bipolar Disorder: Treatment. Retrieved April 23rd, 2019 from https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder/Treatment
4. WebMD. (2019). Psychotherapy for Bipolar Disorder. Retrieved April 23rd, 2019 from https://www.webmd.com/bipolar-disorder/guide/psychotherapy-bipolar-disorder#.
5. Frank, E., Swartz, H. A., & Boland, E. (2007). Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues in Clinical Neuroscience, 9(3), 325–332. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202498/ 
6. Lewis, K. J. S., Gordon‐Smith, K., Saunders, K. E. A., Dolman, C., South, M., Geddes, J., Craddock, N., Di Florio, A., Jones, I., & Jones, L. (2022). Mental health prior to and during the COVID ‐19 pandemic in individuals with bipolar disorder: Insights from prospective longitudinal data. Bipolar Disorders. https://doi.org/10.1111/bdi.13204 
7. Rowland, T. A., & Marwaha, S. (2018). Epidemiology and risk factors for bipolar disorder. Therapeutic Advances in Psychopharmacology, 8(9), 251–269. https://doi.org/10.1177/2045125318769235