Bipolar Disorder is a mental health condition marked by episodes of shift in person’s mood and energy levels. These episodes in mania and hypomania include abnormally elevated, overly confident or irritable mood, and in bipolar depression episode the individual experiences feeling low, empty and exhausted. The duration between these episodes can be calm and composed. However, these episodic shifts impact the person’s sleep, appetite, energy, thoughts, behaviors, relationships, and activities of daily living as well. The correct diagnosis and ongoing support, the symptoms can be reduced significantly.
Quick Answer
Bipolar disorder is a mental health condition that causes episodes of significant changes in mood, energy, activity levels, and the ability to function. These mood changes are much more intense than normal ups and downs.
Key Takeaway
- Bipolar disorder causes significant shifts in mood and energy.
- It includes episodes of mania, hypomania, and depression.
- Bipolar I involve at least one manic or mixed episode.
- Bipolar II involves hypomanic and depressive episodes.
- Genetics, biology, stress, and disrupted sleep can influence it.
- Diagnosis is mainly based on clinical history and symptom patterns.
- Treatment focuses on stability, symptom management, and relapse prevention.
What is bipolar disorder?
In psychology, it refers to a clinically diagnosable mental health disorder where a person experiences distinct mood episodes, most commonly: 1. Elevated or irritable mood, or 2. Depressive mood; with periods of calm and stability in between. According to ICD-11 classification, ‘Bipolar or related disorders’ are mood disorders with episodes of mania, mixed, or hypomania, with alternating depressive episodes.
Types of bipolar disorder
Under the umbrella of ‘Bipolar or related disorders’ there are multiple diagnostic categories based on the course, intensity and patterns of the mood episodes. They are broadly as follows:
Bipolar type I disorder: It consists of at least one manic or mixed episode. They are characterized by euphoria, increased activity, decreased need for sleep and rapid changes in mood (each day or within the same day). Typically, a depressive episode alternates during its course. However, even a single manic or mixed episode is sufficient for the diagnosis.
Bipolar type II disorder: It consists of one or more hypomanic episodes and at least one depressive episode. They are characterized by persistent mood lasting for several days with elevated mood, distractibility, and reckless behavior in hypomanic episodes. The depressive episode is identified by features of depressed mood, diminished interest in activities, difficulty in concentration, and feelings of hopelessness.
Cyclothymic disorder: Over the duration of at least 2 years, the presence of persistent instability of mood, involving several hypomanic or depressive symptoms. The hypomanic symptoms may or may not be definitively present just like a hypomanic episode. However, depressive symptoms are never definitively representative of a depressive episode. There is relatively less duration of stability in mood between symptoms.
All of them vary based on the person’s lifestyle patterns, like how often the episodes recur, the duration of each episode, and how significantly it hinders their functioning.
Symptoms of bipolar disorder:
Manic episodes consist of unusually increased level of energy, irritability, feeling of euphoria. It also includes less sleep without feeling tiredness, talking rapidly, acting impulsively or recklessly. There is also increased self-confidence than usual. In severe cases the person can experience psychotic symptoms (like hallucinations, etc.) as well.
Mixed episodes are characterized by presence of prominent manic and depressive symptoms. These symptoms variation can at times on different days or even in the same day.
Hypomanic episodes include many of the same symptoms as in the manic episodes. However, the symptom severity is less here which makes it less obvious or harder to notice. They still hamper the functioning of the individual in all areas of their daily living.
Depressive episodes consist of feeling persistently low, hopeless or empty. The individual experiences loss of interest in activities which they used to enjoy. They either sleep too much or too little, struggle with concentration, and feel unusually tired. In severe cases, the person may also have thoughts of harming themselves or dying.
What causes bipolar disorder?
The factors leading to bipolar disorder are usually understood as an interaction between biological factors, environmental factors, and personal vulnerability. If someone in the family previously had been diagnosed with bipolar disorder or had another mental health condition, then it increases likelihood of diagnosis in that family. It doesn’t mean that other family members will surely get a diagnosis, but it conveys genetically more chances of being vulnerable to mental health issues. There are many people who have genetic vulnerability in their family, but they have never developed bipolar disorder. There are also people with bipolar disorder without any clear family history of the same.
People with bipolar disorder have a different pattern of their biological systems. Research has shown that there are multiple differences in brain while regulating mood, handling stress, circadian rhythms, and responses to changes in daily routine; in people with bipolar disorder.
An individual’s life events and lifestyle factors can also act as an aid to trigger episodes in bipolar disorder. As people who have shift work, disrupted sleep patterns and work in highly conflicting and stressful environment are more susceptible to bipolar disorder. It is also evidenced that use of different substances for some people can become a trigger. Sometimes seasonal changes can also be influential trigger for some people. A trigger doesn’t become the cause of the disorder, instead it aids an already vulnerable brain to change during specific conditions.
How bipolar disorder is diagnosed
A detailed case history of mood, sleep, energy, daily routine and other aspects of life in the initial sessions give an understanding about how the disorder has developed. Comprehensive details about duration, intensity, and safety risks during the changing episodes from the client and family members are taken to create a clearer picture. Lifestyle patterns and habits are also explored to understand the triggers, if any are present. Also, other health conditions and mental health explanations are required to rule out other possibilities.
There is no specific blood test or brain scan that can give a confirmation for bipolar disorder. However, there are times when mental health professionals administer psychological assessments to rule out other mental health conditions which have similar presentations. The diagnosis of bipolar is still primarily based on clinical history and symptom patterns. Licensed mental health professionals, like clinical psychologists and psychiatrists, can diagnose mental health conditions. If there are thoughts related to death or dying, symptoms of psychosis, or serious impairment, then immediate professional evaluation is highly recommended.
Treatment of bipolar disorder
Bipolar disorders are treatable. Its treatment is focused on reducing symptoms during episodes, preventing relapses, and helping the person to regain confidence in their daily functioning as well. The psychiatrist prescribes medications to regulate the symptom intensity and reduce the risk of future episodes. The clinical psychologist during psychotherapy sessions recognizes the early warning signs and promotes development of coping skills to manage when and if there is increase in symptoms. They encourage making daily routines to maintain better sleep cycle and develop skills to manage stressful and conflicting circumstances. They also motivate healthy communication patterns within relationships for emotional safety and support. Therapy sessions also aim to modify lifestyle to prevent more triggering encounters and create relapse prevention plans for the client. Bipolar disorder is a long-term condition with periods of stability where the realistic treatment goal is focused on recovery and achieving stability.
Living with Bipolar disorder
Living well with bipolar disorder often means creating stable scenarios for reduced symptoms and manageable daily life functioning. At workplace, predictable schedules, clear roles and responsibilities, and planning helps for decreasing stress. In relationships, clear communication during stable periods makes a big difference. As during stable periods, the client can share what helps and doesn’t help with their loved ones for better support and understanding amongst each other. In therapy sessions, education of family members about the disorder, early warning signs, and client specific triggers help in reducing misunderstanding, blame and miscoordination in future episodes as well.
Bipolar Disorder vs Other mental health conditions
Many times, some disorders can look similar, but they are different from each other. Bipolar disorder is differentiated from the following disorders, for better clarity and understanding below:
Depression: Although they both fall under the umbrella of mood disorders, still depression is different from bipolar disorder as it doesn’t have a history of mania/hypomania. Depression also doesn’t occur in distinct episodes like in bipolar disorder.
Borderline Personality Disorder: Both bipolar and borderline personality disorder have intense emotional experiences, but their patterns are different. In bipolar disorder the mood changes occur in episodes, and they are related to biological mood cycle. While in borderline personality disorder the shift in mood is in response to interpersonal stressors.
Schizophrenia: In both these conditions the person can have symptoms of psychosis. In schizophrenia, the symptoms of psychosis (like hallucinations and delusions) and disorganized behavior, are main identifiers. However, in bipolar disorder psychosis is generally related to mood episodes in some cases rather than being a primary factor for diagnosis.
