What is Bipolar Disorder ?

by | Aug 7, 2023 | Blogs

Clinically Reviewed By Dr. Dubey Shivam

Bipolar disorder causes extreme mood swings, including intense highs (mania) and lows (depression), which are much stronger than the normal mood changes everyone goes through. It usually starts around age 25 and affects about 2.8% of people in the U.S. Without treatment, the condition tends to get worse.

With the right treatment, including therapy, medication, a healthy diet, and a regular routine, many people manage well. Symptoms can be varied and may include both manic and depressive episodes, sometimes even at the same time. Diagnosing bipolar disorder usually involves a physical check-up and talking to a mental health expert to exclude other conditions. Recognizing symptoms early is necessary for effective management.

Symptoms

There is a range of possible severity for the symptoms. A person who suffers from bipolar illness could have distinct episodes of mania or depression, but they might also go for long stretches — even years — without showing any symptoms. It’s also possible for a person to experience both extremes at the same time or in fast succession.

Hallucinations and delusions are examples of psychotic symptoms that may accompany more severe bouts of mania or depression associated with bipolar disorder. In most cases, a person’s elevated mood may be seen reflected in their psychotic symptoms. People with bipolar illness who also show signs of schizophrenia are at risk of receiving an incorrect diagnosis of schizophrenia.

Mania. A person must have had at least one episode of manic or hypomanic behavior before they may be diagnosed with the mental illness known as bipolar disorder. Hypomania is a kind of mania that is less severe than manic episodes and does not include psychotic episodes. Hypomanic patients often have normal or near-normal functioning in social or occupational settings. It’s possible that some individuals with bipolar illness may suffer periods of mania or hypomania on a regular basis throughout their lives, while others may only have these episodes very seldom.

A person who suffers from bipolar disorder may find a heightened mood of mania pleasant, particularly if it happens after a period of despair. However, the “high” may not end at a level that is comfortable or under control. It is possible for one’s disposition to swiftly become more irritable, for conduct to become more unpredictable, and for judgment to become more impaired. People who are manic are more likely to act in an erratic manner, make risky choices, and put themselves in unusually dangerous situations.

People who are manic most of the time are not aware of the harmful repercussions of the acts they do because of their mood. Because some persons with bipolar illness have suicidal ideation even when they are in a manic state, suicide is an ever-present risk for those who have this condition. It is possible to improve one’s ability to handle the symptoms of the condition by learning from previous experiences the types of conduct that serve as “red flags” for manic activity.

Depression. People who suffer from bipolar depression often have lows that are so incapacitating that they are unable to function normally or even get out of bed. People who are going through a depressed episode often have trouble getting asleep and staying asleep, while others sleep far more than they normally would. Even seemingly little choices, like deciding what to have for dinner, may be difficult for depressed individuals to make. This negative thinking may lead to thoughts of suicide in the individual because it causes them to become preoccupied with emotions of loss, personal failure, remorse, or powerlessness.

For a diagnosis of clinical depression, a person must have depressed symptoms that impair their capacity to function for a period of at least two weeks, and these symptoms must be present almost every day. Depression that is accompanied by bipolar illness may be more difficult to treat and may need a treatment plan that is individualized to the patient.

Causes

Researchers have not yet zeroed down on a particular factor that triggers bipolar illness. At this time, they think that a number of causes, including the following, may have contributed:

  • Genetics. If any of a kid’s parents or siblings has bipolar disorder, then that child is at a greater risk of acquiring the disease themselves. However, genetics do not have an unquestionable role: A youngster who comes from a household where bipolar illness has been diagnosed in the past may not ever get the disease themselves. Research conducted on pairs of people who are genetically identical to each other has shown that even if one twin has a problem, the other may not.
  • Stress. An bout of mania or depression may be triggered by a stressful life event such as a death in the family, a sickness, a challenging relationship, divorce, or financial troubles. As a result, the manner in which an individual deals with stress may also be a factor in the onset of the disease.
  • The anatomy and function of the brain Brain scans are unable to diagnose bipolar illness; nonetheless, researchers have shown that patients with the disease have small abnormalities in the average size or activity of certain brain areas.

Diagnosis

In order to diagnose bipolar disorder, a physician would often do a physical examination, talk to the patient, and request laboratory testing. Although a blood test or body scan cannot detect bipolar disorder, they may help rule out other disorders that might have similar symptoms, such as hyperthyroidism, which may be mistaken for the disorder. If the symptoms are not caused by any other diseases (or by medications such as steroids), the doctor may suggest seeking treatment for mental health issues.

A person must have had at least one episode of manic or hypomanic behavior before they may be diagnosed with the mental illness known as bipolar disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the reference manual that mental health care practitioners turn to in order to determine the “kind” of bipolar illness that a patient may be experiencing. Mental health care experts examine the pattern of a patient’s symptoms as well as the degree to which the patient is impaired during their most severe episodes in order to establish the kind of bipolar disorder that a patient has.

Four Types Of Bipolar Disorder

1/ People suffering with Bipolar I Disorder have had at least one episode of manic behavior over the course of their disease. Even though a manic episode is not required for a diagnosis of bipolar I, the majority of persons who are diagnosed with the condition will have periods of both mania and depression at some point throughout their lives. In order to get a diagnosis of bipolar I, a person’s manic episodes must either continue for at least seven days or be of such a severe nature that they necessitate hospitalization.

2/ Bipolar II Disease is a subgroup of bipolar illness in which patients endure depressive periods that shift back and forth with hypomanic episodes, but they never experience a “full” manic episode. People who have this kind of bipolar disorder may also experience hypomanic episodes.

3/ Cyclothymic Disorder, also known as Cyclothymia, is a persistently unstable mood state in which persons suffer hypomania and moderate depression for at least two years. Cyclothymic Disorder is often referred to as Cyclothymia. It is possible for people who have cyclothymia to have short periods of normal mood; however, these episodes often persist for fewer than eight weeks.

4/ When a person does not fulfill the criteria for bipolar I, II, or cyclothymia but has nonetheless had episodes of clinically significant aberrant mood elevation, they are said to have Bipolar Disorder, “other specified” or “unspecified.” Bipolar Disorder, “other specified” and “unspecified”

Treatment

The management and treatment of bipolar illness may be accomplished in a number of different ways:

  • Psychotherapy, including cognitive behavioral therapy and family-focused therapy, among other approaches.
  • Medication, including but not limited to mood stabilizers, antipsychotics, and, to a lesser degree, antidepressants.
  • Techniques for self-management, such as knowledge and the ability to recognize the early indications of an episode.
  • Approaches to health care that are considered complementary, such as aerobic exercise, meditation, religion, and prayer, may supplement conventional medical care but should not be considered a substitute for it.

The Systematic Treatment Enhancement for Bipolar Illness, more often referred to as Step-BD, is the biggest study effort ever undertaken to investigate whether treatment approaches are effective for persons who have bipolar disorder. Step-BD tracked approximately 4,000 individuals diagnosed with bipolar illness over the course of time while they were receiving a variety of therapies.

Related Conditions

In addition to these symptoms, those who have bipolar illness may also experience:

It’s possible to make an incorrect diagnosis of schizophrenia in patients who have bipolar illness and psychotic symptoms. Misdiagnosis of borderline personality disorder may also occur in patients with bipolar illness (BPD).

It may be challenging to treat bipolar disorder when additional diseases or incorrect diagnoses are present. For instance, the antidepressants used to treat obsessive compulsive disorder (OCD) and the stimulants used to treat attention deficit hyperactivity disorder (ADHD) may cause symptoms of bipolar illness to become more severe or may even cause a manic episode. If you suffer from many conditions at the same time, often known as co-occurring illnesses, it is imperative that you find a treatment regimen that is effective for you.

Anastasiya Palopoli
Written by Anastasiya Palopoli

Anastasiya Palopoli, a board-certified Psychiatric Nurse Practitioner, has extensive experience in nursing and psychiatric care, with degrees in Nursing from UCF and Psychiatric Mental Health from the University of Cincinnati. Following a residency in General and Child Psychiatry in Florida, she specializes in treating Dementia, psychosis, depression, and anxiety through holistic approaches. Beyond her professional life, she enjoys hiking, tennis, and traveling with her family.