What is bipolar disorder?
The National Institute of Mental Health describes the main symptoms of bipolar disorder as alternating episodes of high and low mood. Changes in energy levels, sleep patterns, ability to concentrate, and other characteristics can dramatically affect a person’s behavior, work, relationships, and other aspects of a person’s life.
Most people experience mood swings at some point, but those associated with bipolar disorder are more intense than normal mood swings, and other symptoms may occur. Some people experience psychoses, which can include delusions, hallucinations, and paranoia.
Between episodes, the person’s mood may be stable for months or years, especially if they’re following a treatment plan.
Treatment allows many people with bipolar disorder to work, study, and live full and productive lives. However, if treatment helps a person feel better, they may stop taking their medication. Then the symptoms may return.
Some aspects of bipolar disorder can make a person feel good. In a heightened mood, they may find that they are more sociable, more conversational, and more creative.
However, a heightened mood is unlikely to persist. Even when this is the case, it can be difficult to maintain attention or implement plans. This can make it difficult to keep track of a project to the end.
According to the International Bipolar Association, symptoms vary from person to person. For some people, an episode can last several months or years. Others can experience “highs” and “lows” at the same time or in rapid succession.
In the case of bipolar “rapid cycling” disorder, the person has four or more episodes within a year.
Mania or hypomania
Hypomania and mania are heightened moods. Mania is more intense than hypomania.
Symptoms may include:
- impaired judgment
- , is wired
- feel, sleep a little, but not feel tired
- a sense of distraction or boredom
- , lack of work
- or school, poor performance at
- The feeling of being able to do something
- , sometimes aggressive, so
- risky behavior
- increased libido
- Feeling intoxicated or euphoric
- to have a high level of self-confidence, self-esteem and self-importance,
- to jump from one topic to another
- To have “racing” thoughts that come and go quickly and bizarre ideas that the person can respond to
- She denies or does not recognize that something is wrong
at work or at school,
A lot to talk about and talk quickly
Some people with bipolar disorder may spend large amounts of money, use recreational drugs, consume alcohol, and engage in dangerous and inappropriate activities.
find out more about the differences between mania and hypomania here.
What are the early signs of bipolar disorder in children and adolescents?
During an episode of bipolar depression, a person may experience:
- a feeling of darkness, despair and hopelessness
- extreme sadness
- insomnia and sleep disorders,
- Afraid of smaller
- Pain or physical problems that do not respond to treatment
- a sense of guilt that may be out of place
- More to eat or eat
- weight loss or gain
- extreme tiredness, fatigue and listlessness an inability
- To enjoy activities or interests that are usually fun
- focus and focus
- , sensitivity to sounds, smells, and other things that others may not notice
- an inability to go to work or school, which may result in insufficient performance
In severe cases, the individual may think about ending their life and may react to these thoughts.
If you know someone who is at imminent risk of self-harm, suicide, or harm, another person:
- Ask the tough question: “Are you considering suicide?
- Listen to the person without judgement.
- Call 911 or the local emergency number, or send TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove weapons, medicines, or other potentially harmful objects.
If you or someone you know is having suicidal thoughts, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 and then 988.
Click here for more links and local resources.
Is it bipolar disorder or depression? Find out more.
If a “high” or “low” episode is very intense, the person may develop psychosis. They might have difficulty distinguishing between fantasy and reality.
According to the International Bipolar Foundation, symptoms of psychosis during a high include hallucinations, which involve hearing or seeing things that aren’t there, and delusions, which involve false but strongly felt beliefs. A person who experiences delusions may believe they are famous, have high-level social connections, or have special powers.
During a depressive or “low” episode, they may believe they have committed a crime or that they are ruined and penniless.
It is possible to treat all of these symptoms with appropriate treatment.
Bipolar disorder can also impair memory. Find out more here.
Types of bipolar disorder
A person can get a diagnosis of one of three major types of bipolar disorder. According to NAMI, symptoms occur on a spectrum, and the distinction between types isn’t always clear.
Bipolar I disorder
To diagnose bipolar I disorder:
- The person must have experienced at least one manic episode.
- The person may have had a severe depressive episode before.
- The doctor must rule out other disorders, such as schizophrenia and delusions.
Bipolar II disorder
Bipolar II disorder involves periods of hypomania, but depression is often the dominant condition.
For a diagnosis of bipolar II disorder, a person must have had:
- one or more episodes of depression
- at least one hypomanic episode
- no other diagnosis to explain mood swings
A person with hypomania may feel good and function well, but their mood will not be stable; and there is a risk of depression following.
People sometimes think of bipolar II disorder as a milder version. For many, however, it is simply different. As NAMI shows, people with bipolar II disorder can have episodes of depression more often than people with bipolar I disorder.
The National Health Service (NHS) in the UK notes that cyclothymia has characteristics similar to bipolar disorder, but the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) classifies them separately. It includes hypomania and depression, but the changes are less intense.
Still, cyclothymia can interfere with a person’s daily life, and a doctor can offer treatment.
Learn more about bipolar spectrum.
A doctor will diagnose bipolar disorder based on the criteria set out in the DSM-5.
The National Institute of Mental Health (NIMH) explains that a person must have had symptoms for at least 7 days to get a diagnosis of bipolar I disorder, or less if symptoms occur were severe enough to be hospitalized. They may also have had a depressive episode that lasted at least 2 weeks.
To obtain a diagnosis of bipolar II, a person has experienced at least one cycle of hypomania and depression.
A doctor may do a physical exam and some diagnostic tests, including blood and urine tests, to rule out other causes.
It can be difficult for a doctor to diagnose bipolar disorder because people are more likely to seek help when they are in a bad mood than when they are in a good mood. As a result, it may be difficult for them to differentiate it from depression.
If the person has psychosis, a doctor may misdiagnose their condition as schizophrenia.
Other complications that can arise with bipolar disorder include:
- Using drugs or alcohol to manage symptoms
- Post Traumatic Stress Disorder (PTSD)
- anxiety disorder
- attention deficit hyperactivity disorder (ADHD)
NIMH urges healthcare providers to look for signs of mania in their anamnesis to prevent misdiagnosis. Some antidepressants can trigger mania in susceptible people.
A person who is diagnosed with bipolar disorder has a life-long diagnosis. They can enjoy long periods of stability, but they will always live with the disease.
Learn more about bipolar disorder versus schizophrenia here.
The treatment is aimed at stabilizing the person’s mood and reducing the severity of symptoms. The aim is to help the person function effectively in daily life.
Treatment includes a combination of therapies, including:
- Medication advice
- physical intervention
- lifestyle products
It may take some time before a correct diagnosis is made and appropriate treatment is found as individuals respond differently and symptoms vary widely.
Treating bipolar disorder during the COVID-19 pandemic can be a challenge. Here are a few tips on how to deal with it.
Drug treatments can help stabilize mood and symptoms A doctor often prescribes a combination of:
- mood stabilizers such as lithium antidepressants,
- Second generation (SGAs)
- Anticonvulsants to relieve maniac medications
- sleep or anxiety
The doctor may need to adjust the medication over time. Some medications have side effects and can affect people differently. If a person has concerns about their medication treatment, they should talk to their doctor.
A person must:
- Tell the doctor about all other medications she uses to reduce the risk of interactions and side effects
- Follow doctor’s instructions regarding medications and treatment
- Discuss concerns about side effects and if she thinks the treatment
- You keep taking medication unless the doctor says it is safe to stop it
- . Remember that the action of the drugs may take some time
. If the person stops their treatment, they may
Psychotherapy and counseling
Psychotherapy can help alleviate symptoms and equip a person to treat bipolar disorder.
Through cognitive behavioral therapy (CBT) and other approaches, individuals can learn to identify important triggers such as stress
- identify and take action to overcome them,
- to identify early symptoms of an episode and take steps to deal with them.
- on factors that help maintain a stable mood for as long as possible
- Enlist the help of family members, teachers, and colleagues
These steps can help a person maintain positive relationships at home and at work. For children and adolescents with bipolar disorder, a doctor may recommend family therapy.
Learn more about treatments for bipolar depression.
Some people may need to spend time in hospital if they are at risk of harming themselves or others.
If other treatments have not helped, a doctor may prescribe electroconvulsive therapy (ECT).
Some lifestyle choices can help maintain a stable mood and manage symptoms. This includes:
- Maintaining a regular routine
- after a healthy and varied diet
- Establishing a regular sleep pattern and taking steps to prevent sleep disorders
- , regular exercise
Some people use supplements, but it’s important to do this with a doctor first. Some alternative remedies may interact with the medications used for bipolar disorder. They may make symptoms worse.
Here are a few tips for caring for a parent with bipolar disorder.
Bipolar disorder appears to be due to a combination of factors.
Genetic factors: Bipolar disorder is more common among people who have a family member with the condition. A number of genetic traits may be involved.
Biological characteristics: Research suggests that imbalances in neurotransmitters or hormones that affect the brain may play a role.
Environmental factors: Life events such as abuse, psychological stress, a “significant loss,” or another traumatic event can trigger a first episode in a susceptible person.
Bipolar disorder is a relatively common but serious mental illness that involves changes in mood, energy levels, and attention, among other symptoms.
It can seriously disrupt a person’s life, but treatment can drastically improve the outlook.
Treatment may not completely eliminate mood swings, but working closely with a doctor can make symptoms more manageable and maximize quality of life.
Read the article in Spanish.