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What is Bipolar Disorder?
An estimated “4.4% of U.S. adults experience bipolar disorder at some time in their lives,” according to the National Institutes of Health (NIH). Bipolar disorder, formerly referred to as manic depression, is a mental disorder where people experience extreme mood swings. Most people with bipolar experience extremely high highs (known as mania or hypomania) and extremely low lows (known as severe depression). It can impact not only a person’s mood but also their “energy, activity levels, and concentration.”
Depression in Bipolar Disorder
Depression, whether it is a byproduct of bipolar disorder or not, often results in a loss of interest in daily activities or tasks that would otherwise be possible to accomplish. During the depression phase, you may experience:
- Worry or emptiness
- Low energy
- Loss of joy
- Oversleeping or insomnia
- Overeating or under-eating
- Muddy focus
- Indecisiveness
- Suicidal ideation or a fixation on death
Mania and Hypomania in Bipolar Disorder
Hypomania typically lasts a few days to a week. Because it is less intense than mania, most people can carry on with their daily tasks. It is usually clear to other people that there are shifts in moods and behaviors when someone is hypomanic, however.
Mania is a severely heightened sense of self and a reduction of inhibitions that can prove dangerous. It typically negatively impacts a person’s day-to-day life and often results in hospitalization. Mania typically lasts for a week or more, although it differs for everyone. During hypomania and mania, one might experience the following symptoms:
Feelings:
- Euphoria
- Highly excitable
- Irritable
- Hypersexual
- Short attention span
- Overconfidence
Behaviors:
- Hyperactivity
- Speedy speech
- Overly social, abnormally social
- Insomnia
- Excessive spending
- A loss of inhibition
Types of Bipolar Disorder
Something you might not know is that bipolar disorder is uniquely personal, where no two people have the exact same symptoms or experiences. Although most people have heard of Bipolar I and Bipolar II, there are actually a few types, including:
- Bipolar I: This type of bipolar disorder is identified based on episodes of heightened mania, as compared to a less severe version known as hypomania.
- Bipolar II: People with bipolar II will experience episodes of extreme depression and episodes of hypomania (a less intense form of mania).
- Cyclothymic disorder: This is a rarer mood disorder under the umbrella of bipolar disorder, where people experience mood swings (ups and downs) that are considered less severe than bipolar I or bipolar II.
Though the exact cause is unknown, researchers believe several factors contribute to the “triggering” of the disorder. According to The Mayo Clinic, “these are thought to be a complex mix of physical, environmental and social factors” that include:
- Genetics: Because bipolar often runs in families, it is thought to have a genetic component though there is no “gene” for it.
- Triggers and PTSD: Including physical or sexual abuse, death, or traumatic events.
- Physical illness: Including chronic illnesses and other comorbidities.
- Sleep disturbances: Insomnia is a common side-effect, but it may also work to trigger the onset of the disorder.
- Overwhelming daily problems: Extreme worry about money, work or impersonal connections are thought to be triggers that might cause the onset of bipolar symptoms.
- Chemical imbalances in the brain: “The chemicals responsible for controlling the brain's functions are called neurotransmitters, and include noradrenaline, serotonin and dopamine but if there’s an imbalance in the levels of 1 or more neurotransmitters, a person may develop some symptoms of bipolar disorder,” according to The Mayo Clinic.
Treatments
Bipolar disorder, no matter the type, is most typically treated with a combination of medications and psychotherapy. Most people take multiple medications, including a mood stabilizer and an antipsychotic or antidepressant. Treatment may also include education or support groups. Without a clear treatment regimen, people with bipolar disorder often have trouble functioning in society. Getting the help you need with this disorder is critical.
It is critical to always discuss your condition specifics with your care team before exploring medication. Common medications prescribed are:
- Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
- Divalproex sodium (Depakote)
- Lamotrigine (Lamictal)
- Lithium
- Valproic acid
- Haloperidol (Haldol)
- Loxapine (Loxitane) or loxapine inhaled (Adasuve)
Doctors may prescribe newer antipsychotic drugs, including
- Aripiprazole (Abilify)
- Asenapine (Saphris)
- Cariprazine (Vraylar)
- Lumateperone (Caplyta)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Olanzapine/samidorphan (Lybalvi)
- Quetiapine fumarate (Seroquel)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
How to Cope
The Substance Abuse and Mental Health Services Administration recommends the following to cope with bipolar disorder alongside talk therapy and a strict medication regimen:
- Create a sleep routine. Insomnia and sleeping issues are a common side effect of bipolar disorder and a lack of sleep can worsen symptoms. By creating some sleep hygiene and sticking to a bedtime routine, you can better guarantee you get the rest you need to deal with this disorder on a regular basis.
- Eat a healthy diet and exercise. There is no downside to treating your body and mind with respect. A 2021 study suggested that “increasing your intake of omega-3s could help stabilize mood and energy levels. This can make managing symptoms of bipolar disorder easier.”
- Take your medication on a regular and consistent schedule. Not taking your medication regularly is a common side effect of people with bipolar disorder but if you do not take your medication, it simply will not work!
- Keep a journal. Helping to understand your moods, whether they are highs or lows, can result in pattern tracking that will help you better anticipate your needs and expectations for your upcoming moods.
- Practice mindfulness. This can help to balance your brain and combat extreme mood swings.
- Avoid mind-and-mood-altering substances. Alcohol and other drugs worsen symptoms of both mania and depression. Avoid them when possible.
Bottom Line for Living with Bipolar Disorder
Living with bipolar disorder may take some time to accept as it is not an easy disorder. Many factors impact an individual’s ability to cope with the disorder including “the severity of the illness, level of self-awareness, one's attitude about mental illness, availability of a support system, and access to quality health care.”
If you need mental health support, please contact a professional to find the right treatment for you. In the meantime, join the PatientsLikeMe.com Mental Health and Behavior forum to find community with other individuals living and coping with this mental disorder.
