Many of us experience mood swings. They are the highs and lows that cause us to feel happy one moment and alternately sad the next. However, for a person with bipolar disorder, these mood changes are more than just daily fluctuations in disposition. They can last for weeks and range from extreme periods of energy and grandiose thinking to lethargy and self-doubt. Some people enjoy a “creative edge” during periods of hypomania, but the more frightening symptoms of bipolar disorder are reckless behavior, the inability to function, and even suicide.
Also known as manic-depressive disorder, bipolar disorder is a diagnosis given to a category of mood disorders that influence mood and affects about 6.1 million adults each year (National Institute of Mental Health). Although children and adolescents can show signs of bipolar disorder, it usually emerges in the late teens or the early twenties and can go undiagnosed for many years. Without treatment, it can be incapacitating. However, bipolar disorder is manageable, and the best course of treatment is a regimen of medication and therapy.
Bipolar disorder is often inherited, but a definitive etiology has not yet been elucidated. Some people have been known to develop bipolar disorder after a head injury. It has also been linked to thyroid disease. Regardless of the cause, the symptoms are often difficult for others to understand.
It is important to note that people who have bipolar disorder have no control over the extreme shifts in mood that they experience. They can experience many dramatic shifts in mood from severe depression to complete mania, as well as milder symptoms of both extremes. People who are going through a milder manic phase (hypomania) often report an ability to be more creative and full of ideas, but are often easily frustrated or irritable. They are spontaneous and can be overly-productive. However, as the symptoms increases, the ideas can come too quickly to keep up with and they can become agitated and enraged. They may also experience little need to sleep and may feel indestructible. A manic phase will last a week or more and co-exist with at least three other symptoms of mania.
Following a manic phase, many people with bipolar disorder will lapse into a depression. It can be so disabling and pervasive that they may refuse to get out of bed. Friends, loved ones, and co-workers are often confused by this shift in behavior because it is so dramatically different from their earlier elevated state.
Drug and alcohol misuse are often present in people with bipolar disorder. They often abuse drugs to self-medicate or increase euphoric symptoms. It becomes a repetitive cycle because substance misuse can also worsen the symptoms of bipolar disorder. In instances where drug or alcohol disorders are present, also known as dual diagnosis, it’s important to treat both diagnoses concurrently in an integrated setting.
Bipolar I Disorder is what people usually refer to when talking about manic depression. They will experience the extreme highs along with the lows and may suffer from hallucinations and/or delusions, as well. However, people diagnosed with Bipolar II Disorder suffer more depression and do not experience the extreme highs in their mood. Instead, they experience what is called “hypomania,” which is a milder form of mania without the psychotic features.
Signs and Symptoms of a Manic or Hypomanic Episode
Here is a list of some of the symptoms of Bipolar Disorder:
- Increased energy
- Pressured speech
- Poor judgment/insight
- Increased/decreased sex drive
- Provocative behavior
- Grandiose thinking or delusions
- Inappropriate humor
- Extreme irritability
- Disjointed thinking
- Rapid talking
- Racing thoughts
- Extravagant spending sprees
- Poor concentration
- Increased use of drugs and alcohol
- Lessened need for sleep
- Creative thinking
- Anxiety symptoms
- Flight of ideas
- Reckless behavior
Signs and Symptoms of a Depressive Episode
- Feeling worthless
- Daily fatigue
- Sleeping too much
- Physical pain
- Memory problems
- Diminished pleasure
- Inappropriate guilt
- Appetite change
- Weight loss/gain
- Thoughts of death/suicide
- Suicide attempts
(Because these symptoms in and of themselves do not always indicate the presence of bipolar disorder, please contact your physician or mental health treatment provider to obtain an accurate diagnosis.)
Treatment for Bipolar Disorder
Bipolar disorder can be successfully managed but must be individualized based on the causes and symptoms. Bipolar disorder is treated with a combination of two or more of the following treatments:
- Cognitive Therapy to change unproductive thinking patterns by sorting out unrealistic thoughts
- Medication Therapy to achieve mood regulation with prevention or amelioration of mood episodes.
- Family Therapy to help families understand and deal with stressors associated with bipolar disorder
- Psychoeducation to help clients and family members learn about the disease and recognize the signs and symptoms of a manic or depressive episode so that intervention can be sought
- Interpersonal Therapy to improve interpersonal relationships and regulate daily routines, including sleep schedules
If you suspect that you or a loved one may have bipolar disorder, please contact a professional mental health provider for diagnosis and treatment.