Bipolar Disorder And Your Life
Characterized by extreme shifts in energy, behaviors, and mood, bipolar disorder, formerly called manic-depression, is a rare disorder that affects 1 – 3% of people in the U.S.
While everyone has ups and downs in their life, bipolar disorder symptoms interfere with school, work, relationships and, oftentimes, the ability to care for yourself.
Bipolar disorder is characterized by “episodes” of manic or depressive symptoms. These moods last for at least a week and significantly disrupt daily life. During these episodes, family, friends, and colleagues may be the first to notice changes in behavior, activities, and thoughts. There is no cure for bipolar disorder, but it can be managed.
Myths Around Bipolar Disorder
You must have depression
The defining feature that differentiates bipolar disorder from depression is mania. If you have one manic or hypomanic episode, then you have bipolar disorder. If you have depression, with no mania, then you have depression. Though depression is common in the bipolar picture, you don’t have to experience a depressive episode. You can have bipolar disorder and only have manic/hypomanic episodes.
Children don’t have bipolar disorder
Bipolar disorder knows no age limits. Commonly diagnosed in the late teens to young adult age range, bipolar disorder does affect children. Their symptoms can look different from adults, but it is the same disorder.
Sometimes, bipolar disorder may begin later in life.
Mood changes with the snap of a finger
More often than not, episodes of mania or depression last for months. The changes are starkly different from the person’s normal mood. Rapid-cycling bipolar disorder, characterized by four episodes in a year, does have quicker episodes, and ultra-rapid cycling bipolar disorder can feature mood changes during the day or within hours. But, rapid-cycling is a rarer course of bipolar disorder. Most mood episodes last for months and in the case of Cyclothymia, for years.
Medication solves the problem
Medication can eliminate symptoms for some people. But for many others, symptoms may linger or push through the medication, especially when stress is high. Oftentimes, medication must be re-calibrated as tolerance grows and finding the right combinations of medication can be a long process. Medication is helpful to reduce symptoms but is not a cure or the final answer to the issues of bipolar disorder.
So, What Exactly Is Bipolar Disorder?
There are four types of bipolar disorder: Bipolar 1, Bipolar 2, Bipolar Not Otherwise Specified (NOS), and Cyclothymic Disorder.
The main difference between Bipolar 1 and Bipolar 2 is the intensity of mania. Bipolar 1 mania is far more intense and may include psychosis. Full-blown mania often leads to a mental hospital.
Bipolar 1 is the classic variant and is the stereotypical representation you may see on TV shows and movies. This person is extremely ill and unaware. Though a stereotype, this representation can be the reality for some with bipolar 1, especially during the first full-blown manic episode or if psychosis is present. The unawareness depicted in this stereotype is accurate, as well. Lack of insight, or Prosopagnosia, is a dangerous feature of all variants of bipolar disorder. Without insight, there will be no reason to seek treatment.
What Are Mania And Depression?
Mania is characterized by extreme happiness, poor judgment, and increased energy. While out-of-this-world joy sounds pleasant, mania is a very dangerous aspect of bipolar disorder and some people worry about their level of happiness. Though, others, welcome mania, because of its pleasant feelings.
Hypomania is a less intense form of mania and shares similar symptoms.
Depression is characterized by extreme sadness and apathy, slowed thoughts and movements, and intense fatigue. The will to live disappears. In many cases, depression is the most experienced mood episode.
What Are The Symptoms Of Mania And Depression?
- Extreme and prolonged bliss (may believe they can do or say whatever they’d like, may think they are invincible)
- Extreme and prolonged irritability
- Increased energy
- Insomnia (even without sleep energy levels are high, esp. in mania)
- Racing thoughts
- Difficulty focusing
- Very fast speech, characterized by hopping from one idea to another, incoherence, and inability to stop talking
- Many unfinished tasks
- Increased sexual drive that may lead to affairs or STDs
- Reckless spending that can lead to debt
- Hallucinations and delusions (characteristic of BP1)
- Impulsivity and poor judgment
- Lack of insight
- Weight loss
- Extreme productivity and creativity (in hypomania)
When a person is in a Mixed episode, they experience both mania and depression. Both of which may occur at the same time or switch rapidly with no mood in between. Mixed episodes usually occur in bipolar 1. Suicide is very high in mixed episodes and can be attempted on impulse.
- Extreme sadness, apathy, and emptiness
- Slowed thoughts and movements
- Decreased productivity and motivation
- No joy from previously enjoyed activities
- Isolating behaviors
- Too little or too much sleep
- Very low energy
- Feelings of guilt and hopelessness
- Difficulty focusing
- Psychosis when depression is severe
Let’s get into the specifics of each variant of bipolar disorder.
Bipolar 1 Disorder
For diagnosis, depression must last for two weeks. Mania must last for a week or less if hospitalization is needed.
- Severe episodes of depression (can last 6 months on average, if untreated)
- Severe episodes of mania (can last two to three months on average, if untreated)
- Mixed episodes
- Psychosis – Hallucinations
- Psychosis – Delusions
- Weight loss/gain
- Loss of the ability to care for self
- Usually has normal mood in between episodes
- Hospitalization (not a symptom, but a reality)
Bipolar 2 Disorder
- Most of the symptoms of Bipolar 1 (excluding mania, psychosis, and hospitalization)
- Severe depression (Bipolar 2 and Bipolar 1 depression is nearly the same)
- Hypomania (able to function in their daily lives, for the most part)
- Chronic course of illness, with less normal moods in between
Bipolar 2, in many ways, has a less intense course of illness than bipolar 1. But, in some ways, this is a misconception. Because people with bipolar 2 have hypomania and never reach full-blown mania, many people think that it’s a less severe disorder. But, bipolar 2 has a more chronic course with less normal mood in between. Depression tends to be the main mood episode and it is just as severe as bipolar 1. This chronic course severely affects daily life and makes it harder to achieve stability.
Due to these factors, bipolar 2 has a higher suicide rate than bipolar 1, so it’s severity in comparison to bipolar 1 is not as cut and dry as it seems.
Sometimes, hypomania can progress to mania. If this happens, your diagnosis will be changed to bipolar 1.
Cyclothymic Disorder (aka Cyclothymia)
- Low-intensity episodes of mania and depression (do not meet diagnostic criteria for either)
- Extremely chronic course (for diagnosis, episodes must last 2 years for adults and 1 year for teens and children)
Bipolar Not Otherwise Specified (NOS)
This person doesn’t fit neatly into the box of either of the other three Bipolar Disorders.
Who gets Bipolar Disorder?
Both men and women, of all ages, in equal rates. If you have a close family member, i.e. parent or sibling, who has bipolar disorder, your chance of having this disorder is more likely, but not guaranteed.
How Is Bipolar Disorder Diagnosed?
Using the Diagnostic and Statistical Manual (DSM). The current version of this book is DSM-5 and is used by trained mental health professionals to diagnose mental disorders. The DSM lists the criteria needed to qualify for diagnosis.
When Should You Get help?
Immediately. If you, your family, or anyone else, notice any of these symptoms clustered together for a period of time, go to your physician, a psychologist, or psychiatrist.
There are many treatments available for Bipolar disorder such as medication, Cognitive Behavioral Therapy (CBT) or talk therapy, and natural alternatives. Lifestyle changes (consistent sleep, good diet, and stress reduction) are another great way to reduce the frequency of episodes.
Bipolar disorder is part of you. With help, you can make it a manageable part.