What is Bipolar?
Bipolar disorder is a treatable illness marked by extreme changes in mood, thought, energy, and behavior. Bipolar disorder is also known as manic depression because a person’s mood can alternate between the “poles”—mania (highs) and depression (lows). The change in mood can last for hours, days, weeks, or months.
Who does it affect?
It usually begins in late adolescence, often appearing as depression during teen years, although it can start in early childhood or later in life.
An equal number of men and women develop this illness. Men tend to begin with a manic episode, women with a depressive episode. Bipolar disorder is found among all ages, races, ethnic groups, and social classes.
The illness tends to run in families and appears to have a genetic link. Like depression and other serious illnesses, bipolar disorder can also negatively affect spouses, partners, family members, friends, and co-workers.
Types of Bipolar Disorders
Different types of bipolar disorder are determined by patterns and severity of symptoms of highs and lows.
Bipolar I disorder
Bipolar I disorder is characterized by one or more manic episodes that last at least a week or require hospitalization. Episodes of depression and hypomania may also occur, along with mixed states (when symptoms of depression and mania or hypomania are present together). Behavior during mania can lead to severe financial, family and social disruption.
Bipolar II disorder
Bipolar I disorder is characterized by one or more depressive episodes accompanied by at least one hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes but are less extreme and don’t last as long. However, the person’s behavior is clearly different from the norm to observers.
Cyclothymic disorder is characterized by chronic mood fluctuations that do not reach the level of a full manic or depressive episode. However, symptoms cause significant distress in personal relationships, work or school, and other areas of life when they occur. Although symptoms are relatively mild compared to Bipolar I or Bipolar II, they recur within two months each time. People with cyclothymic disorder may go on to develop a more extreme form of bipolar illness.
Symptoms of bipolar disorder
Most people who have bipolar disorder talk about experiencing “highs” and “lows.” These swings can be severe, ranging from extreme energy to deep despair. The severity of the mood swings and the way they disrupt normal life activities distinguish bipolar mood episodes from ordinary mood changes.
Symptoms of mania
• Increased physical and mental activity and energy
• Heightened mood, exaggerated optimism, and self-confidence
• Excessive irritability, aggressive behavior
• Decreased need for sleep without experiencing fatigue
• Racing speech, thoughts, and flight of ideas
• Increased sexual drive
• Reckless behavior
Symptoms of depression
• Prolonged sadness or unexplained crying spells
• Significant changes in appetite and sleep patterns
• Irritability, anger, worry, agitation, anxiety
• Pessimism, loss of energy, persistent lethargy
• Feelings of guilt and worthlessness
• Inability to concentrate, indecisiveness
• Recurring thoughts of death and suicide
To determine if you have bipolar disorder, your evaluation may include:
- Physical exam. Your doctor may do a physical exam and lab tests to identify any medical problems that could be causing your symptoms.
- Psychiatric assessment. Your doctor may refer you to a psychiatrist, who will talk to you about your thoughts, feelings and behavior patterns. You may also fill out a psychological self-assessment or questionnaire. With your permission, family members or close friends may be asked to provide information about your symptoms.
- Mood charting. You may be asked to keep a daily record of your moods, sleep patterns or other factors that could help with diagnosis and finding the right treatment.
- Criteria for bipolar disorder. Your psychiatrist may compare your symptoms with the criteria for bipolar and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Diagnosis in children
Although diagnosis of children and teenagers with bipolar disorder includes the same criteria that are used for adults, symptoms in children and teens often have different patterns and may not fit neatly into the diagnostic categories.
Also, children who have bipolar disorder are frequently also diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems, which can make diagnosis more complicated. Referral to a child psychiatrist with experience in bipolar disorder is recommended.
Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse.
Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms. Depending on your needs, treatment may include:
- Medications. Often, you’ll need to start taking medications to balance your moods right away.
- Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.
- Day treatment programs. Your doctor may recommend a day treatment program. These programs provide the support and counseling you need while you get symptoms under control.
- Substance abuse treatment. If you have problems with alcohol or drugs, you’ll also need substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder.
- Hospitalization. Your doctor may recommend hospitalization if you’re behaving dangerously, you feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you’re having a manic or major depressive episode.
The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also may include education and support groups.
You Are Not Alone
The following famous people have suffered from Dipolar Disorder
- Demi Lovato – Singer Demi Lovato was diagnosed with bipolar disorder when she entered rehab at age 22. Before her diagnosis she had struggled with bulimia, drug addiction and cutting. She has chosen to use her fame to help eliminate the stigma and advocate for treatment, taking part in a campaign called “Be Vocal: Speak Up for Mental Health” in 2015.
- Mariah Carey – Mariah Carey says she was first diagnosed with bipolar disorder in 2001. She went public with her diagnosis in April 2018 in an interview with People magazine, saying that she now feels she is in a good place managing her mental health.
- Jean-Claude Van Damme – Jean-Claude Van Damme, star of “Bloodsport” and “Timecop,” had four failed marriages, suffered from cocaine addiction, was arrested for drunk driving and was charged at one time with spousal abuse. He was eventually diagnosed with rapid-cycling bipolar disorder after hitting bottom.
- Russell Brand – British stand-up comedian and actor Russell Brand, known for his public antics and outrageous comedy, was treated for depression when he was young. He struggled with binge-eating, unusual for boys, and while still in his teens began abusing drugs and alcohol.Brand has been diagnosed with ADHD and bipolar disorder. He often references being bipolar in his performances and writing.
- Amy Winehouse – Super-talented British singer-songwriter Amy Winehouse suffered from substance abuse and bipolar disorder. She was not known to have sought treatment for her bipolar disorder. By one estimate, 30-60% of people who suffer from manic depression also have substance abuse problems. Winehouse herself linked her drinking to depression.