
NABHS connects you with treatment options for bipolar disorders, helping you achieve balance and better adjustment in life.
Bipolar disorder, also called manic-depressive illness, is a mental health condition that affects approximately 1.7% of adult Americans in the country.
People with bipolar disorder experience intense mood swings, switching between manic (high energy and excitement) and depressive (low energy and sadness) episodes.
These episodes may significantly impact an individual’s everyday life and relationships, which can linger for days or weeks.
Types of Bipolar Disorders
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
- Substance/Medication-Induced Bipolar and Related Disorder
- Bipolar and Related Disorder Due to Another Medical Condition
Risk Factors for Bipolar Disorders
Although the actual cause of bipolar disorder is undetermined, it is thought to be a result of a confluence of genetic, biochemical, and environmental variables. There is evidence that bipolar disorder runs in families, pointing to a hereditary susceptibility. Brain imaging studies have also shown variations in the brain structure and function of people with bipolar disorder compared with healthy individuals. Environmental stressors, such as traumatic life events, can trigger symptoms in genetically predisposed people. Bipolar disorder can also be brought on by abnormalities in neurotransmitters including serotonin, norepinephrine, and dopamine.
These are somethings you should never say to someone with bipolar disorder!
Symptoms of Bipolar Disorder
Symptoms of the different episodes of Bipolar are:
Manic Episode
- A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
- During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
- More talkative than usual or pressure to keep talking.
- Flight of ideas or subjective experience that thoughts are racing.
- Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity).
- Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
Hypomanic Episode
- A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
- During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
- More talkative than usual or pressure to keep talking.
- Flight of ideas or subjective experience that thoughts are racing.
- Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
- Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
What are some of the comorbid conditions with bipolar disorders? Read more!
Major Depressive Episode
- Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day (observable by others; not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
For a diagnosis of bipolar I disorder, it is necessary to meet the criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes.
For a diagnosis of bipolar II disorder, it is necessary to meet the criteria for a current or past hypomanic episode and the criteria for a current or past major depressive episode.
Cyclothymic Disorder is more sever and the diagnostic criteria include:
- For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.
- During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.
- Criteria for a major depressive, manic, or hypomanic episode have never been met.
Know more about Cyclothymia here.
Treatment for Bipolar Disorders
Treatment methods for bipolar disorder typically include a conjunction of medication and psychotherapy.
- The most common medications used to treat bipolar disorder are mood stabilizers, such as lithium and valproic acid, and atypical antipsychotics, such as olanzapine and quetiapine. Antidepressants may also be used in combination with mood stabilizers for the treatment of depressive symptoms.
- Psychotherapy can include cognitive-behavioral therapy (CBT), which will help patients identify and change negative thought patterns and behaviors, and interpersonal and social rhythm therapy (IPSRT), which focuses on helping individuals regulate their daily routines and improve their relationships with others. Family-focused therapy, which involves family members in the treatment process, may also be equally effective and beneficial for the well-being of the patient’s overall mental health.
- In severe cases, electroconvulsive therapy (ECT) may be used. Lifestyle changes such as maintaining a healthy sleep schedule, regular exercise, and stress management techniques can also help manage symptoms. A mental healthcare professional designs treatments that are specifically tailored to each patient’s needs and situation in order to assist them to solve their problems with the utmost care.
Are you looking for bipolar disorder treatment guidelines? We, at NABHS, are here to help you with the best resources.