Bipolar disorder is thought to be a rare condition consisting of “mood swings” but it’s much more common and complex than that. Bipolar disorder affects 60 million people worldwide and approximately 5.7 million Americans. Of these, an estimated 51% will go untreated or misdiagnosed.
Bipolar disorder, sometimes known as manic-depressive illness or manic depression, is a mental disorder that causes an unusual shift in mood, energy, activity level, concentration, judgement, or ability to perform day-to-day tasks. The “unusual” shifts refer to uncharacteristic changes in an individual lasting days or weeks. This is known as an “episode.” A manic episode is an emotional “high,” while a depressive episode is an emotional “low.”
Manic and hypomanic episodes include three or more of the following signs:
- Unusually upbeat, jumpy, or wired; increased activity, energy
- Exaggerated sense of well-being or self-confidence
- Distractibility, racing thoughts
- Decreased need for sleep
- Unusual talkativeness
- Poor decision making such as excessive shopping, risky sexual behavior, etc.
Depressive episodes include five or more of the following signs:
- Depressed mood; sad, empty, hopeless, irritable feelings
- Insomnia or sleeping too much
- Fatigue/loss of energy
- Restlessness or slowed actions
- Abrupt change in weight and/or appetite
- Decreased ability to think/concentrate
- Feelings of worthlessness or excessive guilt
- Thinking about or attempting suicide
Those with bipolar disorder may not recognize the changes in their behavior. Some may also enjoy the feelings of euphoria that accompany a manic episode, but an emotional crash will always follow. The signs described above are not normal or typical of young children, adolescents or adults, and should be taken seriously.
There are three different types of bipolar disorder diagnoses:
Bipolar I Disorder: Manic episodes lasting at least 7 days or manic episodes so severe that immediate hospitalization is required and depressive episodes lasting at least two weeks. Mixed features may be possible (manic and depressive episodes occurring simultaneously). Bipolar I disorder is the most severe.
Bipolar II Disorder: A pattern of depressive and hypomanic episodes (less severe mania) that last for longer periods but are less severe than bipolar I disorder.
Cyclothymia: Periods of hypomanic and depressive symptoms lasting at least 2 years. Symptoms are less severe than Bipolar I and II disorders and individuals are usually able to function in their daily life.
Bipolar disorder is commonly misdiagnosed, the main reason being that those with the disorder may also have a co-occurring disorder. These can include anxiety disorder, attention-deficit/hyperactivity disorder, substance use disorder, eating disorders, or other mental health disorders. A mental health professional will diagnose bipolar disorder by observing signs and symptoms, life experiences of the individual, and the family health history of the individual. A diagnosis typically occurs in late adolescence with the average age being 25, but those in their later adult years can also be diagnosed.
It’s important that those with bipolar disorder or those with undiagnosed symptoms to attain treatment. If left untreated, an individual’s manic and depressive episodes will not improve. Additionally, they may be at risk for drug and alcohol abuse, legal or financial troubles, impaired performance at work and school, difficulty maintaining relationships and suicide attempts. In fact, 30% of individuals diagnosed with bipolar disorder will attempt suicide at least once in their life. A diagnosis and ongoing treatment are vital.
Individuals with bipolar disorder are at higher risk of thyroid disease, migraine headaches, heart disease, diabetes and more. Treatment is highly individualized, especially when it comes to correct medication, often an antipsychotic and/or anti-depressant. Primary care visits are also important in ongoing treatment.
Treatment can include psychotherapy sessions (talk therapy) and medication taken consistently, regular exercise that benefits brain and heart health, sticking to daily routines, avoiding misuse of substances, as well as journaling for symptom tracking are recommended. Individuals with bipolar disorder can lead wonderfully healthy, functioning lives with the assistance of lifelong treatment.