Bipolar Disorder

All people have mood swings from time to time. A person who has bipolar disorder will experience periods of extreme highs and lows in their moods. Bipolar disorder is classified as a mental illness and the disorder is rare in children and not very common in teens. Typically, the age of onset is around 25. Both men and women can get bipolar disorder and 2.8% of people in the U.S. are diagnosed with bipolar disorder. Bipolar disorder needs to be treated since about 83% of diagnosed cases of bipolar disorder are severe at the time of diagnosis and when left untreated almost always gets worse.

The symptoms of bipolar disorder can be more or less severe and sometimes a person can go years without symptoms. Some people have distinct depressed and manic states and others experience mania and depression in rapid sequence or at the same time. For a doctor to diagnose someone with bipolar disorder they must have experienced at least one episode of mania or hypomania, a mild manic episode without hallucinations or delusions.

Severe manic or depressive episodes can include psychotic symptoms like delusions or hallucinations.

• Hypomania, a milder mania without psychotic symptoms, that may cause a person to function well in social or work situations
• Rare or frequent mania or hypomania
• The high mood does not stop at a comfortable or controllable level
• High moods will turn irritable, with unpredictable behavior, and impaired judgment
• Impulsivity, reckless decisions, and taking unusual risks
• Unaware of the negative consequences of their actions
• Learning the “red flags” of their manic behavior is helpful
• Suicidal

• Debilitating depression
• Unable to get out of bed Difficulty falling or staying asleep
• Sleep more than usual
• Difficulty with minor decisions
• Unable to function nearly every day over two weeks
• Obsessed with feelings of loss, guilt, helplessness, or personal failure
• Negative thinking may lead to thoughts of suicide

With bipolar disorder, suicide is an ever-present danger. A person with bipolar disorder may feel suicidal both during manic and depressive episodes. If you or a loved one is experiencing thoughts of suicide, call 911 or go to the emergency room, or call or text NAMI. You can also call the NAMI Helpline at 800-950-NAMI or text NAMI to 741741.

While we don’t know exactly what causes bipolar disorder, certain factors seem to influence it. If a child’s from a family with a history of bipolar disorder is more likely to have it, but may also not. A stressful situation like a divorce, illness, the death of a loved one, financial problems, or a difficult relationship can trigger a manic or depressive episode, and the way a person handles stress after this event may affect whether or not they develop bipolar disorder.

There are four types of bipolar disorder, and to diagnose them, a doctor will usually do a physical examination and lab tests to rule out other illnesses like hypothyroidism, and then do an interview to look at the pattern of symptoms and severity of episodes.

• One or more episodes of mania
• Usually both manic and depressive episodes
• Manic disorders last seven days or require hospitalization

• Shifting between hypomanic and depressive episodes
• Never a full manic episode

• Chronically unstable mood
• Hypomania and mild depression for two years
• Brief periods (less than eight weeks) of normal mood

• Doesn’t meet criteria for the others
• Clinically significant abnormal mood elevation

Bipolar disorder must be treated. Usually by a combination of medications (antipsychotics, mood stabilizers, or antidepressants), psychotherapy (family therapy or cognitive-behavioral therapy (CBT), other measures like aerobic exercise, faith, prayer, or self-management strategies like being educated about the disorder and able to recognize the early symptoms of an episode.

A person with bipolar disorder sometimes also suffer from posttraumatic stress syndrome (PTSD), attention-deficit hyperactivity disorder (ADHD), substance abuse disorders/dual diagnosis, or anxiety. A person with bipolar disorder can be misdiagnosed with schizophrenia or borderline personality disorder (BPD) before getting a correct diagnosis.

It is sometimes challenging to treat bipolar disorder if the person also suffers from mental disorders with a treatment that has adverse effects on bipolar disorder, like with ADHD, where the stimulants used to treat it can trigger a manic episode or make the symptoms of bipolar disorder worse.

If you think you or a loved one might have bipolar disorder, talk to your doctor about a treatment plan that will work for your specific symptoms or other disorders. People with bipolar disorder who have a good treatment plan including psychotherapy, medications, early identification of symptoms, a healthy lifestyle, and a regular schedule can lead happy and successful lives.