Bipolar disorder is a mental health condition that is characterized by bouts of mania and depression. Mania is characterized by feelings of euphoria, irritability, or energy while symptoms of depression include feeling sad, low, or worthless.
Previously known as manic depression. Here’s how you can tell if you or someone you love might have bipolar disorder, and what you can do to treat it.
What is bipolar disorder?
“Bipolar disorder is a chronic and debilitating illness,” says Pavan Madan, MD, a psychiatrist with Community Psychiatry in California. “While there is no cure for it, like for many other physical and psychiatric problems, it can be well-managed with the help of medications and support.”
There are three separate types of bipolar disorder:
- Bipolar I: People with bipolar I experience a pattern of depressive episodes and manic episodes. Their manic episodes last at least 7 days and are much more severe than other types. They may even require hospital stays.
- Bipolar II: Those with bipolar II also experience patterns of mania and depression, but their manic episodes are less severe than those seen in Bipolar I.
- Cyclothymic disorder is a mood condition where the mood swings are not as severe as those seen in people with bipolar disorder.
Signs you might have bipolar disorder
The average age of onset for bipolar disorder is 25, and it is equally prevalent across genders. While symptoms can vary, here are some of the most common signs of bipolar disorder:
You experience intense periods of depression, combined with periods of energy and excitement
Both manic episodes and depressive episodes can last anywhere from a couple of hours to several weeks. Plus, people with bipolar disorder can experience few or no symptoms between these mood episodes.
Symptoms of manic and depressive episodes
“Manic symptoms are not always as clear-cut or severe, so people are often misdiagnosed for years before they reach an accurate assessment and treatment,” Madan says.
Someone in your family also has bipolar disorder
It is believed there is a genetic component to developing bipolar disorder.
“While scientists have not figured out the exact genes responsible for passing bipolar disorder to children, genetics are considered to be a significant factor in the risk of developing it,” Madan explains.
A 2012 Journal of Psychiatry & Neuroscience found that people who have a first-degree relative (a parent, sibling, or child) with bipolar disorder have a 15% to 35% greater risk of developing the condition themselves. The likelihood increases to 75% if an individual has two first-degree relatives who have bipolar disorder.
You have another mental health condition
Bipolar disorder may also be linked to other mental health conditions. The National Institute of Mental Health links it to anxiety disorders, eating disorders, ADHD, and substance abuse disorders.
Because the exact relationship between bipolar disorder and other mental health conditions isn’t clear, it’s hard to say how likely people with certain mental health conditions are to have bipolar disorder, and vice versa. However, research does suggest that some mental health conditions can co-occur with bipolar. If you live with one of the following conditions, you may want to be on the lookout for symptoms of bipolar disorder:
- Substance abuse. A 2004 study published in the journal Bipolar Disorders evaluated 4,310 people receiving treatment for bipolar disorder at Veterans Administration (VA) facilities. Researchers found that 25% of these patients had alcohol use disorder, 10.4% abused cocaine, and 4.4% abused opiates.
- Psychosis. Research suggests that some types of psychosis — episodes where a person has trouble differentiating between what is real and what’s not — might be linked to developing bipolar disorder. A 2018 paper published in the American Journal of Psychiatry looked at 6,788 people who experienced substance-induced psychosis, which is when using alcohol or drugs triggers delusions or hallucinations. They found that 32.2% of the subjects developed either bipolar disorder or schizophrenia after their psychosis, typically within a few years’ time.
How to get a bipolar diagnosis
If you suspect that you have bipolar disorder, or you’re displaying common symptoms, Madan recommends making an appointment with your primary care physician or a psychiatrist as soon as possible.
Additionally, he says to go directly to the emergency room if you’re ever strongly considering harming yourself or another person. You can also call a free, confidential hotline like the National Suicide Prevention lifeline or the Substance Abuse and Mental Health Services Administration’s helpline.
A doctor will evaluate you for bipolar disorder by reviewing your symptoms and asking questions about your personal and family history. They may also run a few medical tests to rule out any other problems that might be causing your symptoms, including diagnostic and lab tests like blood tests, x-rays, MRI scans, and other physical scans.
Mental health conditions that have some symptoms in common with bipolar disorder include:
- Borderline Personality Disorder (BPD). Symptoms of BPD include mood swings and impulsive behavior, both of which are seen in bipolar disorder as well.
- Attention deficit hyperactivity disorder (ADHD). Symptoms of ADHD include periods of hyperactivity, which could be conflated with mania.
How to treat bipolar disorder
The ideal course of treatment for bipolar disorder will vary for each individual. One common option is medication.
“Bipolar disorder is often treated with the help of medications called mood stabilizers,” Madan says. Common mood stabilizers include:
- Lithium (Lithobid)
- Valproic acid (Depakene)
- Divalproex sodium (Depakote)
Some people may also benefit from antipsychotic medication, like olanzapine (Zyprexa) or risperidone (Risperdal), either prescribed alone or alongside a mood stabilizer. These medications can help treat manic or depressive periods that involve instances of psychosis or hallucinations.
Therapy can also be a helpful treatment option, typically in addition to medication. Cognitive behavioral therapy (CBT) can help people identify unhealthy thoughts or behaviors and replace them with healthier alternatives. A 2017 paper in PLoS One evaluated 19 trials involving 1,384 patients with bipolar disorder. The review concluded that CBT can lower relapse rate, improve depressive symptoms, lessen the severity of manic episodes, and improve day-to-day functioning and interacting with other people.
Depending on the severity of the bipolar disorder in question, people can be treated as outpatients or in a residential psychotherapy program. Madan also recommends that people with bipolar disorder try to avoid extreme stress and sleep deprivation, as these can trigger episodes.
“Regular monitoring by a mental health provider is essential to ensure ongoing stability and appropriate care,” Madan says.