What is Bipolar Disorder?

Let’s talk about Bipolar Disorder. Bipolar Disorder, previously called manic-depressive disorder, is a mood disorder. Bipolar Disorder is one of the most commonly misrepresented disorders in the media and the general public. Bipolar Disorder a mood disorder characterized by two opposing types of mood symptoms; hence the name “bi-“ meaning ‘two,’ and “polar,” meaning ‘opposites.’

Bipolar Disorder is not changing your mind quickly, being indecisive, or going from happy to sad in a matter of minutes.

There are actually two types of Bipolar Disorder: Bipolar I Disorder, and Bipolar II Disorder (abbreviated BPD1 & BPD2). Because of the differing mood symptoms, I’ve listed the criteria for specific episodes before going into detail about both types.

Major Depressive Episode

You feel 5 of the following things for at least 2 weeks (must have #1 or #2):

  1. Depressed mood
  2. Loss of interest in previously enjoyable activities
  3. Losing or gaining 5% body weight in a month OR increased/decreased appetite
  4. Either can’t sleep or can’t seem to stop sleeping
  5. Unconscious shaking/trembling or reduced movement
  6. Fatigue or loss of energy almost every day
  7. Feeling worthless or having inappropriate/excessive guilt
  8. Decreased ability to think or concentrate
  9. Ongoing thoughts of death

If you or someone you know is experiencing thoughts of suicide, please contact your local emergency service providers, 911, or call a national hotline such as the National Suicide Prevention Hotline at (800) 273-8255.

In addition, your depressive symptoms cannot be the result of another condition or a substance. Finally, your depressive symptoms have to cause a “clinically significant impairment” (make a noticeable impact) in at least one area of your life, such as school/work/relationships.
 

Manic Episode

You feel 3 of the following things for at least 1 week:

  1. Inflated self-esteem or feeling more important/impressive (think narcissistic)
  2. Decreased need for sleep (feeling good after 3 hours of sleep)
  3. More talkative or feeling pressured to keep talking
  4. Racing thoughts or flight of ideas (think tornado in your brain)
  5. Easily distracted
  6. Increased energy (like shaking/trembling or writing a novel in a night)
  7. Taking much larger risks (such as spending a lot of money, engaging in risky sexual behaviors, etc.)

With manic episodes, you may experience psychotic symptoms, such as hallucinations or delusions.
Your manic symptoms cannot be the result of another disorder or a substance. In addition, your symptoms must be severe enough to cause a noticeable impact in your daily life.
 

Hypomanic Episode

You feel 3 of the following things for at least 1 week:

  1. Inflated self-esteem or feeling more important/impressive (think narcissistic)
  2. Decreased need for sleep (feeling good after 3 hours of sleep)
  3. More talkative or feeling pressured to keep talking
  4. Racing thoughts or flight of ideas (think tornado in your brain)
  5. Easily distracted
  6. Increased energy (like shaking/trembling or writing a novel in a night)
  7. Taking much larger risks (such as spending a lot of money, engaging in risky sexual behaviors, etc.)

If you experience psychotic symptoms, you are experiencing a manic episode, not a hypomanic episode.
Your hypomanic symptoms cannot be the result of another disorder or a substance. In addition, your symptoms cannot be severe enough to cause a noticeable impact in your daily life.
 
 

Bipolar I Disorder

Bipolar I Disorder requires that you have at least one major depressive episode and one manic episode.
To be diagnosed with Bipolar I Disorder, you only need to have a history of one manic episode. You can experience depressive episodes at every other point in your life and still have Bipolar I Disorder.
Bipolar can also have mixed episodes, where you have symptoms of both depression and mania at the same time. For example, you could feel hopeless and depressed, and still have an excessive amount of energy and take large risks.
 
 

Bipolar II Disorder

Bipolar II Disorder requires that you have had at least one major depressive episode, have never had a manic episode, and had at least one hypomanic episode.
 

Common Misconception: People with Bipolar Disorder do not have Bipolar Disorder AND depression; depression is a part of Bipolar Disorder.

 

Cyclothymic Disorder

Cyclothymic Disorder is sort of like low volume Bipolar Disorder. Cyclothymic Disorder, previously called cyclothymia, states that you have depressive symptoms but don’t meet criteria for a major depressive episode, and that you have hypomanic symptoms but don’t meet the criteria for a hypomanic episode.
This pattern must continue for 2 years before it can be diagnosed.
 

Cause

Bipolar, like almost every other mental illness, has no known cause. Similar to schizophrenia, Bipolar Disorder has a high genetic factor: you are ten times more likely to have Bipolar Disorder if you have an adult relative with Bipolar I or II.
 

Time

People with BPD aren’t symptomatic 100% of the time. Some people have very infrequent mood symptoms at all. Some people have many more depressive episodes than manic episodes. Some people have only had one manic episode. It varies dramatically by person.
People with BPD rarely, if ever, go directly from one mood episode to another (manic to depressed or visa versa).
It’s not very predictable.
Most of the time, people are not diagnosed until adulthood because adolescents have a wide range of what is “developmentally appropriate.” This is not to say you cannot be diagnosed before age 18 only that adolescents should be compared to their individual baseline.
 

Treatment

People with Bipolar Disorder are often prescribed two types of medications: antidepressants and mood stabilizers. In some instances, an atypical antipsychotic is prescribed to help manage manic symptoms.
In additional to medications, it can be helpful to be engaged in therapy and support groups. Of all the disorders I have worked with, people with Bipolar Disorder report benefitting the most from support groups.
Exercising and eating well can be a helpful addition.
As always, having a strong, positive support system will make a big difference in your recovery.
 

Facts

  • ~2.6% of U.S. adults have bipolar disorder.
  • The average age of onset for symptoms is 25.
  • 83% of cases of Bipolar Disorder are classified as “severe.”
  • People with bipolar disorder are more likely to seek help for/during depressive episodes.
  • 60% of people with Bipolar II Disorder have more than one (“co-occurring”) disorder.
    • 75% have an anxiety disorder
    • 37% have a substance abuse disorder
  • ~0.4-1% of U.S. adults struggle with Cyclothymic Disorder.
  • Mania is typically misrepresented as a euphoric feeling, when in reality it is most often expressed as irritability.
  • Women are slightly more likely to be diagnosed with Bipolar Disorder than men.
  • Men and women are equally likely to be diagnosed with Cyclothymic Disorder.
  • People with Bipolar Disorder are 15 times more likely to attempt suicide.
  • People with Bipolar Disorder may account for up to 25% of suicides each year.
  • Untreated mental health disorders can result in substance abuse.

What to Know About Bipolar Disorder: Bipolar Disorder Facts

Where did you first learn about bipolar disorder? Was it accurate?

4 thoughts on “What is Bipolar Disorder?

  1. Bipolar is a disease (much like cancer) that I would not wish on anyone. It hurts everyone involved. You are blessed if you have that supportive network as often times you are left alone because it’s very difficult to live with someone with this disorder.
    Describing it as euphoric might sound awesome to someone who doesn’t experience it, but it’s only ‘euphoric-like’ because you’ve finally escaped the depression.
    I am very grateful for those who support those with this mood disorder as I know it is very difficult to ride this roller coaster.

    1. Sara, thank you for your comment. You make excellent points. Mental illnesses are the same as physical illnesses, only invisible. This is definitely something that is often overlooked.
      And you make a very strong argument for why having a support system is crucial. People with various mental illnesses often feel isolated or alone.

  2. This is a great write up! I really appreciate how thorough and clear this is. There are so many misconceptions about bipolar. While I do not suffer from it I know people who do, and at one point I almost thought I did until I learned what bipolar really was, we should all be more informed!

    1. Thanks, Allyson! One of my primary goals with this blog is to provide accurate and easy to understand mental health information. I’m glad it was helpful and clear!

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