Bipolar Disorder

Overview

Bipolar disorder is characterized by extreme changes in mood, energy and sleep. People with bipolar disorder experience distinct and persistent periods of manic, hypomanic or depressed moods. While everyone experiences some ups and downs, extreme mood shifts in bipolar disorder are more severe and may result in serious negative consequences. Rapid mood changes are not necessarily a sign of bipolar disorder. People with bipolar disorder often stay in extended periods of extreme mood, and those extreme times can be interspersed by periods with few symptoms and full functionality. About 0.6% of American adults suffer from bipolar disorder I and 0.8% of suffer from bipolar disorder II in a given year.

Types of bipolar disorders

  • Bipolar I Disorder – Experience at least one manic episode
  • Bipolar II Disorder – Experience at least one hypomanic episode and major depressive episode
  • Cyclothymic Disorder – Experience some symptoms of hypomanic and major depressive episodes for at least two years without meeting their criteria. No symptom free periods for more than 2 consecutive months.
  • Other types of bipolar disorders – These include types related to medical conditions and substance use.

Symptoms

Mania and hypomania share the same symptoms but differ in duration and severity. They are characterized by an elevated mood, increased energy and excessive optimism. People in these episodes may be excessively cheerful and feel “on top of the world.” Some people experience increased irritability, instead. Poor judgment often is a part of manic or hypomanic episodes, and may result in risky or impulsive behaviors, like spending sprees, sexual promiscuity, reckless driving, and more.

Mania lasts for one week or more and causes marked impairment in daily functions. Hypomania lasts for at least four days and may not cause significant impairment. Common symptoms include:

  • Abnormally elevated mood, energy or irritability
  • Unrealistically elevated self-esteem
  • Decreased need for sleep
  • More talkative than usual
  • Racing thoughts
  • Distractibility
  • Excessive planning and participation in multiple activities
  • Excessive risk taking or impulsivity

Major depressive episodes are characterized by depressed moods or loss of interest or pleasure. Common symptoms include:

  • Depressed mood, most of the day, nearly every day
  • Loss of interest or pleasure in almost all activities
  • Significant changes in weight
  • Sleep problems
  • Restlessness or slowing down (severe enough to be noticed by others)
  • Fatigue or loss of energy
  • Feeling worthless or excessively guilty
  • Difficulty concentrating or thinking
  • Suicidal thoughts

Treatment

Bipolar disorder cannot be cured, but can be managed with treatment, consisting of medications and talk therapy (psychotherapy). It is important individuals consistently take medications as prescribed and do not discontinue them without consulting with the prescribing physician even when their mood has improved. Establishing a regular daily routine, especially with sleep, may be helpful to regulate mood. Keeping track of your mood, sleep and other symptoms may provide helpful data in your treatment.

Medications:

  • Mood stabilizers
  • Atypical antipsychotics
  • Antidepressants

Therapy:

  • Psychotherapy https://www.div12.org/diagnosis/bipolar-disorder/
  • Cognitive therapy includes education about the disorder, importance of medications and coping strategies. It may also address ways to manage negative or overly positive thoughts.
  • Family focused therapy involves an entire family. It teaches how to manage the disorder together by educating about early warning signs and coping strategies.
  • Interpersonal and social rhythm therapy helps people implement regular daily routines and sleep schedules. It also focuses on coping with the impact of bipolar disorder and managing interpersonal problems caused by the disorder.
  • Psychoeducation provides information on the biological aspects of bipolar disorder and helps people take medications as prescribed. It also teaches people to recognize early signs for episodes and identify triggers for risk management and early intervention.

Reference: DSM-5: Diagnostic and statistical manual of mental disorders, fifth edition. By American Psychiatric Association (2013)

Resources

With treatment, many people are able to function well and be successful. If you or someone you know are experiencing serious suicide thoughts, it is important to seek help immediately. If you notice someone is in a manic episode, it is as important that you quickly get help for the individual because they may engage in serious risky behaviors. CAPS and the Student Health Center can provide confidential treatment and consultation for bipolar disorders. Below are other valuable resources.

Online:

WorkBook

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