All you know of bipolar disorder is that it used to be called manic depression. Beyond that, just what you’ve seen on TV. What’s true?
The word bipolar, thanks to the media, has become an adjective and a superlative instead of the mental health condition it is. Bipolar disorder’s brain changes cause shifts in mood, not the other way around.
Onset on average is around 25 years old, but it can certainly manifest later in life and even as early as childhood. There are two predominant types of bipolar disorder with slightly different presentations:
|Bipolar I||Characterized by unprompted good- or bad-feeling boundless energy cranked up beyond control. Each episode can last 7 days or longer. Think little sleep, fidgety, mind racing.|
Depressive episodes lasting 2 weeks or longer can happen with bipolar 1, but it’s not a definitive part of the diagnosis.
Academic, employment-related, social, or legal consequences of the mood shifts are more common with this type of condition.
|Bipolar II||It is characterized by both unprompted energy (less intense than that of bipolar 1) or agitation and depressive episodes. Each can last at least 7 days or longer.|
Behavioral changes can be noticeable to others but don’t often lead to consequences that disrupt life.
It’s a long-term condition that can be managed with therapy and medication. Those are the basic facts, but we know you may still have some lingering curiosities about bipolar disorder.
Q: Bipolar disorder means mood swings, right?
A: Not actually. That’s what’s been sensationalized by the news and entertainment industries, according to author Karla Dougherty.
There are four types of bipolar disorder, as touched on above:
Bipolar I criteria has only to include periods of mania (highs).
Bipolar II is characterized by mania and at least one depressive episode. Clinically bipolar II is described as having shifts in mood.
Cyclothymia (sigh-clo-thigh-me-uh) is a form of bipolar disorder that’s characterized by less interpersonally disruptive episodes of mania and depression, but these moods last for at least 2 years straight.
Mixed episodes include mania and depression occurring simultaneously. Think of the phrase “laugh to keep from crying” as a push-pull of emotion occurring inside of you in unexpected sessions lasting days, weeks, or months on end.
Mood swings insinuate a person with bipolar disorder is volleying back and forth like a pendulum. In reality, someone can experience a single episode for a longer period of time, followed by a period of no psychological episodes, and then perhaps the same or opposite episode — hence shifts.
Truth be told, we all have shifts in mood as a normal part of human behavior, author, researcher, and clinical psychologist and Psych Central founder John M. Grohol explains.
Q: My mom has it. Am I doomed?
Is there a test to tell me if I have, or may inherit, bipolar disorder?
A: Currently, no test can tell if a person is at risk of developing bipolar disorder, nor they’re a carrier of the genetic differences. But also know: It’s a myth that if your parent has it, you’re guaranteed to have it or pass it on.
Someone told therapist Colleen King since two of her immediate family members managed bipolar disorder, she shouldn’t have children.
As a marriage and family therapist now, she emphasizes to her patients meaningful relationships and children are possible when both partners are well informed about the condition and have a sound treatment team, period.
Also, while genetics can be one cause of bipolar disorder, there is such a thing as epigenetics. It’s the study of your gene’s lightswitch ability to turn on, or leave off, inherited differences in your DNA.
To learn more about the science behind this phenomenon, look at this article on complex trauma and epigenetics.
If you have symptoms that are often associated with this condition and want to see for yourself, you can take our bipolar quiz now.
Q: Can someone have a medical condition that appears to be bipolar disorder but actually is something else?
A: Certain conditions mimic mood disorders, including bipolar disorder. Common ones are:
- thyroid conditions
- neurological diseases, such as multiple sclerosis, brain tumors, stroke, or epilepsy
- infections of the brain from conditions such as HIV, syphilis, sleep apnea, and Lyme disease
- deficiencies of certain vitamins, such as B12
- corticosteroid use, especially in high doses
- medicine used to prevent diseases like tuberculosis and AIDS
Talking with your doctor about your medical history and the medications that you are taking can help determine the cause of your condition.
Q: What if someone I know has bipolar disorder?
A: Establish boundaries as best as you can and understand there may be inadvertent breaches from time to time.
You can’t control them, but you can manage your response to a manic episode that turns confrontational.
If the person you are close to is in a bipolar disorder depressive episode, we’ve crafted an ultimate resource in how to effectively communicate with someone in depression.
In our greater Facebook community, the question “What about your mental health condition frustrates you the most?” was asked. Among the top frustrations, commenters lament:
- Not being able to control episodes, regaining control thereafter
- Not being able to articulate the turmoil inside
- People not understanding what they’re witnessing
- People’s lack of empathy
It’s clear just as much as you may be wary of interacting with someone who manages bipolar disorder, they may be weary of explaining, apologizing, or bracing themselves against the apathy and stigma surrounding their condition.
Find out how to help someone with bipolar disorder.
Q: I’ve been diagnosed with bipolar disorder, are meds now my only hope?
A: Only, no; cornerstone, yes.
Take heart, as you age and your hormones change, your brain changes and bipolar disorder presentations may require alterations in dosages and prescriptions. Some find episodes of manic and depressive symptoms lessen in intensity or duration as they get older.
Bipolar disorder is psycho-social and neurological; it’s complex. In the same way, management of the condition is dynamic and will entail more than meds.
Learn all you can about your illness by becoming a sponge to all media discussing healthful approaches, data and tools. There are insightful blogs, books, podcasts and even social communities for folks managing bipolar disorder.
Depression and Bipolar Support Alliance is a good place to look for a support group in your area. In these groups, you can hear how others face life’s challenges and manage their mood and treatment medications.
For helpful hints for managing your illness, see coping with bipolar disorder.
Q: I just want to live my life, have fun and companionship. How can lifestyle really help me manage bipolar disorder?
A: Lack of a consistent routine and disrupted sleep can trigger a mood episode. Choosing work and play activities that allow proper sleep and rest is important to maintain healthy emotional functioning.
You, or the one close to you, can certainly enjoy companionship, social relationships, and live fully. It just has to be done mindfully and healthily.
Be aware: The mania component of bipolar disorder can include doing things without considering the consequences, like taking risks with financial, sexual, or physical health.
If you’re partake in alcohol or non-prescribed drugs, they can really nosedive your mood and brain function.
In fact, emerging data has shown how trying to manage mood episodes with cannabis is actually counterproductive, author George Hofmann explains in his roundup of cannabis research.
Learn more Living with Bipolar Disorder.
Q: How do you distinguish what’s the real person and what’s their disorder?
A: It’s not uncommon for people close to those diagnosed with bipolar disorder to vent their suspicions that the other person uses their condition to say or do what they want or hiding behind their illness.
In a recent social media discussion within our Facebook community, people with mental health conditions were asked, “What do you wish people knew about [your] mental health?” The top responses?
- We didn’t ask to be this way.
- That it’s not in our heads and we aren’t lazy [n]or crazy. Not being able to see the symptoms doesn’t mean something isn’t wrong.
It’s important to know also that many of the very people with bipolar disorder are on a journey to acquaint themselves with their own inner self, apart from their diagnosis.
Learn 6 ways to distinguish between yourself and your illness.
Psychiatrist and author Candida Fink explains that particularly during a manic state, people with bipolar disorder are unable to perceive and buffer their symptoms.
She adds if you have to take action in a situation to protect yourself or the one you’re close to who has bipolar disorder, you can do it with neutrality and support.
Fink emphasizes the importance of heeding people when expressing feelings or thoughts of depression, mania, psychosis, or suicide.
She added that the worry you’re enabling by expressing your care or holding out until their behavior improves or they show remorse pales in comparison to the risk of not responding to a hand extended for help.
Q: If I’m feeling better, can I stop taking my meds?
A: That is a no. When you start feeling better, thanks to the medication, you may be tempted to put it back on the shelf, but that can lead to a resurgence of mood episodes that were being managed.
Meds being “optional” is a common myth within bipolar disorder management. The unnegotiability is what clinicians call “treatment compliance” or “treatment adherence.” In other words, the need to continue taking medication as prescribed, no matter your feelings.
In one study, nearly 30% of patients stopped taking medication for reasons spanning from the unwanted sedative effects to ignorance about the need for treatment adherence.
It is perhaps one of the most sneakily disruptive issues in treating bipolar disorder and leads many people to greater distress than if they just kept taking their medications.
Q: Does bipolar disorder really require psychotherapy?
A: Consider this: You can walk without shoes, but you don’t need shoes if you don’t yet know how to walk. Medication helps to fortify you as you step through daily life, but psychotherapy trains you in how to stride along in the first place.
There’re many misconceptions behind psychotherapy strategies‘ usefulness, but the truth is there are varied models to support different goals with bipolar disorder management.
The Canadian Network for Mood and Anxiety Treatments and International Society for Bipolar Disorders (ISBD) details the evidence-based
- Psychoeducation: Provided either individually or in a group setting to educate the person looking to manage bipolar disorder or their loved ones about the condition, the treatments, and overarching coping strategies
- Cognitive Behavioral Therapy (CBT): Talk therapy that can focus on practical skills aimed toward goals or current mood state and functioning
- Family Focused Therapy (FFT): A maintenance therapy helpful for people who are having a depressive episode. FFT also guides family members in understanding how the condition manifests in their family dynamic.
- Interpersonal and Social Rhythm Therapy (IPSRT): Crafted for bipolar disorder treatment specifically and focuses on identifying and maintaining sleep patterns and routines to alleviate symptoms of bipolar disorder
- Mindfulness-based cognitive therapy (MBCT): Known to lessen anxious and depressive symptoms in bipolar disorder
Alisha Brosse is the director of the Sutherland Bipolar Center at the University of Colorado, Boulder. She says productive conversations from FFT help clarify the disorder, so every emotion of the person managing bipolar disorder isn’t attributed to the condition.
Q: I now see that I’ve experienced some of the mania and psychosis bipolar disorder symptoms. But I was already diagnosed with depression. Can’t I just keep treating that?
A: A review of studies found as many as 40% of people with bipolar disorder are initially misdiagnosed, usually as having major depressive disorder.
Perhaps the clinician didn’t probe deeper past depression. Seems like an innocent mistake? It can actually be a costly one.
Antidepressants used to treat depression can have the opposite effect and trigger symptoms of bipolar disorder if taken unbeknownst to the person with mania, or both mania and depression.
If you have been treating depression and have ever experienced bouts of unprompted max energy for at least a week while seeming to need very little sleep, contact your treatment team and ask to be re-evaluated.
All bipolar disorder diagnoses aren’t the same. There are four types actually, and within those, episodes of mania, depression, or psychosis can last from at least a week to upwards of 2 years. Bipolar disorder can be noticeable to those close to you or so disruptive it instigates consequences in life outside the home.
Managing bipolar disorder is the most successful when it includes medication, psychotherapy, tailored routines, local and virtual support systems.
Consistency and flexibility with your or your loved ones’ treatment plan as well as mindfulness to adapt it as needed to life’s normal milestones and curveballs can keep you living well and full.