It’s hard to believe that some myths and stereotypes about bipolar disorder continue to circulate. We’re here to dispel them and set the record straight.
Bipolar disorder is a complex neurocognitive condition characterized by shifts in mood.
There are a handful of types of the disorder, and more features and specifiers that make each person’s diagnosis nuanced. The manifestations of the disorder can also change as a person ages.
Manic episodes can manifest as bouts of overflowing energy, increased confidence, and a sense of invincibility, among other symptoms. Depressive episodes can bring about feelings of hopelessness, lack of motivation, and suicidal thoughts.
Types of bipolar disorder
The encyclopedia for all things psychiatry is the Diagnostic and Statistical Manual of Mental Disorders (5th ed.). It lists the types of bipolar disorder and their diagnostic criteria. Of these, bipolar I and II disorder are the most common types:
Treatment for bipolar disorder can incorporate any combination of:
- talk and behavioral therapies
- nutritional adjustments
- exercise and lifestyle changes
- a strong emotional support network
The difference a solid routine makes for the condition is significant and evidence-based.
With support and the right care, it’s very possible to successfully manage bipolar disorder.
Sometimes, even people living with the disorder can get caught up with self-doubt and believe the exaggerations of their condition.
Myth: ‘My bipolar disorder is going to ruin any chance I have at a meaningful relationship’
FACT: While having bipolar disorder can present significant challenges to one’s romantic and intimate life, healthy, fulfilling relationships are absolutely possible.
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When both partners have a continuing education approach to bipolar disorder depression, recognize what the early stages of bipolar disorder psychosis are, and learn how to predict or possibly prevent manic episodes, they can cultivate their relationship and adapt to whatever comes their way.
Myth: ‘I can drink alcohol or use cannabis as much as the next person who doesn’t have bipolar disorder — not that big of a deal’
FACT: Substance use is a serious and common co-occurrence among people with bipolar disorder. Research shows that alcohol, cannabis, and other recreational drugs can worsen mania and interfere with your meds.
Not convinced? Here are some stats:
review of multiple studiesfound at least 40% of people with bipolar I disorder will experience a substance use disorder (SUD) during their lifetime. At least 20% of people with bipolar II disorder will.
- An existing SUD can make managing bipolar disorder
- Men with bipolar disorder develop an SUD more often than women with bipolar disorder.
- A high rate of manic episodes and suicidal ideations is also linked to an increased risk of SUD.
- Certain folks with bipolar disorder are uniquely at risk of an SUD, including veterans and transgender people.
You can manage bipolar disorder and also have a healthy and robust social life. Many people use substances to relax, or with the hope to calm an episode of mania, hypomania, or hypomanic symptoms. There are other ways to achieve the same goal, like with self-care and exercise.
Myth: ‘It’s not me, it’s bipolar disorder — I don’t have to apologize’
FACT: You never have to apologize for having bipolar disorder. But you can and should take varying degrees of responsibility for harmful actions that may stem from bipolar disorder episodes, treatment changes, or decisions to suddenly stop medication unsupervised.
If you’re comfortable sharing your diagnosis, letting people know you are managing a mental health condition can help them understand and contextualize what they might observe.
As Dr. Descartes Li, director of the bipolar disorder program at the University of California, San Francisco, and professor of psychiatry explains, sharing your diagnosis with select people may provide crucial support in times of crisis.
“Having family members or friends who are aware of your situation, who can jump in and help out when needed, can be literally a lifesaver,” he says.
For those in your life who may already know, and who were hurt or otherwise negatively affected by your actions, making amends in real time can help preserve those core relationships.
How to make amends
Depending on your level of closeness with someone, you can be specific in how you make amends.
There’s a difference in saying “I’m sorry” versus “I apologize.” Sorry expresses personal regret without accepting responsibility, and apologizing takes responsibility for an action, not necessarily with any sentiment behind it.
When you manage a condition that can cause interpersonal conflict or complication, here’s how you can acknowledge an action and move past it while maintaining the relationship, according to Janet D. Stemwedel, San José State University associate professor of philosophy:
- Name the action.
- End on a high note, without rationalizing.
No need to share your diagnosis if the person you’re apologizing to is not in your trusted circle or you’re not comfortable.
“Sorry goes a long way,” Li says, “but you don’t have to acknowledge a 100% responsibility” or apologize for having a mental health condition.
He adds that sometimes sudden changes in behavior can stem from recent treatment adjustments under your prescribing clinician.
But other times, people may still need to take a degree of responsibility for actions that may take place after stopping meds without professional supervision.
Myth: ‘My meds are going to make me less creative’
FACT: Medication may affect your life in unforeseen ways, but relying on bipolar disorder episodes for productivity works against overall well-being.
It’s also a prevailing inaccuracy. Some experts have said their clients find creative space to explore when on their prescribed medication since it provides clarity.
Taking medication is still considered the cornerstone of treating bipolar disorder in most cases.
Myth: ‘I can go off my meds when I feel better’
FACT: Stopping a medication “cold turkey” can be incredibly dangerous. Changes or adjustments to medication should only be made in full concert with your healthcare team.
Li observes that nonadherence can occur when people are far out from acute episodes, feel stable, and sometimes wonder why they’re still on medication: “I don’t even feel like I have an illness anymore,” you may say to yourself.
When that happens, Li urges, “What I want you to do is come and talk to me, and let’s have a discussion about it.” Clinicians are used to, and expect, patient needs and goals to change.
Ultimately, it’s important to always be transparent and honest with your doctor about how you’re feeling, and what you want out of your treatment.
Myth: People with bipolar disorder can control their moods if they really want to
FACT: Bipolar disorder is a very real neurocognitive and chronic mental health condition. It cannot be wished away with positive thoughts and requires a consistent treatment regimen.
Bipolar disorder develops in the very synapses of the brain and presents from the inside out.
You wouldn’t tell someone with a broken arm to control their pain, right? And so it is with bipolar disorder.
When it comes to talking about bipolar disorder, we choose to specify “shifts in mood” versus the stigmatizing imagery of “mood swings.” The latter implies a constantly moving, random wildness.
Psych Central stands for resilience for the person and respect for the biochemical complexity of each mental health condition.
Myth: Bipolar disorder = swinging between depression and aggression
FACT: Mood shifts caused by bipolar disorder exist on a broad spectrum. It’s actually inaccurate to say all people with bipolar disorder go back and forth from mania and depression.
|Type of Bipolar Disorder||Mania||Hypomania||Symptoms of Hypomania||Euthymia||Depression||Symptoms of Depression|
|Bipolar I disorder||✓||✓|
|Bipolar II disorder||✓||✓||✓|
Different types of bipolar disorder include particular mood types. To receive a diagnosis of:
- bipolar I disorder, you must have episodes of mania. Bipolar I disorder may include depression but it’s not necessary to receive a diagnosis.
- bipolar II disorder, you must have both hypomania (a less severe presentation of mania) and depression (which can be severe).
- cyclothymia disorder, only some symptoms of hypomania and some symptoms of depression are needed to receive a diagnosis. These symptoms occur at the same time for periods on and off within a 2-year phase, each time.
In all three types of bipolar disorder, when a person is not having an episode, they experience what’s called euthymia, which is simply a calm state.
While depression is among the most commonly experienced mental health conditions, mania is rarer and less understood by the general public. The next myth on this list discusses mania in more depth.
Myth: Energy surge? Sociable? Confidence and spontaneity? Mania can’t be that bad
FACT: The energetic high of mania may seem like a plus, but it’s often misunderstood.
Some folks with bipolar disorder admit they look forward to manic episodes as they offer respite from depression and the invigorating benefits of euphoria, self-confidence, and increased productivity.
In her famous, radically honest account of her own bipolar disorder, Dr. Kay Redfield Jamison writes that mania can feel like becoming the best possible version of yourself, the “liveliest, most productive, most intense, most outgoing and effervescent.”
However, having a manic episode can be unsettling and exhausting, as manic or hypomanic symptoms can last for hours to months. When untreated, manic episodes can lead to hospitalization and trigger psychosis. Symptoms include but are not limited to:
- talking fast
- racing or intrusive thoughts, sudden flood of ideas or interest in new ventures
- insomnia yet operating on a “full tank”
- irritability, restlessness
- fidgety with clothing or having body tics (known as psychomotor agitation)
- impulsive behavior (like excessive spending or other conduct that can cause sexual, legal, interpersonal, or medical consequences)
Myth: Kids can’t get bipolar disorder
FACT: Bipolar disorder can occur at any age.
Confirming a bipolar disorder diagnosis in children can be particularly difficult as their moods already may change more suddenly than adults, and prescribing medication to young patients can be less optimal. Kids also demonstrate warning signs of bipolar differently than adults.
Myth: Bipolar disorder stems from childhood abuse or dependence on substances
Fact: Not necessarily.
Not all people with bipolar disorder have experienced both or either, but there are some links for some folks.
A family history of mental health conditions and the presence of trauma or adversity in childhood plays some role in the appearance and severity of bipolar disorder in people who’ve received a diagnosis.
And among the types of bipolar disorder outlined in the DSM-5,
Myth: Bipolar isn’t a ‘real’ disability
Many people with bipolar disorder experience severe impairment in multiple areas of their life. Adjustments and accommodations — particularly regarding work and interpersonal relationships — may be needed to allow some people with bipolar disorder to reach their fullest potential.
Bipolar disorder is a neurocognitive condition that can have serious impacts on everyday life when not treated. There are different types of bipolar disorder, and a person can receive a diagnosis as young as childhood. It’s more than mania and depression, and there are periods of calm.
Though lifelong, the condition is manageable with consistent routines and treatment. You can live with the condition and enjoy a healthy, creative, productive, and full life with meaningful relationships.