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Bipolar Disorder

Bipolar disorder is a mood disorder and mental health condition resulting in intense changes in mood, energy levels, thinking patterns, and behavior. 

Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.8% of the U.S. population, annually. The condition was previously known as manic depression.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).

How Bipolar Disorder Affects You

Bipolar disorder causes intense shifts in mood. You may experience cyclical changes in mood between extreme highs, extreme lows, and every stage in-between the two. These shifts may last for hours, days, weeks, or even months. 

These mood swings can interrupt your ability to carry out daily functions by affecting your sleep, energy, activity, judgment, behavior, and ability to think clearly.

Depending on whether you are experiencing a high or low, your mood may shift between mania, hypomania (less intense than mania), and depression. 

Extremely high, elated, irritable, or energized behavior is usually identified as a manic episode. On the other hand, very low, sad, indifferent, or hopeless periods are identified as depressive episodes. If the manic episode is less severe, it may be classified as a hypomanic episode.

However, even with bipolar disorder, you may not always be in hypomanic, manic, or depressive states. Such periods of normal or balanced mood are known as euthymia.

Defining Manic Episodes

An episode of mania, or a manic state, is characterized by a period of abnormally elevated or irritable mood, as well as extreme changes in emotions, thoughts, energy, talkativeness, and activity level. 

People in manic states may indulge in activities that cause them physical, social, or financial harm. They may also be susceptible to developing psychotic symptoms, such as delusions and hallucinations.

Defining Depressive Episodes

A depressive episode is usually characterized by a low or depressed mood, loss of interest in most activities, and other symptoms of depression.

  • Tiredness
  • Changes in appetite
  • Feelings of worthlessness and hopelessness

Types of Bipolar Disorder

There are three types of bipolar disorder involving significant fluctuations between manic, hypomanic, and depressive episodes. 

Bipolar I Disorder

People with bipolar I disorder have had at least one manic episode that may be preceded or followed by a hypomanic or major depressive episode. For a bipolar I diagnosis, your manic episodes must last at least seven days or be severe enough to need hospitalization. The occurrence of a depressive episode is not mandatory for diagnosis.

People with bipolar I may also experience mixed states, where they experience episodes of both manic and depressive symptoms. In some cases, mania may trigger a break from reality (psychosis).

Bipolar II Disorder

People with bipolar II disorder experience depressive episodes and at least one hypomanic episode. However, they do not experience manic episodes. Although hypomania is less intense than mania, bipolar II disorder can be more debilitating than bipolar I disorder because chronic depression is more frequent with a bipolar II diagnosis.

Cyclothymic Disorder

This diagnosis is arrived at when people have chronically unstable states of mood. They experience many episodes of hypomania and depressive state over a two-year period. People with cyclothymia may also have brief periods of euthymia, but they typically last fewer than eight weeks.

Other Specified or Unspecified Types

This classification is used when people do not meet the criteria for a clear diagnosis of any of the above types of bipolar disorder. An unclear diagnosis, despite experiencing periods of clinically significant abnormal mood elevation, is classified as other specified or unspecified bipolar disorder. 

This can include bipolar and related disorders induced by certain drugs, alcohol, or medical conditions, such as Cushing's disease, multiple sclerosis, or stroke.

Causes of Bipolar Disorder

Although the exact cause of bipolar disorder is not clear, it is believed that any of the following factors may be involved.

Structural differences in the brain. People with bipolar disorder appear to have physical changes in their brains. Research identifies subtle differences in the average size or activation of some brain structures in people with bipolar disorder. However, the condition cannot be diagnosed with a brain scan.

Genetics. People with a first-degree relative with bipolar disorder are more likely to have the condition themselves. Bipolar disorder is considered one of the most inheritable psychiatric conditions. While everyone with a family member who has the condition is not sure to have bipolar condition, more than two-thirds of people with bipolar disorder have at least one close biological relative who is afflicted with the same condition.

Environmental and emotional factors. Stressful or traumatic events, such as the death of a loved one, a serious illness, divorce, or financial problems, can all trigger a manic or depressive episode.

Symptoms of Bipolar Disorder

Symptoms of bipolar disorder depend on the type of episode you experience. Here is a list of symptoms you may experience during a manic or depressive episode.

Symptoms of a Manic Episode
Symptoms of a Depressive Episode
Feeling very up, high, elated, or extremely irritable
Feeling very down, sad, or anxious
Abnormally jumpy or wired, more active than usual
Feeling slowed down or restless
Reduced need for sleep
Trouble falling asleep, waking up too early, or sleeping too much
Unusually talkative, with a need to discuss lots of things
Talking very slowly, feeling unable to find anything to say, or forgetting about the topic of conversation
Racing thoughts, high degree of distractability
Trouble concentrating or making decisions
Feeling charged to do many things at once without getting tired
Feeling unable to do even simple things
Excessive appetite for food, drinking, sex, or other pleasurable activities
Lack of interest in almost all activities
Feeling unusually important, talented, or powerful - euphoric feeling
Feeling hopeless or worthless, or thinking about death or suicide

Bipolar Disorder Diagnosis

Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Bipolar symptoms may sometimes become apparent during childhood. 

Diagnosing bipolar disorder involves the following checks.

  • A physical exam.
  • A thorough medical history, with questions about your symptoms and family history.
  • Blood tests or other tests to rule out other conditions, such as hyperthyroidism.
  • A mental health evaluation.

To be diagnosed with bipolar disorder, you must have experienced at least one episode of mania or hypomania. The type of bipolar disorder is confirmed after an assessment of the pattern of your symptoms and how they affect your life during the most severe episodes.

People with bipolar disorder may sometimes experience symptoms similar to those with schizophrenia or borderline personality disorder (BPD). It is, therefore, vital that you answer all questions from your physician as clearly and honestly as possible.

Treatment for Bipolar Disorder

Although the symptoms can vary over time, bipolar disorder requires lifelong treatment. However, the condition is manageable with a prescribed treatment plan. 

An effective treatment plan is likely to include a combination of the following therapies.

  • Talk therapy.
  • Medications.
  • Self-management strategies to help identify early symptoms of an episode or possible triggers.
  • Helpful lifestyle habits, such as exercise, yoga, and meditation, to support treatment.
  • Electroconvulsive therapy (ECT) in case of poor response to medication. ECT may be particularly helpful in cases with suicide risk or catatonia (a state of unresponsiveness).
  • Transcranial magnetic stimulation (TMS).
  • Light therapy may be considered if patients with bipolar disorder experience seasonal worsening of depression in the winter.

Bipolar disorder is a lifelong condition, so treatment is a lifelong commitment. Even though there may be periods without episodes of mania or depression, most people continue to experience lingering symptoms.

Managing Bipolar Disorder in Denver, Colorado

If you have symptoms of or have been diagnosed with bipolar disorder, you need an immediate strategy to start treatment. Proper care and a long-term treatment plan can help you improve your quality of life, despite your diagnosis.

Axis Integrated Mental Health in Denver provides a full suite of integrated mental health treatments under one roof. For appointments, call us at (720) 400-7025 or fill out our contact us form today.

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