According to NAMI (the National Alliance on Mental Illness), over 10 million people in the United States have bipolar disorder, previously known as manic depression. 

So, if you’ve been asking yourself, “Do I have bipolar disorder”, you’re certainly not alone. Just under 3% of the US population struggles with this debilitating mental health condition, with men and women impacted equally. 

For bipolar disorder, the average age of onset is 25, although symptoms can present earlier or later in life. 

Bipolar disorder can cause significant disruptions to daily functioning, although the impact of this condition will vary from person to person. 

Fortunately, with the right support and treatment in place, many people diagnosed with this condition manage to live fruitful, productive lives. 

an image of a man looking out a window struggling with bipolar disorderBipolar Disorder: What Is It? 

Bipolar disorder is an SMI (serious mental illness) characterized by extreme shifts in mood. 

Some bipolar episodes last for a few days, while others persist for weeks. Episodes can occur several times a week or less frequently. 

As well as dramatic mood swings, it also triggers pronounced changes to concentration, focus, and energy levels.

The most recent edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the diagnostic tool used for bipolar disorder. DSM-5 recognizes two types of bipolar disorder: 

  • Bipolar I disorder: One or more manic episodes or mixed episodes, then either major depressive episodes or hypomanic episodes.
  • Bipolar II disorder: One or more major depressive episodes, then a hypomanic episode.

Bipolar I disorder is more severe than bipolar II disorder. 

Due to the diverse and distressing symptoms associated with bipolar disorder, up to 60% of people with this condition self-medicate these symptoms with drugs or alcohol, according to SAMHSA. When this becomes a dual diagnosis (substance use disorder or alcohol use disorder co-occurring with bipolar disorder), treatment is more complicated and should be integrated for best results. 

Individuals with bipolar disorder are prone to four types of episodes: 

  1. Major depressive episodes
  2. Manic episodes
  3. Hypomanic episodes
  4. Mixed episodes 

1) Major depressive episodes

A major depressive episode induces feelings of detachment and causes you to lose interest in everyday activities. 

To qualify clinically as a major depressive episode, symptoms must last for at least two weeks.

2) Manic episodes

Manic episodes unfold at the opposite end of the emotional spectrum. These episodes can promote either hostility or excessive friendliness depending on the person and the circumstances. 

These episodes typically last for a week or so. In many cases, manic episodes require hospitalization, enabling you to stabilize while out of harm’s way.

3) Hypomanic episodes

There is a fine line dividing manic and hypomanic episodes. 

A hypomanic episode is usually brief and less severe, seldom lasting longer than four days.

4) Mixed episodes

Mixed bipolar episodes are characterized by various traits of manic, hypomanic, and major depressive episodes.

Symptoms can vary significantly, with co-occurring alcohol use disorder or substance use disorder usually provoking even more intense symptoms. This can perpetuate the vicious cycle of self-medication unless you seek appropriate dual diagnosis treatment for both of these conditions. 

Bipolar I

Bipolar I is defined by manic episodes lasting for at least a week, or by symptoms severe enough to warrant immediate hospitalization. 

Often, depressive episodes also present, lasting for two weeks or more. 

Some people with bipolar I experience mixed episodes, as outlined above. 

A bipolar I diagnosis requires: 

  • One or more manic episodes lasting for at least one week
  • Symptoms impacting daily functioning
  • Symptoms are unrelated to other medical or mental health conditions
  • Symptoms are unrelated to substance abuse – this may result in a dual diagnosis

Bipolar II

Bipolar II is a specific subset of bipolar disorder. 

Less severe than bipolar I, those diagnosed with bipolar II may experience major depressive episodes and hypomanic episodes, but not full manic episodes. 

A bipolar II diagnosis requires: 

  • One or more hypomanic episodes lasting for at least four days, and involving at least three hypomanic symptoms
  • Changes to mood and daily functioning are noticeable to others, although may not impact your everyday life
  • One or more major depressive episodes lasting for at least two weeks, and involving at least five core depression symptoms significantly impacting daily life
  • Symptoms are unrelated to other medical or mental health conditions
  • Symptoms are unrelated to substance abuse – this may result in a dual diagnosis

What causes this condition, though?

an image of 4 men who got help for bipolar disorderWhat Causes Bipolar Disorder?

Scientists have not isolated a single cause of bipolar disorder, although it can be triggered by genetics, brain chemistry, stress, and traumatic environments. 

  • Genetics: If your parents or siblings have this condition, your risk profile for developing bipolar disorder is increased. Research has so far failed to reveal the role of genetics in the development of this condition, though.
  • Brain chemistry: While bipolar disorder cannot be diagnosed using brain scans, some research shows subtle differences in the brain structure of some people with this condition, according to NAMI.
  • Stress: Illness, the death of a loved one, divorce, and financial problems could all play a part in the development of bipolar disorder.
  • Traumatic environments: Traumatic environments can increase your risk of developing this mental health disorder. 

Bipolar Disorder Symptoms

According to the International Bipolar Association, the signs of bipolar disorder vary from person to person. 

Some people experience episodes lasting for months, sometimes even years. Others experience much more fleeting episodes, or swiftly alternately highs and lows. Rapid cycling bipolar is characterized by at least four episodes in the space of a year. 

Symptoms of bipolar disorder can be categorized as follows: 

  • Manic or hypomanic symptoms
  • Depressive symptoms 

Manic or hypomanic symptoms

Mania and hypomania are elevated moods, with mania more intense than hypomania. 

These symptoms of bipolar can include: 

  • Sleeping little without feeling tired
  • Impaired judgment
  • Feeling bored or distracted
  • Edginess
  • Feeling capable of doing anything
  • Underperforming at school or work
  • Missing school or work
  • Being overly sociable
  • Engaging in risky behaviors
  • Denying or not realizing anything is wrong
  • Heightened libido
  • Euphoria or exhilaration
  • Talking quickly and excessively
  • Elevated levels of self-importance, self-esteem, and self-confidence
  • Racing thoughts
  • Rapidly shifting topics in conversation 

Depressive symptoms

During episodes of bipolar depression, you could experience any of the following symptoms: 

  • Irritability
  • Problems with focus
  • Memory issues
  • Feelings of hopelessness and helplessness
  • Extreme sadness
  • Insomnia and other sleep problems
  • Deep fatigue
  • Weight loss
  • Weight gain
  • Anxiety about minor concerns
  • Misplaced sense of guilt
  • Inability to enjoy favored activities
  • Changes to appetite
  • Oversensitivity to noises or smells
  • Missing work or school
  • Underperformance at work or school
  • Physical pain that doesn’t respond to treatment
  • Suicidal thoughts 

an image of someone on a mountain summit who got bipolar disorder treatmentBipolar Disorder Treatment

The right treatment can be effective even for those with the more severe forms of this condition. 

Most treatment plans for this condition involve a combination of medication-assisted treatment (MAT) and psychotherapy, also known as talk therapy. 

Bipolar is a lifelong condition with episodes of both depression and mania often recurring over time. Some people enjoy spells free of mood changes, while others are plagued by lingering symptoms. Even these persistent symptoms can be managed with continuous and long-term treatment, though. 

In addition to MAT and psychotherapy, the following therapies can sometimes prove effective: 

  • Electroconvulsive therapy (ECT)
  • Transcranial magnetic stimulation (TMS)
  • Holistic therapies like acupuncture
  • Supplements

Psychotherapy

Psychotherapy is a term used to describe a range of treatment techniques with the following goals: 

  • Identifying problematic thoughts, emotions, and behaviors
  • Changing these thoughts, emotions, and behaviors

Applied to bipolar disorder, psychotherapy often takes the forms of cognitive-behavioral therapy (CBT) or psychoeducation. 

Other newer therapies and family-focused therapies can also be beneficial for the treatment of this condition.

Medications

Bipolar disorder medications are a vital component of treatment for most people with this condition. 

MAT can help those people with co-occurring bipolar disorder and addiction. These FDA-approved medications can reduce the intensity of cravings, while at the same time minimizing withdrawal symptoms. 

What about medication, then? 

The following can all be effective for treating some cases of bipolar disorder: 

  • Mood stabilizers like Lithium
  • Benzodiazepines
  • Antipsychotics
  • Anticonvulsants

Benzodiazepines have a strong potential for addiction and abuse, so they should only be used short-term and as prescribed. Benzos can help counter episodes of mania, as well as soothing withdrawal symptoms. 

You should not stop taking bipolar medication without first speaking with your treatment provider. Abruptly stopping this medication can trigger a rebound effect, with symptoms returning more intensely than ever before.

Getting Help for Bipolar Disorder at The District

Whether you have bipolar disorder with or without a co-occurring addiction to drink or drugs, we can help you get back on track here at The District. 

We offer a variety of structured outpatient treatment programs for mental health, including intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). This allows you to access the structure and support of inpatient treatment without the attendant costs and restrictions. 

Learn more about our evidence-based treatment programs for bipolar disorder and co-occurring disorder by calling 844.287.8506.