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Bipolar Disorder: Diagnosis, Symptoms, Treatment & More

Bipolar disorder is a condition that affects the brain and often results in mood changes and depressive or manic episodes. In some cases, psychotic symptoms are present. In the past, bipolar disorder has been popularly referred to as manic depression. Although the two polarities often associated with bipolar disorder are mania and depression, not everyone with bipolar disorder experiences the same mood episodes.

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According to the American Psychological Association, bipolar disorder affects the lives of around 4 percent of children and adults in the United States alone.

Symptoms of Bipolar Disorder

Symptoms of bipolar disorder include the following:

  • Severe mood swings (often lasting several weeks)
  • Depression
  • Withdrawn or disengaged behavior
  • Mania

Given that everyone experiences changes in moods, it can be challenging to determine if an individual has bipolar disorder or is simply experiencing stronger changes in mood or mood swings.

Although mood swings, depression, and feelings of being withdrawn are fairly clear-cut, mania is a symptom that necessitates a more in-depth explanation.

Mania, or being in a manic state, generally consists of euphoria, which is often experienced as a sharp contrast when compared to depressive states. Lack of sleep and increased irritability are also associated with being in a manic state.

Symptoms of mania also include lack of focus, speaking faster than usual, and disorganized thinking. Being in a manic state can also give way to delusions and hallucinations.

It’s also important to make a distinction between bipolar disorder and unipolar depression. While bipolar disorder generally exhibits the symptoms mentioned above, unipolar depression is characterized by feelings of sadness and depression that often last two weeks or more. Those who suffer from unipolar depression may exhibit symptoms such as loneliness and emptiness, disinterest, lack of appetite, and suicidal thoughts.

Bipolar Disorder & Its Relation to Substance Abuse

People who live with bipolar disorder are at an increased risk for substance abuse although it remains unclear why. This is an acute problem due to the fact that drugs and illegal substances have a way of counteracting bipolar medication.

According to the National Alliance on Mental Illness, 17 million adults in the United States experienced mental illness coupled with a substance use disorder. Roughly half of those who experience a substance abuse problem will also experience mental illness, and the same goes true for the reverse scenario.

Co-occurring disorders might include the following:

  • Depression
  • Anxiety disorders
  • ADHD
  • Bipolar disorder
  • Schizophrenia
  • Personality disorders
  • Other mental illnesses

A substance abuse problem can also result in symptoms associated with bipolar disorder, including depression, mood swings, withdrawn behavior, and delusions or hallucinations.

When a person has bipolar disorder and a substance abuse problem simultaneously, effective treatment will address both conditions. Treatment for co-occurring disorders ensures that both disorders are treated simultaneously, increasing the likelihood of recovery on all fronts.

Types of Bipolar Disorder

Bipolar disorder is further broken down into four types, which include bipolar I, bipolar II, cyclothymic disorder, and unspecified bipolar disorder.

Bipolar I

Those diagnosed with bipolar I might take comfort in the fact that this is the most common bipolar disorder type. Bipolar I is characterized by one or multiple manic episodes, with or without depressive episodes occurring. Manic episodes are severe and last one week or more, requiring hospitalization.

Symptoms of bipolar 1 include an inflated sense of self, disorganized thoughts, loud or fast speaking patterns, hypersexuality, and impulsive behavior.

Bipolar II

Bipolar II is generally associated with being hypomanic and depressive. Hypomania results in elevated and extreme mood changes, which are abnormal for the person in question. Symptoms include mood swings, self-harm, and suicidal thoughts.

Cyclothymic Disorder

Cyclothymic disorder (also called cyclothymia) is characterized by mood shifts and episodes that last longer than bipolar I and bipolar II.

Episodes can persist for more than two years. Depressive and manic episodes do not fall in line with bipolar I and II disorder episodes. Someone living with cyclothymic disorder might experience feelings and moods of normalcy, but these stable periods generally last less than eight weeks.

Unspecified Bipolar Disorder

Unspecified bipolar disorder is diagnosed when an individual does not exhibit patterns that fit bipolar I, bipolar II, or cyclothymic disorder. However, unspecified bipolar disorder does involve manic episodes.

Bipolar Disorder Causes

Even though there have been many medical and mental health advancements in recent years, the exact cause of bipolar disorder remains somewhat elusive.

Bipolar disorder is recurrent and heterogeneous, meaning that bipolar disorder can arise from dissimilar and diverse circumstances and conditions. Still, physicians and mental health experts work tirelessly to uncover the mechanisms that cause bipolar disorder.

Currently, bipolar disorder is believed to run in families. People with certain genetics are more susceptible to bipolar disorder.

Bipolar disorder typically starts to become noticeable in a person’s youth. In many cases, a person with bipolar disorder will have a family member or relative who also has bipolar disorder or some type of clinical depression. Research is still being conducted to determine the genetic factors responsible for this increased risk.

Environmental and lifestyle factors such as stress, physical and/or sexual abuse, substance abuse, trauma, and physical illness can also influence bipolar disorder development or trigger bipolar symptoms.

Diagnosis

Bipolar disorder is generally diagnosed via a physical exam and mental evaluation performed by a doctor. Blood testing may also be recommended to investigate whether or not bipolar-related symptoms might be due to some other underlying health condition, like hypothyroidism, for instance.

When undergoing a psychological evaluation, a doctor or specialist will ask a series of questions, which might include taking a family history in addition to discussing the symptoms experienced.

A health specialist will also inquire whether or not the individual uses drugs or illegal substances as well as if they are experiencing depression or suicidal ideation. A specialist might also consult with partners, friends, or family members to get a full picture of the situation.

After symptoms and family history have been explored in depth, a doctor or specialist will have a feedback session. During the doctor’s feedback session, the diagnosis will be given, and treatment options will be discussed.

Related Conditions

Those who live with bipolar disorder may also experience related conditions, which include ADHD, PTSD, anxiety disorder, and, as mentioned previously, substance use disorders.

Often, people with bipolar disorder can be misdiagnosed with schizophrenia or borderline personality disorder.

Conditions related to bipolar disorder can disturb and disrupt treatment. For instance, OCD antidepressants or stimulants prescribed for ADHD can often worsen bipolar disorder symptoms. Antidepressants and stimulants might also trigger a manic episode for those with bipolar disorder.

Treatment Options for Bipolar Disorder

It is always best to obtain treatment from experienced medical and mental health professionals, preferably a psychiatrist who has extensive experience and is highly skilled in the treatment of all four bipolar disorder types.

Bipolar disorder is classified as a lifelong disorder, so there is no cure. Treatment entails managing symptoms related to bipolar disorder. Treatment options include medication, substance abuse treatment (for co-occurring disorders), counseling, and hospitalization.

Evidence-based prescribing practices are strongly encouraged when it comes to utilizing prescription medication for the treatment of bipolar disorder. Bipolar medications include mood stabilizers, antidepressants, antipsychotics, and anti-anxiety medications.

Common medications prescribed for bipolar disorder include mood stabilizers such as lithium, valproic acid, and carbamazepine. Those with bipolar disorder may also be prescribed antipsychotics, such as aripiprazole, cariprazine, olanzapine, risperidone, or other antipsychotic medications.

Treatment for bipolar disorder and co-occurring disorders, such as substance use disorders, may present more of a challenge, but treatment is available and remission and recovery are possible. Early intervention increases the chances of sustained recovery from co-occurring disorders.

Get Prompt Treatment

If you believe you may have bipolar I, bipolar, II, cyclothymic disorder, or unspecified bipolar disorder, it is very important to see a medical professional who can successfully and effectively diagnose the problem. Although bipolar disorder is a lifelong condition, early detection and treatment will help ensure symptoms and episodes can be successfully managed.

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated June 26, 2023
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