People with bipolar disorder struggle daily with the unpredictable and often confounding features of this complex mental health disorder. There is still no known cause of the disorder, despite ongoing research. Some factors associated with bipolar disorder include family history of bipolar or other mental illness, unique brain structure features, highly stressful events, brain chemistry imbalance that affects mood regulation, and a history of abuse or trauma.
There are four different types of bipolar disorder, each having unique features. The prevailing characteristics involve intense mood swings, shifting from manic episodes to depressive episodes, often without warning. Resulting changes in sleep patterns, eating habits, emotions, and behaviors accompany the mood swings.
What is Bipolar Disorder?
Bipolar disorder, once known as manic-depressive disorder, is a mental illness that features extreme shifts between manic emotional states and depressive emotional states. In most cases, bipolar disorder appears in the teen or early adult years, and affects 2.6% of the U.S. adult population, or approximately 5.7 million people, according to the National Institute on Mental Illness.
Living with bipolar disorder can be extremely challenging. The mood changes can be swift, or each episode can linger for several days. While in a manic phase the individual may experience supercharged energy, sharp concentration, and feel inspired to conquer the world, the depressive episode will swoop in and dash those dreams. This leaves the person feeling very fatigued, defeated, and sad.
The intense mood swings between mania and depression can be very disruptive in daily life, although there may be long periods of calm that separate these mood shifts. Although there is no cure for bipolar disorder, there are, fortunately, coping methods and medications that help individuals manage the symptoms and enjoy a productive life.
Symptoms of Manic Episodes
Episodes of mania and hypomania (less severe mania) are prevalent features of bipolar disorder. While the signs of mania may at first be a pleasant diversion from the dark depressive episodes, the manic phase can also be destabilizing and self-destructive.
Symptoms include:
- Euphoria
- Racing thoughts and difficulty staying focused, easily distracted
- Rapid speech
- Excessive energy, hyperactivity
- Aggressive behavior
- Irritability or agitation
- Very little sleep
- Impulsive behaviors, using poor judgment
- Risky behaviors, such as substance use or sexual promiscuity
- Psychosis (hallucinations or delusions)
Symptoms of Depressive Episodes
Depressive episodes can also emerge without warning. Some of the triggers for these depressive periods include lack of sleep, excessive stress, or a negative life event, but often there is no known cause for the depression. The depressive episodes must be carefully monitored, as there is an increased risk of suicidal behavior during these phases.
Symptoms include:
- Persistent sadness
- Feelings of despair and hopelessness
- Intense fatigue
- Anxiety
- Sleep disturbances
- Loss of interest in activities once enjoyed
- Chronic pain with no known medical cause
- Trouble concentrating
- Irritability
- Suicidal thoughts
4 Types of Bipolar Disorder
Using the DSM-5, the patient interview, and various diagnostic assessment tools, the mental health practitioner can pinpoint the specific type of bipolar disorder present. According to the National Alliance on Mental Illness there are four types of bipolar disorder. These include:
Bipolar I. Bipolar I disorder is the most common of the four types. Bipolar I involve one or more manic episodes, with or without depressive episodes occurring. The mania must be severe enough that hospitalization is required and lasts a week or longer.
Bipolar II. Bipolar II disorder is characterized by the shifting between the less severe hypomanic episodes and depressive episodes.
Cyclothymic disorder. Cyclothymic disorder, or cyclothymia, involves repeated mood shifts between depressive and hypomanic that persist for more than two years. The depressive and mania episodes do not meet the diagnostic criteria for bipolar disorder episodes. There may be periods of normal mood as well, but those periods last less than eight weeks.
Unspecified bipolar disorder. Bipolar disorder not otherwise specified is present when the symptoms do not fit the other three categories, but still involve episodes of unusual manic mood.
Bipolar disorder is a difficult mental health condition to treat and manage. However, by charting thoughts, feelings, trigger exposures, work and family issues, and health conditions, it is possible to better predict and manage pre-relapse situations. This allows you to be proactive in taking steps to prevent a bipolar relapse, thereby enjoying a better quality of life.