A closer look at the different types of bipolar disorders, causes, and treatment options available
What is bipolar disorder?
Bipolar disorder, also known as manic-depression, is a mood disorder characterized by exaggerated mood swings. Bipolar means two poles or extremes, and if you have bipolar disorder you are likely to have intense ups and downs. You might experience varying extremes of mania (“up” periods) and depression (“down” periods).
Everyone has ups and downs (including those related to hormonal changes in adolescence and to the menstrual cycle in women). However, bipolar disorder is a medical condition where you have extreme mood swings, or “mood episodes,” widely out of proportion, or totally unrelated to what’s happening in your life. These swings affect your thoughts, feelings, physical health, emotional health, behavior and day-to-day functioning. These symptoms can be extremely disruptive to your life, and distressing to your friends and family.
Every time you experience symptoms at one extreme for at least one week, it is called an episode. People with bipolar disorder experience four main mood episodes—mania, hypomania, depression and mixed mood.
Manic episode (or “Mania”)
A manic episode happens when you experience an unusual and constantly elevated or bad-tempered mood, lasting at least one week.
During times of mania, you might experience:
Elevated or euphoric mood. This can include being full of energy and being happy. Euphoria is often described as being on a high or “on top of the world”
Changes in activity levels. You might notice changes in your sleeping and eating patterns
Faster thinking and speaking patterns. Thoughts can be quicker than usual, which might lead you to speak faster and jump from subject to subject
Lack of inhibitions. You might find it more difficult to see what the consequences of your actions could be
Irritability. You might be more likely to be angry or annoyed with others, particularly if they seem to reject your plans or ideas
Unrealistic or grandiose plans and beliefs. You might have unrealistic beliefs about your talents. For example, you might believe that you’re a king, queen, film star or religious figure
Risk taking behavior. You might take unnecessary and unsafe risk
Hypersexuality. You might experience increased sexual thoughts, feelings, or behaviors, or use explicit sexual language
Measuring behavior. You might find it hard to decide what behavior is appropriate in a particular situation
A hypomanic episode is similar to a manic episode, with less extreme symptoms. These are more commonly seen in people with Bipolar II.
A depressive episode is when you have either a depressed mood or the loss of interest or pleasure in nearly all activities. This episode typically lasts for at least two weeks.
When you are experiencing a depressed mood you might:
Lose interest in day-to-day activities
Feel unusually tired and exhausted
Have no appetite or an increased appetite, and experience changes in body weight
Feel worthless or guilty
Have difficulty concentrating
Check out the fact sheet on Depression for more information about the characteristics of depression.
A mixed episode is when you experience both manic and major depressive symptoms nearly every day for at least one week. Your mood might vary with the time of the day.
Types of bipolar disorder
Diagnoses of different bipolar disorders are based on your experience of mood changes, what relatives and friends tell mental health professionals about what they’ve witnessed, professional observation, and an assessment by a psychiatrist or other mental health professional who is licensed to diagnose and treat mental health disorders. Understanding the different classifications of bipolar disorder can help you identifying the best way of managing it.
Bipolar I is a type of disorder where you experience one or more manic episode or mixed episode, and often one or more major depressive episode. Each depressive episode can last for several weeks or months, alternating with intense symptoms of mania that can last just as long. Between these extremes, you might have periods where life continues normally. Your symptoms can also be affected by changes in the seasons or life situations that come up, like school exams.
Bipolar II is a type of disorder where you experience one or more major depressive episode, along with at least one hypomanic episode. Between episodes, there might be periods of normal life functioning. Symptoms might also be related to seasonal changes and life situations.
Cyclothymic disorder is a chronic, or long-lasting, fluctuating mood pattern that involves periods of hypomania and periods of depression. It is a milder form of bipolar disorder. The duration of the symptoms is shorter, less severe and not as regular.
Bipolar disorder not otherwise specified (NOS)
When symptoms don’t fit any other type of bipolar disorder; it is called bipolar disorder not otherwise specified. Although the experiences of this form of bipolar disorder vary from person to person, someone with bipolar disorder NOS will still experience some variation of manic and depressive episodes. Just like the other three types, bipolar disorder NOS is a treatable disorder.
Causes of bipolar disorder
Men and women have equal chances of developing bipolar disorder, although men are often diagnosed at an earlier age. Bipolar disorder might be associated with a combination of factors, including genetics, biochemistry, stress and in some cases the seasons. Approximately 1% to 5% of people suffer from bipolar disorder.
Getting help for bipolar disorder
Bipolar disorder is a treatable illness, and usually requires long-term management. Many people with bipolar disorder are creative and intelligent, and with proper management of this condition, can lead full and productive lives. Treatment options are available for managing both mania and depression. It is a good idea to speak to your doctor about which options might be best for you.
Medication. Your local doctor should be able to tell you about what medications are available for bipolar disorder. Most people are referred to a psychiatrist for diagnosis and medical treatment. Mood stabilizers, antipsychotics and antidepressants can all be used to control bipolar disorder.
Seeing a counselor or psychologist. If you’re experiencing bipolar disorder, you might also find it helpful to talk with someone like a psychologist, counselor, social worker or other mental health professional. By doing this, you can gain a better understanding of what you’re experiencing. It can also be helpful just to talk about how you feel, and these professionals should help you work out why you feel this way. In most situations, a psychiatrist will manage any medication and monitor your situation, while another mental health professional can assist you to manage your life better.
Family/friend support network. Family members and friends can help with the day-to-day management of bipolar disorder by providing feedback on mood states, as well as by giving support, friendship, understanding and a non-judgmental listening ear.
Support groups. Bipolar disorder support groups offer valuable first-hand information from others who live with the disorder. You can find support both locally and on the Internet.
Lifestyle. Regulating your eating and sleeping patterns can help you manage bipolar disorder, and can help prevent manic, hypomanic, depressive or mixed episodes. You should also consider drinking less or no alcohol and not taking drugs.
Stress management and relaxation. Decreasing stress levels, planning ahead and learning relaxation techniques are also important strategies that can help control bipolar disorder.
Hotlines. When things get tough and you want to talk to someone anonymously about your emotions, or if you’re worried about a friend whom you suspect might be bipolar, you can call Lines for Life’s YouthLine at 1-877-968-8491 or by texting teen2teen to 839863. The helpline is free and staffed 24 hours a day with trained volunteers. If you are feeling suicidal, or worried about a friend who might be suicidal or in crisis, you can also call the Suicide LifeLine at 1-800-273-8255. For a directory of crisis services, check out our Crisis Helplines article.
Psychiatric hospital. To keep safe and get the best support, it might be necessary to be admitted to hospital during more extreme episodes of mania or depression.
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Acknowledgements: This article was originally developed by youth and staff for us.ReachOut.com