Bipolar disorder, previously called manic depression, is a mood disorder characterized by swift mood swings that move between exaggerated mania and episodes of depression.
Patients diagnosed with bipolar disorder have a chemical imbalance in the brain that affects their emotions and actions. In some cases, individuals are not diagnosed appropriately, or they may refuse treatment. Without treatment, bipolar disorder leads to potentially serious consequences.
Experts worry that many people with bipolar disorder go undiagnosed. The number of people diagnosed with bipolar disorder remains low, only around 2.6 percent of the U.S. adult population. Around 83 percent of people diagnosed have severe cases. This suggests only people with significant symptoms and dysfunction get a diagnosis.1
Categories of Bipolar Disorder
Bipolar disorder is very complex and has been subdivided into different categories. Each category is classified according to the pattern and intensity of the symptoms.
- Bipolar disorder I – This classification of bipolar disorder describes a patient who has one manic episode lasting at least seven days or that is severe enough to require hospitalization. Episodes of depression or mixed episodes (experiences both mania and depression are also common.
- Bipolar disorder II – Bipolar disorder II is signified by a predominance of depressive symptoms sometimes linked to a few days of hypomania, which involves mild manic episodes.
- Cyclothymic disorder – Cyclothymic disorder is defined by a state of perpetual unstable mood with periods of hypomanic and depressive symptoms for at least two years, without meeting the criteria for either bipolar I or II.
- Bipolar disorder not otherwise specified (NOS) – Some patients present with symptoms of bipolar disorder that do not fit into any established category. These patients are classified as bipolar disorder NOS.2
Bipolar disorder does not seem to be caused by just one factor. Typically, bipolar disorder is due to a combination of biological and genetic factors. These factors appear to trigger a variety of chemical imbalances within the brain that are associated with the disorder.
- Genetic factors – Certain genes seem to give people a greater chance of developing bipolar disorder; however, there are no genes that necessarily mean someone will develop it.
- Family history – People with an immediate relative — like a parent or full-sibling — often have a higher risk of developing bipolar disorder; however, again, this does not mean someone necessarily will. In fact, most people with a family history of bipolar disorder do not end up with the disorder themselves.
- Neurological factors – Patients with bipolar disorder often present structural and functional differences in brain imaging studies.
Symptoms of Mania and Depression
Patients suffering from bipolar disorder often feel intense emotions and behave differently than they normally would. Cycles of mood episodes may look differently for different people, and symptoms may change for individuals between episodes.
Signs of mania include the following:
- Easily angered and irritated
- Rapid incomprehensible speech
- Trouble sleeping
- Feeling important and powerful
- Difficulty concentrating
- Abusing alcohol and other drugs
- Spending exorbitant amounts of money
- Reckless behavior
When depressed, bipolar individuals are profoundly sad and unmotivated. They rarely want to do anything and often isolate themselves. Depression is often characterized in the following ways:
- Not finding pleasure in previously enjoyable activities
- Feeling numb or empty
- Uncontrollable, irrational crying
- Feeling very slow
- Extremely low self-esteem
- Weight fluctuation and changes in appetite
- Difficulty making decisions
- Memory problems
- Headaches, backaches, muscle pain or digestive distress
- Constantly thinking about death and suicide2
Impact on Families
Bipolar disorder often affects more than just the patient. Because their mood and behavior is generally negatively affected by the disorder, patients’ relationships with family and friends also suffer. Loves one also hurt for the patient watching them struggle with the debilitating symptoms of bipolar disorder.
Before the disease is diagnosed, family members may be confused and hurt by the actions of the bipolar relative. They will not understand why their loved one is seemingly happy one moment and then intensely disturbed the next. They may feel guilt and grief because they believe that they are responsible, in some way, for causing their loved one to develop bipolar disorder.
Because of the constant worrying and monitoring, many families also struggle internally when there is a member with bipolar disorder. They may become increasingly isolated from their community, too. Many families find themselves stressed financially, frequently skipping events to handle a crisis and losing touch with close friends.
As family members become more aware of what is going on with their loved one, the best thing they can do is to reach out for help for the patient as well as themselves. Pursuing healing among relationships will help their loved one feel more confident in personal treatment as well.
Self-Medication and Addiction
Bipolar disorder also puts people at greater risk for developing an addiction. The prevalence is so high that many therapists and doctors suggest that all people with a bipolar diagnosis be screened for substance abuse. Some people abuse drugs to manage a depressive episode after coming down from the high of a manic episode. Drugs like heroin, prescription painkillers or methamphetamine create a fleeting period of euphoria, a feeling unavailable in the depths of a bipolar depressive cycle.
The impulsivity of a manic episode also increases a person’s chance of taking high doses of drugs or alcohol. Some sufferers believe taking drugs puts them back in control. Unfortunately, any control is temporary, as substances shift people from one extreme to another.
Intervention and Treatment
Treatment for bipolar disorder provides both pharmacological and psychological therapy to the patient. Without treatment, people with bipolar disorder are at a high risk of suicide or developing other co-occurring mental illnesses. Many families find themselves at a loss of how to help their loved ones —especially if they are unaware of the severity of what is going on and resistant to help.
A professional interventionist can help educate your family on how to speak with your loved one and how to help them pursue treatment. They can help you structure a loving and firm conversation helping your loved ones understand the severity of their illness. An interventionist will also lead family members in seeking out treatment on the familial level.
Help for Bipolar Disorder
If you think you or your loved one may be suffering from bipolar disorder, we can help. Our caring admissions coordinators can review your options, discuss insurance coverage and answer other questions you may have. You don’t have to do this by yourself. We’re serious about helping everyone find solutions within your unique situation. Please call our 24-hour, toll-free helpline today at 855-317-8377.
1 "Bipolar Disorder." National Alliance on Mental Illness, August 2017.
2 "Bipolar Disorder." National Institute of Mental Health, April 2016.