Bipolar And Related Disorder
Bipolar disorders are mental health conditions that cause extreme changes in mood, energy, and daily functioning. These changes, known as mood episodes, can last from days to weeks. There are two main types of episodes: manic/hypomanic, where one feels very happy or irritable, and depressive, where one feels deep sadness and loses interest in enjoyable activities. People with bipolar disorder can also experience periods of stable mood, and with proper treatment, they can live productive lives.
Unlike regular mood swings that typically last hours and don’t disrupt daily life, bipolar mood changes can affect relationships, work, and social interactions.
Bipolar disorder includes three main types: bipolar I, bipolar II, and cyclothymic disorder. It often runs in families, with 80 to 90 percent of individuals affected having a relative with the condition or depression. Factors such as stress, lack of sleep, and substance use may trigger episodes in vulnerable individuals. While the exact causes are not fully understood, both genetic and environmental factors play a role, with symptoms often beginning in a person’s mid-20s.
Bipolar I Disorder
Bipolar I disorder is a mental health condition characterized by significant shifts in mood and energy levels. You may also encounter the terms “manic-depressive disorder” or “manic depression,” which are older names for this condition.
If you have bipolar I disorder, it means you’ve experienced at least one manic episode that lasted a week or longer. A manic episode involves an unusually elevated or intensely irritable mood, paired with increased energy and unusual behavioral changes.
In addition to mania, many individuals with bipolar I also experience periods of depression. This can create a challenging emotional journey, cycling between the highs of mania and the lows of depression. However, it’s important to note that there are also times when the symptoms don’t interfere significantly with everyday life, allowing for more stability. Understanding these patterns is key to effectively managing the condition.
Symptoms:
If you have bipolar I disorder, your emotions can be much more intense than usual at times. During these episodes, you might behave quite differently – for example, sleeping less, being very active, or engaging in risky activities without considering the consequences.
You may not notice these changes, which can be harmful to you and those around you. Mood episodes can last for most of the day and may last for several days, weeks, or even months.
During a manic episode, you might experience:
- Rapid shifts from one idea to another
- Talking quickly or being excessively loud
- Heightened energy levels
- Less need for food or sleep
- Extremely high self-esteem
- Overspending
- Increased sexual desire
- Substance abuse
You might also struggle to distinguish reality during a manic episode, which can lead to symptoms of psychosis, such as:
- Feeling like people are plotting against you
- Hearing voices
- Seeing things that aren’t real
- Believing you can achieve impossible goals
- Thinking you have a special purpose
If left untreated, manic symptoms can persist for weeks or months. Depression may follow soon after, or it may not appear for a long time – or even at all. Not everyone with bipolar I experiences depression.
Diagnostic Criteria:
- Manic Episode: At least one manic episode, which may be preceded or followed by hypomanic or major depressive episodes.
- Manic Episode Symptoms: A manic episode is defined by a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week (or less if hospitalization is required).
- Manic Episode Symptoms (continued): During the period of mood disturbance and increased energy or activity, at least three (or four if the mood is only irritable) of the following symptoms have persisted:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or pressure to keep talking
- Flight of ideas or racing thoughts
- Distractibility
- Increase in goal-directed activity or psychomotor agitation
- Excessive involvement in activities that have a high potential for painful consequences
Bipolar II Disorder
Bipolar II disorder, often called “bipolar two,” is a mental health condition characterized by mood swings that fluctuate between highs and lows. Unlike bipolar I disorder, individuals with bipolar II do not experience full mania; instead, they go through milder elevated moods known as hypomanic episodes.
To be diagnosed with bipolar II, a person must have had at least one hypomanic episode in their life. While some may enjoy the upbeat energy of hypomania, it can also lead to impulsive and risky behaviors. Most individuals with bipolar II tend to experience more depressive episodes than hypomanic ones, which can resemble typical clinical depression, featuring sadness, loss of interest, low energy, guilt, and sometimes thoughts of suicide.
Hypomanic episodes can last from a few days to several months, but they are usually shorter than depressive episodes. It’s common for people to cycle between these moods, experiencing periods of normal mood in between.
Symptoms:
Symptoms during hypomanic episodes include:
- Flying suddenly from one idea to the next
- Having exaggerated self-confidence
- Rapid, “pressured” (uninterruptible) and loud speech
- Increased energy, with hyperactivity and less need for sleep
Diagnostic Criteria:
- Hypomanic Episode: At least one hypomanic episode, which is defined by a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 4 consecutive days,
- Major Depressive Episode: At least one major depressive episode.
Cyclothymic Disorder
Cyclothymia, or cyclothymic disorder, is a rare mood disorder characterized by emotional ups and downs that are milder than those in bipolar I or II disorder.
People with cyclothymia have periods of elevated mood followed by dips in mood. You might feel great for a while, then experience a low phase where you feel down, but in between these mood changes, you may feel stable.
Even though the mood swings in cyclothymia aren’t as severe as in bipolar disorder, it’s important to get help managing these symptoms, as they can affect your daily life and increase the risk of developing bipolar I or II disorder.
Symptoms:
Cyclothymia involves mood swings that go from emotional highs to lows. The highs are characterized by symptoms like an elevated mood (hypomania), while the lows include mild to moderate depression.
Although cyclothymia shares similarities with bipolar I and II disorders, its symptoms are less intense. People with cyclothymia can usually manage daily life, but mood changes can create challenges, as you never know how you’ll feel next.
Hypomanic Symptoms:
- Euphoria and extreme happiness
- Overconfidence and increased self-esteem
- Talking more than usual
- Poor decision-making and risky behavior
- Racing thoughts
- Agitation or irritability
- Increased activity and drive to accomplish goals
- Less need for sleep
- Difficulty concentrating
Depressive Symptoms:
- Sad, hopeless, or empty
- Tearful
- Irritable, especially in kids and teens
- Disinterest in activities you once enjoyed
- Changes in weight
- Feelings of worthlessness or guilt
- Sleep disturbances
- Restlessness
- Fatigue
- Trouble concentrating
- Thoughts of death or suicide
Diagnostic Criteria:
- Hypomanic Symptoms: For at least 2 years (at least 1 year in children and adolescents), presence of numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode.
- Depressive Symptoms: For at least 2 years (at least 1 year in children and adolescents), presence of numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.