Everything You Need to Know About Bipolar Disorder

I have a confession to make. Before I launched my blog, My Big Fat Bipolar Life, I did very little research on bipolar disorder. I thought having bipolar meant—well, I thought it meant I had bipolar.

I don’t know why I never immersed myself in knowledge about bipolar disorder. It is not something I ever gave any thought to. I was too busy going about the business of living with bipolar, and when I was diagnosed in 1997, there was no such thing as a Google search.

We live in a different world now, with a wealth of information available at our fingertips. As a bipolar disorder awareness blogger and advocate, it is time for me to expand my knowledge of bipolar disorder and all of its classifications, so I can better help others navigate their diagnosis as successfully as I do.

I will not only better educate myself in all things bipolar, but I will also educate you too. My goal is to share everything you need to know about bipolar and provide the tools to navigate your diagnosis or the diagnosis of someone you love.

Sifting Through Bipolar Resources

There is a plethora of information on bipolar on the internet. You could get lost for days digesting all the resources available.

It is natural to get overwhelmed at the thought of sifting through all of the resources available to learn the ends and outs of bipolar disorder and all of its classifications. That is where I come in. I am going to do the heavy lifting for you.

For this discussion, I narrowed my research to two credible sources. I gathered all the facts in this post from articles on the websites of the National Alliance on Mental Illness and the Mayo Clinic.

Bipolar 101

According to the National Alliance on Mental Illness (NAMI), “Bipolar disorder is a mental illness that causes dramatic shifts in a person’s mood, energy, and ability to think clearly. People with bipolar disorder experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience.”

Bipolar disorder affects 2.8% of American adults, and it affects men and women equally. Although the median age of onset is 25, bipolar can start in early childhood or later in life. It affects all ages, races, and social classes.

Four Types of Bipolar Disorder

According to the National Alliance on Mental Illness (NAMI), there are four types of bipolar disorder:

1. Bipolar I Disorder

For a bipolar I disorder diagnosis, the patient must experience at least one episode of mania. Most patients with bipolar I disorder have both manic and depressive episodes, but a depressive episode is not necessary for diagnosis. For diagnostic purposes, the manic episode must last at least a week or require hospitalization.

2. Bipolar II Disorder

For a bipolar II disorder diagnosis, the patient must experience shifting episodes of depression and hypomania (a milder form of mania without psychotic features) without ever having a full-blown manic episode. It is NOT a milder form of bipolar I disorder.

3. Cyclothymic Disorder or Cyclothymia

For a cyclothymic disorder diagnosis, the patient must exhibit a chronically unstable mood with hypomania and mild depression for at least two years. For children and teenagers, the length of the instability must be one year. The patient may experience periods of stability, but it lasts less than eight weeks.

4. Bipolar Disorder, “Other Specified” and “Unspecified”

For this diagnosis, the patient must not meet the diagnostic requirements for any of the other three classifications, but they must still experience significantly abnormal elevated moods over time. This classification may also cover episodes triggered by drugs, alcohol, or a medical condition.

Symptoms

Mania and Hypomania

A manic and hypomanic episode must include three or more of these symptoms:

• Abnormally upbeat, jumpy, or wired
• Increased activity, energy, or agitation
• An exaggerated sense of well-being and self-confidence
• Decreased need for sleep
• Unusual talkativeness
• Racing thoughts
• Distractibility
• Poor decision-making (shopping sprees, taking sexual risks, foolish investments)
• Psychotic features like hallucinations and/or delusions

Depression

A major depressive episode must include five or more of these symptoms and noticeably impair the patient’s day-to-day life:

• Depressed mood, such as feeling sad, empty, hopeless, or tearful
• In children, a depressed mood may present as irritability
• Marked loss of interest or feeling no pleasure in all—or almost all—activities
• Significant weight loss when not dieting, weight gain, or appetite changes
• In children, failure to gain weight as expected can be a sign of depression
• Insomnia or sleeping too much
• Either restlessness or slowed behavior
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Decreased ability to think or concentrate or indecisiveness
• Thinking about, planning, or attempting suicide

Causes

Scientists have not yet pinpointed the exact cause of bipolar disorder, but several factors contribute to an individual developing the condition.

• Genetics. A person with a first-degree relative such as a parent or sibling is more likely to develop bipolar disorder. Having a genetic predisposition does not make the diagnosis inevitable. Studies have shown that in identical twins, one may develop bipolar disorder while the other does not. Scientists are trying to determine which genes cause the development of bipolar disorder.
• Brain Structure and Function. Research has shown differences in the brains of people with bipolar disorder.
• Stress. A traumatic life event can trigger mania or depression. The way a person handles stress may also play a role in a person’s development of bipolar disorder.

Treatments

A multifaceted treatment plan tailored to the patient’s specific needs is necessary to manage bipolar disorder.

Common interventions include:

• Medication including lithium, mood stabilizers, second-generation antipsychotics, and antidepressants.
• Psychotherapy including cognitive behavior therapy, family-focused therapy, and stress regulation.
• Electroconvulsive Therapy (ECT) involves a brief electrical stimulation of the brain while the patient is under anesthesia.

Psychotherapy and proper medication are the standard of care in most cases. It usually takes a combination of medications to keep a patient stabilized. Because antidepressants can trigger mania, they are usually prescribed with mood stabilizers and antipsychotics. Electroconvulsive therapy (ECT) is an option if a patient with severe mania or depression does not respond to other treatments.

In addition, solid self-care habits, a set routine, and a support system are crucial. It is also critical to have the self-awareness to recognize symptoms at their onset. Educate your family members and support system, so they know what to expect too.

The Takeaway

If I have learned anything in all my years of managing bipolar, it is that it is not one size fits all. Sufferers may have similarities in symptoms and treatment protocols, but ultimately, bipolar is a nuanced condition that will present uniquely to a particular person’s hardwiring.

In my experience, having the right psychiatrist is an essential element in any treatment plan. The patient must trust the doctor’s judgment and have confidence they have their best interests at heart.

Do your homework so you can be your own advocate and pick a psychiatrist you trust. Then you can work together to construct a treatment plan that fits your needs.

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