Understanding Bipolar Disorder: DSM-5 Criteria And Treatment Options
Bipolar disorder is a mental health condition marked by the presence of hypomania or mania, often alongside depressive episodes. Misconceptions and misdiagnoses may surround this complex condition, underscoring the benefit of accurate treatment and psychoanalysis. To understand bipolar disorder and its subtypes in further detail, looking at the criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) can be helpful.
What Is Bipolar Disorder?
Bipolar disorder, formerly known as manic depression, is a mental health condition often characterized by extensive mood swings. These mood episodes may range from elevated and energized (manic episodes) to sad and hopeless (depressive episodes). Individuals experiencing bipolar disorder have periods of intense emotion, changes in sleep patterns and activity levels, and altered behavior.
Note that not everyone with bipolar disorder experiences mania or depressive episodes. There are three primary subtypes of bipolar disorder that can be essential to understand when looking at the diagnosis of this condition.
Signs And Symptoms
Bipolar disorder symptoms vary among individuals and depend on the subtype of diagnosis. The most common may include the following:
Mood swings between mania or hypomania and depression
Changes in energy levels, sleep patterns, and appetite
Difficulty concentrating and making decisions
Increased risk-taking behaviors
Suicidal thoughts
If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.
Causes And Risk Factors
There is no one primary cause of bipolar disorder. However, researchers believe that a combination of genetic, environmental, and biological factors contributes to the development of the condition, including the following:
A family history of bipolar disorder or other mental health conditions
Periods of high-stress or traumatic events
Substance use
Imbalances in brain chemicals and neural circuits
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.
Types Of Bipolar Disorder
There are three primary types of bipolar disorder, each with unique symptoms. These subtypes include the following.
Bipolar I Disorder: Characteristics And Impact On Daily Functioning
Bipolar I disorder is a subtype of bipolar disorder distinguished by at least one manic episode. People with bipolar I disorder may not have depressive episodes, but they can occur.
Manic episodes in bipolar I disorder are characterized by a distinct period of abnormally elevated, expansive, or irritable mood, which persists for at least seven days or necessitates hospitalization due to the severity of symptoms.
During a manic episode, individuals may exhibit symptoms like the following:
Inflated self-esteem
A decreased need for sleep
Increased talkativeness
Racing thoughts
Distractibility
Heightened goal-directed activity or agitation
Engagement in risky behaviors with potentially severe consequences
Paranoia
Delusions
Psychosis (in some cases)
The intensity of these symptoms often interferes with daily functioning, leading to disruptions in work, school, social, or family life. Depressive episodes may accompany these episodes, but their presence is unnecessary for a diagnosis.
Bipolar I disorder may cause significant distress for affected individuals and their families, as the severity of manic episodes may result in marked impairment in various aspects of life. The unpredictable nature of mood swings may also contribute to difficulties in maintaining stable relationships, employment, or academic progress. Therefore, early diagnosis and appropriate intervention are often crucial.
Bipolar II Disorder: Features And Effects On Daily Life
Bipolar II disorder is another subtype of bipolar disorder, differentiated by at least one major depressive episode and one hypomanic episode, a milder form of mania. Unlike bipolar I disorder, bipolar II disorder does not involve manic episodes. However, this condition still causes significant distress and impairment in daily functioning.
Hypomanic episodes in bipolar II disorder are often characterized by a distinct period of elevated, expansive, or irritable mood lasting at least four consecutive days. The symptoms may be like those in manic episodes but are less severe and do not require hospitalization.
Common manifestations during a hypomanic episode include the following:
Increased self-esteem
A decreased need for sleep
Heightened talkativeness
Racing thoughts
Distractibility
Increased goal-directed activity
Engagement in activities with potentially harmful consequences
Major depressive episodes in bipolar II disorder involve symptoms of major depressive disorder (MDD), like the following:
A persistent depressed mood
Diminished interest or pleasure in activities
Significant changes in weight or appetite
Sleep disturbances
Psychomotor agitation
Fatigue
Thoughts of worthlessness
Excessive guilt or shame
Difficulty concentrating
Recurrent thoughts of suicide
The combination of depressive and hypomanic episodes in bipolar II disorder often leads to difficulty functioning in areas of work, school, social interactions, and relationships. The alternating mood episodes may create challenges in maintaining consistency in daily functioning and managing stress effectively. Thus, timely diagnosis and intervention are often beneficial.
Cyclothymic Disorder
Cyclothymic disorder is a subset of bipolar disorder that may be diagnosed when one does not meet the criteria for bipolar I disorder or bipolar II disorder. It involves chronic, fluctuating mood disturbances involving numerous hypomanic and depressive symptoms.
In addition, symptoms persist for at least two years in adults or one year in children and adolescents. The depressive episode cannot meet the criteria for a major depressive disorder diagnosis and cannot involve a manic episode, which is only found in bipolar I disorder.
DSM-5 Criteria For Bipolar Disorder
The DSM-5 provides criteria for diagnosing bipolar disorder. To be diagnosed with a mental health condition, it can be crucial to consult a doctor or mental health professional for a thorough evaluation, as the symptoms may overlap with other psychiatric conditions.
To be diagnosed with bipolar I disorder, individuals must have experienced at least one manic episode. In contrast, individuals with bipolar II disorder must experience at least one major depressive episode and one hypomanic episode. A diagnosis of cyclothymic disorder requires chronic, fluctuating mood disturbances involving numerous hypomanic and depressive symptoms.
Treatment Options
While there might not be a cure for bipolar disorder, a combination of medication, psychotherapy, and lifestyle changes may help individuals manage symptoms and improve their quality of life. Below are a few of these options.
Medication
The option to use medication might be available for individuals with bipolar disorder, depending on the severity and frequency of symptoms. However, consult your primary care physician or psychiatrist before starting, changing, or stopping any medication.
Psychotherapy
Therapy is often an effective method of treating bipolar disorder. A few of the most recommended modalities include the following:
Cognitive-behavioral therapy (CBT)
Family-focused therapy
Interpersonal and social rhythm therapy
Psychoeducation
Lifestyle Changes
People with bipolar disorder can make a few lifestyle changes to improve daily life and potentially reduce symptom severity, including but not limited to the following:
Regular sleep schedule
Balanced diet
Exercise
Stress reduction techniques
Avoiding substance use
Support Options
If you’re living with bipolar disorder or believe you may have this condition, you’re not alone. Various support options are available for mental health conditions, and you don’t have to be diagnosed to attend therapy. In addition, if you face barriers to reaching in-person therapy or affordable counseling, online platforms like BetterHelp may offer more care options.
Through an online platform, individuals with bipolar disorder or any mental health challenge can receive support from home or anywhere with an internet connection. In addition, online platforms allow users to choose between phone, video, or live chat sessions and have unique resources like journaling prompts, group sessions, classes, and worksheets.
Studies showcase that online therapy can also be as effective as face-to-face options. In one study of online therapy for bipolar disorder, 95% of participants reported an increased quality of life after treatment, with results similar to in-person studies on therapy.
Takeaway
Understanding bipolar disorder can involve recognizing its complexity, diagnostic criteria, and various treatment options. Bipolar disorder can often be managed with treatment; you’re not alone if you live with this condition. Consider contacting a therapist online or in your area to receive further compassionate support and guidance.
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