How To Treat Bipolar Disorder: Four Steps To Promoting Longterm Recovery
Occasional mood swings can be an expected part of daily life. Depending on the day, your personality, or how much you’ve slept, you may be tired and “down” one day and excited and “upbeat” the next. However, if your moods and emotions fluctuate on a consistent long-term basis, seem excessive and unpredictable, and affect your ability to function, you may be experiencing a mental health condition like bipolar disorder.
Bipolar disorder is a mental illness characterized by extreme mood swings and significant shifts in energy, activity levels, and concentration. Left untreated, this condition may prevent you from fully engaging in daily tasks and relationships. However, psychologists have deepened their understanding of the symptoms and treatment of bipolar disorder, which is divided into three types.
To understand the treatment options for bipolar disorder, looking at the three main types of this condition can be helpful. Note that the information below does not replace a medical diagnosis or treatment plan. You can work with your doctor or therapist to determine the underlying cause of your mood swings, confirm the diagnosis, and create a personalized treatment plan.
The three types of bipolar disorder
While bipolar disorder is divided into three subtypes, all diagnoses involve significant changes in mood, energy, and activity levels. Individuals diagnosed with this condition may also experience periods of more neutral moods. With proactive treatment, this condition is often treatable. Below are further explanations of the three most common subtypes of bipolar disorder that can be diagnosed.
Bipolar I disorder
According to the American Psychiatric Association (APA), bipolar I disorder is diagnosed when someone experiences at least one manic episode, a period of an elevated, expansive, or irritable mood. During a manic episode, a person may experience increased activity, energy, talkativeness, racing thoughts, self-esteem, and other intense emotions. They may also experience paranoia, psychosis, and severe delusions.
People with bipolar I disorder may experience depressive or hypomanic episodes. Hypomanic episodes involve less severe manic symptoms that last four days or less, whereas manic episodes last at least a week. During hypomanic periods, people may be more energized. However, the shift may not be as severe as mania and is not associated with severe delusions, psychosis, or paranoia like mania can be. Some people who experience mania may be hospitalized for a manic episode due to the severity of this symptom.
Bipolar II disorder
A person diagnosed with bipolar II disorder must have at least one major depressive episode and one hypomanic episode. Unlike bipolar I disorder, people diagnosed with bipolar II disorder have not experienced a full manic episode.
People commonly receive this diagnosis after their first depressive episode since hypomanic episodes may not affect daily functioning and can be pleasurable, as they tend to increase energy levels and perceived productivity. However, note that hypomania is still a serious symptom and can negatively impact one’s life—it is not “fun,” “quirky,” or “cool.” Bipolar II disorder can be as serious as bipolar I disorder and often requires treatment.
The depressive symptoms of bipolar II disorder are often worse than those of bipolar I disorder. These symptoms may lead to severe, prolonged depressed moods, a lack of ability to care for oneself, and 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.
Cyclothymic disorder is a milder form of bipolar disorder. According to the APA, this disorder is defined by mood swings, hypomania, and depressive symptoms that occur over at least two years. Among people with this subtype of bipolar disorder, also called cyclothymia, the hypomanic and depressive symptoms do not meet the diagnostic criteria for a major depressive or hypomanic episode.
Treating bipolar disorder: Four common steps
If you suspect that you are experiencing bipolar disorder, it can be essential to meet with a licensed physician for a thorough examination and diagnosis.
In addition to gathering your medical history, a doctor may request blood tests to rule out other conditions that could be causing your symptoms. Your doctor may also order a mental health evaluation to confirm the diagnosis of bipolar disorder or other health conditions using the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
With a complete diagnosis, your provider may craft a treatment plan tailored to your needs, symptoms, and goals. While doctors commonly suggest the following four steps, consult your physician before introducing treatments or lifestyle changes.
Make healthy lifestyle changes
A balanced diet and regular exercise may help you manage the symptoms of health conditions, including bipolar disorder. For people with this condition, it can be important to eat regular meals to avoid sudden drops in blood sugar, which can negatively affect your mood. Incorporate fresh fruits, vegetables, whole grains, and other wholesome foods that stabilize your blood sugar and energy levels.
Some research suggests that omega-3 fatty acids play a role in managing the symptoms of depression, schizophrenia, obsessive-compulsive disorder (OCD), bipolar disorder, and other mood disorders. To increase your daily dose of omega-3, focus on eating more fish, walnuts, and seeds, and ask your doctor about omega-3 supplements.
Beyond your plate, you can make efforts to stay active and find a type of exercise you enjoy and can commit to consistently. In cases of bipolar disorder, regular exercise may improve mood and reduce the number of mood swings you experience.
Depending on the severity of your symptoms, your doctor may prescribe medications. For clients with bipolar disorder, medications called “mood stabilizers” may be used to reduce mood swings and improve emotional well-being.
Therapists cannot prescribe medication—only a board-certified physician can recommend and prescribe medication. In addition, consult a physician before starting, changing, or stopping any medication for bipolar disorder.
In some cases, complementary therapies, such as electroconvulsive therapy (ECT), are recommended when people with bipolar disorder do not respond to medication or psychotherapy. ECT is delivered in several rounds and involves applying a brief electrical current to a person’s scalp while under anesthesia. This treatment results in a short, controlled seizure, which is believed to remodel the brain signaling pathways and improve the emotional symptoms of bipolar disorder.
Practice self-care strategies
Regardless of your diagnosis, self-care can be essential to lifelong mental health. If you’re living with bipolar disorder, your self-care routine may include activities or rituals that stabilize your mood and bring you peace and calm.
Some common self-care activities include:
Going on a walk with a friend
Meditation or yoga
Deep breathing exercises
Reading a book
Listening to music
Calling a loved one
Scheduling coffee with a co-worker
Self-care can include solitary activities and social outings with acquaintances and loved ones. When you live with bipolar disorder, it may help to balance solitary time with social support and prioritize spending time with people who know and care about you.
In addition to casual check-ins with friends, consider joining a bipolar disorder support group, which you may be able to find in your local community or online.
For some people with bipolar disorder, talk therapy is a foundational tool. A licensed therapist can help them learn more about their diagnosis, adhere to a medication schedule, and identify any emotional or physical factors that may worsen mood swings and other symptoms.
In a digital era, more people may use online therapy through platforms like BetterHelp, which can offer more flexibility than traditional modes of therapy. Using an online platform, you can match with a licensed therapist within 48 hours and schedule your first session. Some BetterHelp therapists specialize in working with people with bipolar disorder and related conditions, and they’ll listen to your concerns with compassion and expertise.
Several studies show that online therapy can be as effective as face-to-face sessions. One 2019 study found that an online, mindfulness-based psychotherapy was effective for treating people with “late stage” bipolar disorder who have experienced numerous bipolar disorder episodes. Participants in the online program reported significant increases in their quality of life, which can be a crucial concern among people with severe bipolar disorder. The researchers concluded that online mindfulness therapy is an effective, feasible, and hopeful treatment option.
Can you overcome bipolar disorder?
Bipolar disorder is a chronic condition that typically lasts for life. However, the symptoms can be managed with appropriate bipolar disorder treatment, such as mood stabilizers, psychotherapy, and lifestyle changes. Maintenance treatment, which may involve ongoing medication and therapy, can help prevent relapses of manic or hypomanic episodes and bipolar depression.
What can trigger bipolar?
Bipolar disorder itself is a complex condition with triggers that can cause or worsen episodes. Triggers for bipolar disorder may vary and include stress, lack of sleep, and major life changes. Recognizing and avoiding triggers are often a key part of managing symptoms.
How do people with bipolar think?
People with bipolar disorder may experience different thinking patterns during manic, hypomanic, or major depressive episodes. During manic or hypomanic episodes, they might have racing thoughts or experience more creativity. During major depressive episodes, they may have negative, hopeless thoughts and trouble concentrating.
Can someone with bipolar experience love?
Yes, individuals with bipolar disorder are capable of experiencing love and maintaining fulfilling relationships. However, both partners may want to communicate about specific needs and the warning signs of mood changes. Family-focused therapy can often help loved ones understand and support someone with bipolar disorder.
How long can a bipolar person live?
Bipolar disorder may be associated with other health risks, such as substance misuse and heart disease. As a result, a person with bipolar disorder may have a shorter life expectancy than someone without the condition. Eating a healthy diet, regularly exercising, and adhering to a treatment plan may help improve the chances of a longer life.
Is bipolar a mental illness or disorder?
Bipolar disorder is a mental illness or disorder in which an individual experiences severe mood swings, including manic, hypomanic, and major depressive episodes. The symptoms of this condition can affect a person's mood, energy levels, and ability to function.
Who is at greatest risk for bipolar disorder?
Bipolar disorder can affect people of any age, gender, or background. However, different factors, such as a family history of bipolar disorder or other mental health conditions, may increase the risk. Early warning signs often appear in late adolescence or early adulthood.
Does bipolar get worse as you age?
Bipolar disorder can change over time, and for some, symptoms may worsen with age if not properly managed. A healthcare provider may recommend regular visits and adjustments in the treatment plan to help manage the disorder over time. For example, they might change the dosage of medications like mood stabilizers or recommend other therapies like electroconvulsive therapy.
How do you calm a bipolar mind?
A combination of treatment strategies may help calm a bipolar mind. Prescribed medications like mood stabilizers or antipsychotics, psychotherapy, and self-care practices like meditation, yoga, or social rhythm therapy may help manage bipolar symptoms. Staying consistent with taking medication and therapy is often key for stabilizing mood.
How not to argue with a bipolar person?
If you find yourself interacting with someone experiencing a bipolar episode, remain calm and avoid confrontations. During manic or hypomanic episodes, the individual may have intensified emotions or irritability. Instead of escalating the situation, communicate in a clear, supportive, and non-confrontational manner. Keep in mind their reactions may be part of their condition, not a personal attack.
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