Understanding Common Bipolar Tendencies And Impacts On Mental Health

Bipolar disorder is a complex mental health condition. Formerly known as manic depression or manic depressive illness, it's characterized by episodes of mania and depression that can significantly impact a person's mood, energy, and ability to carry out everyday activities. In the article, we break down the most common signs associated with bipolar disorder, explore the different types of bipolar disorder, what causes it, and how it can be treated.

What is bipolar disorder?

Bipolar disorder is a serious mental health condition marked by episodes of mania and depression. This type of disorder affects a person’s mood and energy levels, which can in turn affect their ability to function in day-to-day activities. It typically manifests in adolescence or adulthood, with the average age of onset being 25. 

Bipolar disorder as a mood disorder

Bipolar disorder is considered a mood disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes mood disorders broadly as either bipolar disorders or depressive disorders.

The mood swings of bipolar disorder are generally very different from everyday mood swings. In bipolar disorder, mood swings are typically more severe, last longer, and can seemingly come out of the blue.

Another significant difference between everyday mood swings and bipolar disorder is the cause. Typical mood swings can be caused by many things, including diet, caffeine withdrawal, blood sugar changes, inadequate sleep, and stress. On the other hand,the cause of bipolar disorder is thought to be related to a chemical imbalance in the brain. In addition, the American Psychiatric Association reports that 80 to 90% of people with bipolar disorder have a relative with bipolar disorder or depression, indicating that a genetic component is likely to exist as well. There are other risk factors that are thought to contribute to the development of the disorder, including the use of recreational drugs, highly stressful or traumatic events, and sleep disruptions. 

Bipolar disorder is sometimes comorbid with other mental illnesses, such as attention-deficit hyperactivity disorder (ADHD), eating disorders, substance use disorders, or anxiety disorders. It is also associated with an increased risk of certain types of physical illness, such as heart disease, which can lead to further complications in day-to-day life. 

Common symptoms of bipolar disorder

As mentioned, one of the most recognizable symptoms of bipolar disorder is some level of alternation between manic or hypomanic and depressive states. With bipolar disorder, people can experience varying patterns of symptoms, such as rapid cycling, in which four manic, hypomanic, or depressive episodes occur in one year. They may also experience mixed episodes, periods marked by both manic and depressive symptoms. In this section, we’re taking a closer look at what characterizes these two moods.

Manic or hypomanic symptoms

During a manic episode, a person might describe themselves as feeling wired or “up”. Mania symptoms—including increased energy, irritable mood, feelings of euphoria, and a heightened sense of self-esteem—can be disconcerting to the person experiencing them and their loved ones. As a result of the mood symptoms of a manic episode, the individual may have irregular sleep patterns and may speak quickly, jumping frequently from topic to topic. Mania can also come with feelings of agitation and irritation. 

A person in a manic phase may experience racing thoughts, which can lead to engaging in excessive and/or risky activities such as drug use, spending, or unsafe sexual behaviors. A true manic episode will last at least one week, and symptoms will typically be categorized as severe. Note that people with different types of bipolar disorder may experience hypomania instead, which is characterized by milder symptoms of mania that typically last for at least four days instead of at least a week. Hypomania often has the same symptoms of mania, but unlike the symptoms of a manic episode, they typically do not cause social or occupational impairment.

Depressive symptoms

Low mood, loss of interest in activities, excessive sleep, and lack of motivation may be common warning signs of a major depressive episode. When someone with bipolar disorder is experiencing a depressive episode, they may begin feeling sad, hopeless, or empty. People with bipolar depression are also likely to have low energy levels, which can make daily functioning or even getting out of bed difficult. Activities they once enjoyed may hold no value or interest for them during this time. 

The individual may also experience feelings of anxiety, difficulty concentrating, forgetfulness, and significant changes in eating and sleeping habits. As with manic bipolar episodes, thoughts of self-harm may arise during depressive episodes, which is one reason that seeking treatment for a disorder like this can be so important. How long a depressive episode lasts depends on the type of bipolar disorder a person has.

Types of bipolar disorder

While fluctuations between manic and depressive states represent the key symptom of bipolar disorder, the intensity, duration, and some particulars of the way they manifest can vary from person to person. These factors are typically related to the type of bipolar disorder an individual has. There are four key types, as detailed below.

Bipolar I disorder

Bipolar I disorder is a severe form defined by episodes of mania that last for at least seven days, or possibly by manic symptoms that are so severe that the individual may need to be hospitalized. They will typically also experience depressive episodes lasting at least two weeks at a time. “Mixed episodes”, which have characteristics of both mania and depression, may also occur.

Bipolar II disorder

Those with bipolar II disorder will also tend to experience fluctuations between manic and hypomanic episodes or “high” and “low” states. This is especially true for manic episodes, as those with bipolar II disorder usually do not have full manic episodes that would require hospitalization. Instead, they experience periods of hypomania, a milder form of mania, in between depressive episodes.

Cyclothymic disorder 

Cyclothymic disorder, or cyclothymia, is the third type of bipolar disorder. It’s usually characterized by alternating symptoms of hypomania and mild depression. However, the duration and intensity of hypomanic and depressive symptoms will generally be shorter and less severe, respectively, than those individuals with bipolar disorder I or II might experience, so that they don’t qualify as clinical episodes. 

Unspecified bipolar disorder and related disorders

Finally, some people may experience symptoms that match up with bipolar disorder in general, but that don’t neatly fit into any of the three categories described above. Many people with bipolar disorder also have other mental disorders or conditions. Some of the most common are anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), and eating disorders. Co-occurring mental health conditions can make treatment more challenging as the symptoms of one disorder may contribute to or overlap with symptoms of another. 

How bipolar symptoms affect daily life

The mood shifts that accompany bipolar disorder can have a significant impact on daily life. The highs and lows of this condition can ripple outward, affecting everything from personal relationships to professional performance to physical health.

Relationships and work functioning

During manic episodes, people with bipolar disorder can make decisions that may impact their relationships in many ways. For example, manic episodes may cause strains on marriages, family relationships, and friendships, while depressive episodes can lead to social withdrawal. At work, unpredictable moods can cause difficulty concentrating, missed workdays, and difficulty maintaining professional relationships, which can affect one’s ability to keep a job or advance in one's career.

Substance use and risk behaviors

Research suggests that drug and alcohol misuse is much more common in people with bipolar disorders than in the general population, with the lifetime prevalence of substance use disorders estimated at up to 56% for people with bipolar disorder. Substance use disorder tends to occur early in the course of bipolar disorder and typically predicts more severe illness, more relapses, more hospitalizations, and a poorer outcome. 

Beyond substance use, bipolar disorder also generally leads to higher impulsivity and risk-taking behavior, such as reckless spending, dangerous driving, or risky sexual behaviors, which can ultimately result in personal, legal, or financial harm.

Triggers and patterns of bipolar episodes

Mood changes in bipolar disorder can have various triggers, and patterns can change over time. That said, it can also be important to remember that everyone’s experience with bipolar disorder is unique. To figure out your own triggers, keeping a journal can help you identify patterns. Talking to a mental health professional can also help you learn to identify your unique triggers and how to cope with them.

What can trigger manic or depressive episodes

A number of factors can trigger episodes in bipolar disorder. 

Some common things that can trigger manic episodes may include: 

• Highly stimulating environments 
• Major life changes
• Poor sleep patterns
• Substance use

Depressive episodes can also have triggers, some of which may include: 

• Stressful life events
• Fasting
• Decreased sleep

Changes across the lifespan

Bipolar disorder is a serious illness that affects people across their entire life, and its symptoms can shift with age. Research suggests that episodes may happen more frequently over time, with symptom-free intervals between episodes growing shorter. In older adults, coexisting physical health conditions can add further complexity to long-term management.

Diagnosing bipolar disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM) gives specific diagnostic criteria for each type of bipolar disorder. Because of this, it can be important to work with a mental health specialist for an accurate diagnosis.

Depending on the situation, the presence of three or four of the following must be present to qualify as a manic episode in bipolar I or a hypomanic episode in bipolar II: 

• Having an inflated sense of self-esteem or grandiosity
• Experiencing a decreased need for sleep
• Talking excessively or being more talkative than usual
• Experiencing flight of ideas or racing thoughts
• Having high distractibility
• Experiencing increased goal-directed activity or psychomotor agitation
• Getting excessively involved in activities that have a high potential for painful consequences

To meet the diagnosis of a major depressive episode, someone must experience five or more of the following symptoms daily or nearly every day for a two-week period:

• Having a depressed mood most of the day (or depressed mood observed by others)
• Experiencing anhedonia (reduced ability to experience pleasure or interest in previously enjoyed activities) most of the day
• Having significant weight loss when not dieting, weight gain, or a decrease or increase in appetite
• Experiencing insomnia or hypersomnia
• Having psychomotor agitation or retardation
• Experiencing fatigue or loss of energy
• Having feelings of worthlessness or excessive or inappropriate guilt
• Having a decreased concentration or indecisiveness
• Experiencing recurrent thoughts of death or suicidal ideation without a specific plan

Treatment options for bipolar disorder

According to experts, prompt diagnosis and treatment can improve the prognosis of someone with bipolar disorder by reducing the risk of relapse and improving the response to medications. Many people with bipolar disorder can live stable, fulfilling, autonomous lives with the right type of treatment, which can even be effective for those with severe cases.

Medication management

Medication is often used to treat bipolar disorder, though an individual’s treatment plan will typically depend on their specific symptoms, medical history, and the existence of any comorbid conditions. Age is another important factor, given that children’s and teens’ symptoms can differ from those of adults.  

Commonly prescribed medications to treat bipolar disorder include mood stabilizers and antipsychotics. Other drugs, such as antidepressants, may also help with mood changes. Always consult with a healthcare professional prior to starting or stopping any medication. If you feel you may be experiencing bipolar symptoms, speaking with a qualified health professional for evaluation and treatment options is typically recommended. An experienced provider can explain the benefits and potential side effects of mood stabilizers, antipsychotics, and other medications.  

Therapy and psychosocial support

For people with bipolar disorder, research suggests that psychosocial support can play a significant role in life satisfaction. The study used the Multidimensional Scale of Perceived Social Support, which assesses various aspects of receiving emotional, practical, and comfort support from friends and family.

Lifestyle strategies and relapse prevention

Bipolar disorder can make people feel like they don’t have control, but there is a range of things that people with this condition can do to manage their symptoms and improve overall well-being. Some of these may include: 

• Monitoring their mood
• Staying alert for triggers
• Understanding personal warning signs
• Managing stress
• Sticking to a routine
• Getting enough sleep
• Getting regular exercise
• Turning to a support network

Getting support through BetterHelp

Most people who seek treatment for bipolar disorder will develop a relationship with a psychiatrist who can help them manage their symptoms. Some individuals may also choose to meet with a therapist to help them process any emotions about their condition in a safe place and to assist them in developing healthy coping mechanisms for distressing feelings or symptoms. If you’re interested in seeking the support of a therapist in addition to the medical or psychiatric attention you’re receiving for bipolar disorder, you can typically do so either in person or online. 

For those who are seeking a more cost-effective option, online therapy is a popular choice. With a virtual counseling platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging to get support for the challenges you may be facing. A 2024 study that compared virtual and in-person treatment for people with bipolar disorder found that telehealth patients showed similar reductions in depressive symptoms and similar mood stability to those in traditional treatment, while also being more likely to remain in treatment until completion.

Takeaway