Bipolar Disorder: Symptoms, Testing, Types, and Treatment

Bipolar disorder is often misunderstood, as the term is liberally used in everyday conversation to describe ambivalence or a volatile temper. Contrary to popular belief, bipolar disorder does not merely refer to indecisiveness or sudden bouts of anger.

Bipolar disorder, known initially as manic-depressive illness or manic depression, is a condition that causes sudden and drastic fluctuations in an individual’s mood, energy levels, activity levels, and ability to concentrate and complete daily tasks.

Bipolar disorder is not simply feeling happy one day and sad the next. People with bipolar disorder can experience various symptoms and a mix of emotions that can make it difficult for them to decipher what they are feeling and why. 

Individuals with bipolar disorder typically experience periods of heightened mood, known as mania, followed by periods of depression. These mood changes can interfere with sleep, energy levels, mental clarity, judgment, and overall behavior.

Symptoms of Bipolar Disorder 

While it’s common for our moods to change from day to day, extreme fluctuations in emotions, energy levels, and mood may signal bipolar disorder. Individuals with bipolar disorder are often described as having manic episodes where they are “up,” meaning in a state of elation, irritability, or hyperactivity, or depressive episodes where they are “down,” meaning in a state of sadness, indifference, fatigue, or hopelessness. 

Symptoms of a manic or hypomanic (less intense mania) episode include:

• Feeling abnormally upbeat, energetic, or euphoric
• Inflated sense of well-being and self-esteem
• Increased activity or agitation
• Increased irritability
• Decreased need for sleep
• Racing thoughts
• Increased talkativeness
• Getting distracted easily
• Impaired judgment leading to impulsive or risky behavior (e.g., spending sprees, dangerous activities, etc.)

Major depressive episodes tend to interfere with aspects of daily life, including work, school, and relationships. Symptoms of a major depressive episode include:

• Feelings of sadness, emptiness, hopelessness, and indifference
• Loss of interest or pleasure in activities typically enjoyed
• Irritability
• Significant weight loss or gain while not on a diet
• Loss of or changes in appetite
• Sleeping too much or too little
• Slowed movements
• Low energy levels and fatigue
• Low self-esteem, feelings of worthlessness and guilt
• Trouble focusing
• Suicidal thoughts

Bipolar disorder manifests differently in each individual. Some patients may experience mood shifts very rarely, while some may experience them several times a year. In addition to the above symptoms, some individuals with bipolar disorder may experience anxious distress, melancholy, and psychosis.

Testing for Bipolar Disorder 

Bipolar disorder can be diagnosed at any age but is most commonly identified in people’s teens and early 20s. Bipolar disorder is typically diagnosed when a patient has experienced at least one manic, hypomanic, or depressive episode. Because bipolar varies drastically from person to person, it can be hard to know when to see a doctor.

People with bipolar disorder often enjoy the symptoms of mania, such as euphoria and increased productivity. As a result, many people with bipolar disorder only seek help during depressive episodes, meaning the condition is often mistaken for major depression. It’s vital to know the difference, as antidepressants can trigger manic episodes in people with bipolar disorder.

Diagnosing bipolar disorder is a complex process. No single test, such as bloodwork or a brain scan, can be taken to diagnose the condition. Instead, diagnosis relies on a series of physical and psychiatric evaluations that offer insight into a patient’s condition. 

As symptoms of bipolar disorder overlap with those of other conditions, such as anxiety, OCD, and personality disorders, your doctor may wish to perform a physical assessment to help rule out the possibility of another condition. In some cases, hormonal disorders like hypothyroidism can contribute to symptoms of a mood disorder.

Once your doctor has ruled out an underlying condition, they may refer you for psychiatric evaluation. To help with diagnosis, you may be asked to record your daily symptoms, including mood swings and sleep patterns.

Types of Bipolar Disorder 

Bipolar disorder has three main types:

• Bipolar I. Characterized by manic episodes lasting beyond seven days or depressive episodes lasting two weeks. Patients may experience manic and depressive symptoms simultaneously. Severe symptoms that require hospitalization may be a sign of Bipolar I disorder.
• Bipolar II. Characterized by milder manic and depressive symptoms. Typically, periods of hypomania are followed by periods of depression. In general, symptoms of Bipolar II are not strong enough to be considered manic or depressive episodes. However, people with Bipolar II may experience more prolonged periods of depression than those with Bipolar I.
• Cyclothymic disorder. Characterized by periods of hypomanic symptoms and depressive symptoms, but not episodes, for at least two years.

Lesser-known forms of bipolar disorder exist, including alcohol-induced bipolar disorder and bipolar disorder related to an underlying medical condition like multiple sclerosis or stroke.

Treatment Options for Bipolar Disorder

Although bipolar disorder is a lifelong condition, treatments, including medication and psychotherapy, can help mitigate symptoms. Speaking with a doctor or mental health professional is the first step towards learning to live with your bipolar disorder.

During our initial assessments, we discuss symptoms, medical history, and family history to get a better picture of our patient’s condition. Our goal is to understand your situation as fully as possible so we can offer a personalized approach to bettering your mental health.

Depending on the nature of your bipolar disorder, we may prescribe any of the following treatments:

• Medication. Continued use of medication is often required to mitigate symptoms of bipolar disorder. Medications can include mood stabilizers, antipsychotics, antidepressants (typically paired with a mood stabilizer), and anti-anxiety medications.
• Counseling and psychotherapy. Therapy is a helpful tool for individuals to better understand and navigate their symptoms. 
• Substance abuse treatment. If your bipolar disorder is influenced by drug or alcohol use, substance abuse counseling can help.

In some cases, hospitalization may be necessary. This typically occurs when a patient experiences suicidal thoughts, behaves dangerously, or experiences psychosis.

If you or someone you know is experiencing suicidal thoughts, call 911 or the National Suicide Prevention Lifeline at 800-273-8255 immediately.