Currently, this disorder affects more than 5.8 million Americans. 

Signs and Symptoms of Bipolar Disorder

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and uncharacteristic behaviors—often without recognizing their likely harmful or undesirable effects. These distinct periods are called “mood episodes.” Mood episodes are very different from the moods and behaviors that are typical for the person. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks.

People having a manic episode may:	People having a depressive episode may:
Feel very “up,” “high,” elated, or irritable or touchy	Feel very sad, “down,” empty, worried, or hopeless
Feel “jumpy” or “wired”	Feel slowed down or restless
Have a decreased need for sleep	Have trouble falling asleep, wake up too early, or sleep too much
Have a loss of appetite	Experience increased appetite and weight gain
Talk very fast about a lot of different things	Talk very slowly, feel like they have nothing to say, forget a lot
Feel like their thoughts are racing	Have trouble concentrating or making decisions
Think they can do a lot of things at once	Feel unable to do even simple things
Do risky things that show poor judgment, such as eat and drink excessively, spend or give away a lot of money, or have reckless sex	Have little interest in almost all activities, a decreased or absent sex drive, or an inability to experience pleasure (“anhedonia”)
Feel like they are unusually important, talented, or powerful	Feel hopeless or worthless, think about death or suicide

Causes of Bipolar Disorder

According to the Centers for Disease Control and Prevention (CDC), bipolar disorder’s average start is 25 years.

Though it is more common in women, men have an earlier onset of the disease. Women may start with a depressive phase while men may start with a manic episode.

Doctors don’t know the exact cause of this disorder. Even so, the likely causes are:

• Genetic factors and family history
• Stressful or traumatic events
• Alcohol and drug abuse
• Presence of another anxiety disorder, such as depression
• Biological or neurological changes, for example, due to hormonal imbalances
• Environmental factors, such as having a bipolar parent

Various studies show certain genes increase the chance of having the disease. As for family history, many bipolar patients have someone in the family who has the disease as well. To be clear, having this family history does not mean the illness will occur.

Stressful events could involve death or being in an abusive relationship. They could involve suffering long-term illness. Such events trigger immense grief, pain, and even illness due to a weakened immune system.

Over time, this stress becomes chronic and starts affecting other areas of the person’s life. Signs of this appear as anxiety, weight gain, affected memory, and high blood pressure.

Alcohol and drug abuse rewire the brain thus making it dependent on the substances. This rewiring is part of the biological or neurological changes causing mental illnesses. The substances can also interrupt sleeping patterns and change a person’s mood.

Last, going through childhood adversity also plays a role in becoming bipolar. University of Manchester researchers found childhood adversity increased the risk of the disease. Examples of adversity range from neglect, the death of a parent, violence, to bullying.

In-depth Look at the Types of Bipolar Disorders

Bipolar I Disorder: Definition, Causes, Symptoms, and Treatment

Bipolar 1 disorder goes by the name manic-depressive disorder. The pronunciation is “bipolar one”.

A person must experience at least one manic episode to have the bipolar 1 classification. They must also have a depressive episode at some stage. The depressive episodes last longer than the manic ones.

Manic episodes progress from the hypomanic stage to full-blown mania. Thus, the patient has the atypical elevated mood and energy. Experiencing one manic episode is the key to making an accurate diagnosis.

Later, the individual may cycle through the manic and depressive phases. This causes a disruption in their lives. Their mood may go from feeling euphoric to being irritable. Add the reckless behavior and this disorder can have serious repercussions.

For example, people in the manic phase might feel overconfident. They might carry themselves in a grandiose manner. As such, this might lead them to spend all their money to match their perceived status.

Untreated manic episodes last for weeks or months. Thereafter, the depressive phase takes over. These depressive episodes have the same symptoms as clinical depression.

Psychosis: Symptoms, and Causes

In dire circumstances, the manic episodes may trigger psychosis. In this state, the individual is no longer in touch with reality. It ranges from engaging in abnormal behavior to being in a disturbed mental state.

The symptoms of psychosis include hallucinations, persecutory delusions, catatonia, and disturbed thought patterns. Catatonic expressions involve being in trance, experiencing seizures, or doing something repeatedly.

Some of the causes of psychosis are the same as the bipolar 1 causes. These include genetics, neurobiology, chronic stress, and early environmental factors.

Other causes range from sensory and sleep deprivation to caffeine intoxication. Psychoactive drugs such as methamphetamines and LSD also play a role.

Diagnosing and Treating Bipolar I Disorder

Diagnosing bipolar 1 involves ruling out substance-induced symptoms and other mental disorders. As you know, some medications, drugs, toxins, and treatments can cause bipolar-like symptoms.

Mental disorders like schizophrenia can have bipolar 1 symptoms. Examples include delusions, social withdrawal, and disorganized thoughts and speech patterns.

Thus, the doctor must do several medical assessments. They may use drug tests, ultrasounds, CAT scans, and an EEG (electroencephalogram). Other tests will check the blood, urine, thyroid, and liver.

Once they get a bipolar 1 diagnosis, the patient will receive Lithium medication. They might also use antipsychotics, electroconvulsive therapy, and anti-seizure drugs.

Bipolar II Disorder: Definition, Causes, Symptoms, and Treatment

The pronunciation of this disorder is “bipolar type 2” or “type 2 bipolar”. To diagnose bipolar 2, there must be at least one episode each of hypomania and major depression.

One key feature of bipolar II disorder is the patient should never have had a manic episode. Plus, the hypomania must last more than four days.

Type two bipolar patients suffer depression longer than they do with hypomania. Due to this, there is a tendency to misdiagnose it as unipolar depression. Doctors don’t spot the hypomania symptoms. This is because people with hypomania continue functioning normally in their daily lives.

A hypomanic episode appears normal because everyone sometimes has the same experiences. These include feeling happy, energetic, sleeping less, and wanting to compete with others. Yet, an important difference is bipolar II patients can suffer mixed episodes. This means they could have both hypomanic and depressive symptoms.

The episodes may even cycle from one to the other in a rapid and distinct manner. Doctors call this “rapid cycling”. The depressive episodes become more frequent and mirror symptoms of clinical depression. Symptoms can be thoughts of worthlessness, despair, and suicide.

Diagnosing and Treating Bipolar II Disorder

Diagnosing type two bipolar is difficult because patients suffer a long depressive phase. They never account for the times when their mood is higher than normal. Thus, doctors focus on treating depression without being aware of the hypomania.

Getting the right diagnosis prevents the adverse effects of antidepressants on bipolar patients. Doctors use mood disorder screening tests to identify disorders in the bipolar spectrum. The spectrum is a framework for defining different disorders and mental health illnesses.

Bipolar 2 treatment uses psychotherapy, mood stabilizers, dopamine agonists, and antipsychotic medication.

Doctors must prescribe different mood stabilizers to prevent recurrent episodes. They can also try benzodiazepines to control insomnia and anxiety.

Cyclothymic Disorder: Definition, Causes, Symptoms, and Treatment

Cyclothymia is a mild form of bipolar disorder. Its unofficial name is “bipolar 3”. It has persistent or recurring changes to and from mild depression to hypomania. Normal moods do not last more than 8 weeks.

The DSM-V notes that cyclothymic disorder does not have dramatic mood changes. The depressive states are brief and don’t have the symptoms of major depression. Moreover, hypomania doesn’t reach full mania levels.

Still, the emotional highs and lows must last for at least 2 years to get the term cyclothymia. There should not be a gap of more than two months between symptoms.

About 1 percent of Americans have cyclothymia. Its onset is around adolescence. The pattern of this disorder is unpredictable. No one is sure about its causes either. Yet, family history and genetics seem to be the likely ones.

Diagnosing and Treating Bipolar 3

This illness does not present the full-blown symptoms of other disorders. Despite this, the depressive episodes make the patient seek treatment.

Patients experience chronically unstable moods and engage in risky behavior. These mood swings create problems in relationships. There could be instances of alcohol and drug abuse as well.

Doctors struggle to diagnose this disorder because it can co-occur with other disorders. It can also present the same symptoms as another disorder. An example is the increased energy present in Attention Deficit Hyperactivity Disorder (ADHD).

Bipolar 3 treatment involves the use of mood stabilizers such as lithium. Making sure the mood remains stable could prevent the risk of suicide.

Unspecified Bipolar Disorder: Definition, Causes, Symptoms, and Treatment

Some bipolar disorders don’t have a specific pattern. They also don’t match the other three disorders. Yet, they still have to meet the criteria for abnormal mood changes.

The subtypes of bipolar disorder are bipolar 4 and 5. They are subthreshold types of disorder. This means their symptoms are not as pronounced.

Bipolar IV Disorder

In this subtype, hypomanic and manic episodes come from taking antidepressant drugs. Doctors prescribe antidepressant medication to treat other types of mental illness. Unfortunately, this can trigger bipolar disorder.

Patients must then learn to cope with the manic and depressive feelings. They must learn to avoid substances like alcohol as well.

Bipolar V Disorder

This subtype involves people who have genetic bipolar disorder. The patient only suffers from major depression despite a family history of bipolar disorder.