Bipolar I Disorder

This type of the disorder is characterized by the experience of at least one manic episode during one’s lifetime followed by either a period of hypomania or major depression.

What are the symptoms of mania?

  • A distinct period of an abnormally elevated, expansive or irritable mood
  • Increased energy or activity
  • Decreased need or desire for sleep (e.g., feeling rested after only 3 hours of sleep)
  • Inflated self-esteem or grandiosity
  • More talkative than usual or pressure to keep talking
  • Racing thoughts
  • Excessive distractibility
  • Increased goal-directed behavior (excessive planning and participation in multiple activities)
  • Increased risk-taking behavior (e.g., gambling, sexual promiscuity, excessive spending, aggressive or threatening actions, etc.)
  • Delusions and psychosis (e.g., sharpened senses; false beliefs about themselves, their environment or events; paranoia, and hallucinations)

It is not unusual for people in a manic state to require hospitalization in order to stabilize their symptoms. Psychotropic medications are often necessary to treat mania.

What is hypomania?

Hypomania shares the same symptoms as mania except that the symptoms may be present for a shorter period of time (e.g., several days) and do not cause as significant impairment in one’s ability to function in usual routines at home, work or school.

Bipolar II Disorder

Bipolar II disorder is sometimes misunderstood. Some believe it is a “milder” form of bipolar I disorder. This is not the case. Bipolar II disorder tends to be more chronic and individuals who have the disorder tend to struggle longer with depressive episodes. The distinction between Bipolar I and II is the recurrence of mood episodes.

This cycling of moods is what characterizes Bipolar II disorder. Individuals with this type of bipolar experience several mood episodes alternating between depression, mania, hypomania or mixed mood states throughout the course of a year. Some individuals experience rapid cycling, in which mood states switch several times over the course of several days or weeks.

What is a mixed mood state?

A mixed mood state is characterized by an activated body (insomnia, restlessness, an inability to relax or sit still) and a depressed, irritable or angry mood. Oftentimes, individuals in a mixed mood state will complain of severe anxiety, racing thoughts and agitation. Suicidal ideation is also very common during a mixed episode.

Most often, clients who seek treatment do so during a depressive episode because this is when they do not feel good and are not functioning per their norm. Hypomania is often difficult to identify because most people enjoy the periods in which they have an elevated mood and energy level. The distinction must also be made between hypomania and euthymia, which is a normal state of positive energy and a happy or content mood.

The most common and effective treatment for bipolar II disorder is a combination of psychotherapy, either individual or group; and mood stabilizing medications, such as lithium, Depakote, lamotrigine or carbamazepine and some of the neuroleptics. Lifestyle is also extremely important in maintaining a balanced state. Regular sleep, a healthy diet, exercise and avoidance of alcohol and other illicit substances are vitally important to staying healthy.

Common Myths about Bipolar Disorder

Bipolar disorder is rare.
Not true. According to the National Institute of Mental Health (NIMH), about 5.7 million American adults are affected by this disorder.
Bipolar disorder is just another name for mood swings.
False. Day – to – day mood swings are a natural part of the human experience. The mood swings associated with bipolar disorder are very different as they are far more severe and cause major impairment in one’s ability to function.
People with bipolar disorder switch from depression to mania very frequently.
This idea refers to the Dr. Jekyll/Mr. Hyde personality. Although some people with bipolar disorder can experience more frequent mood shifts, their moods do not flip on a dime from sad to euphoric and back again. The predominant mood state is depressed.
When someone is manic, this means he/she is really happy.
  • This is only somewhat true. For some, euphoria is a symptom. For many others, people feel edgy, irritable and sometimes even frightened.
There is a test for bipolar.
  • Again, not quite true. In 2008, an at-home saliva test made headlines and was sold over the internet. This test looks for two mutations in a gene called GRK3, which is associated with the disorder. If you have the marker, it does not mean you have the disorder.
You must be 18 years old to be diagnosed with bipolar disorder.
Not true. It is more difficult to diagnose the disorder in children and adolescents because of typical childhood behaviors such as tantrums from which kids quickly recover.
Antidepressants should not be taken if you have bipolar disorder.
This is partly true. Antidepressants can elicit hypomanic or manic symptoms. However, antidepressants are sometimes necessary to treat the pervasive depressive symptoms. If antidepressants are used, the goal is to use them briefly and in combination with a mood stabilizer. Regardless, medications do need to be routinely monitored by a psychiatric clinician to ensure safety and efficacy.
Medications and psychotherapy are the only way to manage bipolar disorder.
Nope. Medications and therapy are important. So is your lifestyle. Regular sleep, exercise, a healthy diet and stress management are key factors to managing bipolar disorder.

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