Bipolar disorder
Bipolar disorder is a mood disorder marked by episodes of unusually high mood and energy, called mania or hypomania, as well as episodes of low mood and low energy, known as depression. These changes in mood are more severe than everyday ups and downs and can have a big impact on thinking, behavior, relationships, performance at work or school and daily routines.
Types of Bipolar Disorder
- Bipolar I: Characterized by at least one manic episode, often with periods of depression.
- Bipolar II: Involves episodes of hypomania, a milder form of mania, along with major depressive episodes.
- Cyclothymic disorder: Consists of chronic, shifting mood disturbances that are less severe but persistent over time.
Symptoms
Manic symptoms can include:
- Very elevated or irritable mood
- Increased energy
- Decreased need for sleep
- Rapid or excessive talking
- Racing thoughts
- Impulsive or risky behavior
- Grandiose ideas
- Sometimes, symptoms of psychosis such as delusions or hallucinations
Hypomania has similar but milder symptoms and usually does not cause major problems with daily functioning or include psychosis.
Depressive symptoms often include:
- Persistent sadness
- Loss of interest in usual activities
- Changes in appetite or sleep
- Fatigue
- Feelings of worthlessness or excessive guilt
- Slowed thinking or movements
- Thoughts of death or suicide
Causes and Risk Factors
Bipolar disorder results from a mix of biological, genetic and environmental factors. The strongest risk comes from a family history of bipolar disorder or other mood disorders. Biological contributors may include unique differences in brain structure or function and imbalances in brain chemicals. Stressful life events, sleep problems, substance use or some medications can also trigger episodes.
Who Is Affected?
Bipolar disorder typically starts in the late teens or early adulthood, but it can begin earlier or later in life.
How Bipolar Disorder Is Diagnosed
There is no single test for bipolar disorder. Diagnosis is made by a mental health professional who takes time to learn your psychiatric history and look at your current symptoms. Tools like mood charts, rating scales and input from family or caregivers can help. Tests may be ordered to rule out other causes of mood symptoms, but bipolar disorder itself is diagnosed based on patterns of mood episodes.
Treatment
Bipolar disorder is treatable and many people find relief with the right approach. Treatments often include a combination of mood-stabilizing or antipsychotic medications, various forms of therapy like cognitive behavioral or family-focused therapy, healthy routines, substance avoidance and ongoing monitoring. Early treatment, sticking to the plan and having a strong support system can make a real difference.
When to Get Immediate Help
Some signs call for urgent care. If someone is suicidal, unable to care for basic needs, has severe psychosis or is behaving in ways that are very risky or impulsive, it is important to reach out for emergency help or a crisis line right away.
Living with Bipolar Disorder
With steady treatment, support and self-care, many people living with bipolar disorder can lead fulfilling, productive lives. Staying in regular contact with healthcare providers and speaking up early about changes in symptoms can help prevent relapses and improve quality of life.
How do I know if I have bipolar disorder or just depression or stress?
Bipolar disorder is different from depression or stress because it includes episodes of mania or hypomania as well as depression. If you have had periods when your mood and energy were much higher than usual, you needed less sleep, talked more than usual, acted impulsively or had big ideas about yourself that are out of character, these could be signs of mania or hypomania. Our team looks at your mood patterns over time and may gather information from family or close friends to help make a careful diagnosis.
What is the difference between mania and hypomania?
Mania involves severe symptoms that can disrupt work, relationships or daily life and may need hospital care. Sometimes, mania includes psychosis, such as hallucinations or delusions. Hypomania is milder, with noticeable changes in mood and energy, but it does not cause major problems or psychosis.
What treatments are effective for bipolar disorder?
Treatments usually include mood stabilizers, certain antipsychotic medicines, therapy like cognitive behavioral therapy, interpersonal and social rhythm therapy, family therapy, learning about the condition and lifestyle changes such as setting a regular sleep schedule and avoiding alcohol or drugs. Our specialists personalize care, sometimes using more than one therapy to best support you.
Are medications safe long-term?
Many people take mood-stabilizing medications safely for years and find they manage symptoms well. Regular check-ins help monitor the benefits and any possible side effects, such as changes in weight or certain lab values. Deciding to continue medication for the long term is something you and your TidalHealth provider will discuss together, balancing the positives and any concerns.
Can bipolar disorder be cured?
Bipolar disorder cannot be cured, but many people reach long periods of stability and good quality of life with ongoing treatment and follow-up. Our team is here to help you find a plan that works for you and adjust it as your needs change.
Is bipolar disorder genetic? Will my children get it?
Bipolar disorder does have a genetic link, meaning it is more likely if someone in your close family has it, but genes are just one part of the picture. Life events and other factors also play a part. If you are concerned about family risk, our team or a genetic counselor can help you understand more.
What is rapid cycling?
Rapid cycling means having four or more episodes of mania, hypomania or depression within one year. It can be more challenging to treat and may have links to things like thyroid problems or substance use.
Can pregnant or breastfeeding people take bipolar medications?
Some medicines are safer than others during pregnancy or while breastfeeding. If you are pregnant, planning to become pregnant or breastfeeding, please talk with your psychiatrist and other health providers early to find the safest treatment approach together.
How can family and friends support someone with bipolar disorder?
Support can make a big difference. Family and friends can help by learning about the condition, encouraging ongoing treatment, helping with routines like sleep and meals, looking for warning signs of mood changes and having a crisis plan if needed. Family therapy or support groups may also help your loved ones understand and cope better.
When should I seek emergency care?
Get emergency help if you or a loved one has thoughts of suicide or self-harm, severe confusion or psychosis, extreme agitation or impulsive behavior, trouble taking care of basic needs or symptoms that get worse very quickly. Call emergency services, go to the nearest emergency department or contact a crisis hotline for immediate support.
If you have more questions about bipolar disorder, your symptoms or how to find care, TidalHealth’s primary care team and mental health specialists are here to help you with answers and next steps.
