What Is Bipolar Disorder (Formerly Manic Depression)?
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Bipolar disorder, formerly known as manic depression, is a prevalent and severe mental health condition characterized by significant emotional swings. Depressed mood and low energy levels are typical during depressive episodes, while elevated moods and high energy levels occur during manic or hypomanic episodes. Distinguishing bipolar disorder from other disorders—like borderline personality disorder, severe depression, or attention-deficit/hyperactivity disorder (ADHD)—requires a thorough mental health evaluation. Bipolar disorder is treatable, and many individuals find that their mood symptoms are stabilized through a combination of treatment options, such as antidepressant medication and therapy.
People diagnosed with bipolar disorder may experience intense emotional shifts, including manic or depressive episodes, that can dramatically alter how they feel, think, and act. Shifting episodes occurring four or more times per year are classified as rapid cycling, though some people with bipolar disorder can experience daily oscillations in mood. Experiencing rapid cycling does not mean the pattern is permanent or lifelong. Adjustments in bipolar disorder care, such as modifying treatment plans, may effectively reduce the occurrence of rapid cycling and help maintain a more normal mood instead of experiencing swings between manic and depressive episodes.
Depressive episodes
Sadness is a common emotion for most people, but those experiencing depressive episodes describe periods of negative thoughts that extend beyond general sadness. A five-year study of people with bipolar disorder found that it takes individuals in a depressive cycle 11 weeks, on average, from the time of initial symptoms of depression to return to a state without diagnosable mental health conditions. Many people experiencing a depressive episode, including mild depression or bipolar depression, experience some of the following symptoms:
Difficulty focusing
Low energy and/or motivation
Trouble sleeping, oversleeping, or general changes in sleep patterns
Little interest in activities that were once enjoyable
Feeling lonely, worthless or both
Change in eating habits
Feeling extended periods of sadness or unhappiness
Isolating behavior from friends, family members, and loved ones
Thoughts of suicide
Manic episodes
During depressive episodes, many people with bipolar disorder may experience symptoms of major depressive disorder. During manic episodes, however, symptoms are different.
Symptoms of manic episodes might include:
Impulsive decision-making
Racing thoughts or speaking quickly
Experiencing high levels of energy
Delusions of grandeur
Engaging in risky behaviors
Feeling extremely confident, excited, or irritable
Needing less sleep
Experiencing paranoia and/or hallucinations
Though the heightened energy levels of a manic episode may sound like a positive emotional change to some, many people with bipolar disorder experience serious concerns during mania. Symptoms such as an irritable mood, anger, and a lack of control can be challenging to manage. Bipolar I disorder is diagnosed during manic episodes.
Diagnosis
Psychosis is a mental health term that describes hallucinations and grandiose delusions. Studies suggest that half of individuals diagnosed with bipolar disorder may experience some degree of psychotic symptoms within their lifetime. Individuals experiencing psychosis may be misdiagnosed as schizophrenic or with related disorders, and this may be particularly common amongst Black and Hispanic individuals. A medical doctor should evaluate you in person, taking a careful history to make an accurate diagnosis. 80-90% of people with bipolar disorder have a family member with depression or bipolar disorder, so your doctor will also look at your family history.
Assessment standards for bipolar disorder in adults and children have improved significantly within the past decade. During assessment, a medical doctor (such as a psychiatrist) will evaluate mood fluctuations and determine if you meet the criteria for any type of bipolar disorder. Bipolar I (manic depressive), Bipolar II (major depression and less severe hypomanic cycles), or unspecified bipolar disorder are the categorizations used to classify the condition. A doctor may diagnose you with a less severe form of bipolar disorder or another mental/neurodevelopmental disorder (e.g., attention-deficit/hyperactivity disorder). In children, diagnosing bipolar disorder can be more challenging because they commonly experience mixed episodes with symptoms of both mania and depression. People with bipolar II disorder may have additional mental health conditions that increase the severity of their symptoms of bipolar disorder.
Sometimes, bipolar disorder can be confused with other mental health or neurodevelopmental conditions. For example, symptoms of attention-deficit/hyperactivity disorder (ADHD) can mimic those of a manic or hypomanic episode. A mental health professional may need to differentiate between the two conditions in some cases. In others, bipolar disorder and ADHD might be comorbid. Research suggests that 10-20% of adults with bipolar disorder live with comorbid attention-deficit/hyperactivity disorder.
How do mood swings work?
Though many people living with diagnosed bipolar disorder experience symptoms that enable early detection of a bipolar episode, mood swings can be unpredictable. They may occur gradually, or they can occur abruptly, and they can last for hours, weeks, or months at a time. As described by Dr. David A. Merrill for Forbes Health, the reoccurrence of mood swings is “the expectation, not the exception” because the disorder is characterized by these mood oscillations. A therapist can help you work to recognize overstimulation and things that may make the occurrence of episodes more likely, and you can keep a mood journal to document how your emotions change over time. With proper treatment and support from organizations like the Depression and Bipolar Support Alliance, individuals can better manage their condition and even prevent bipolar disorder episodes.
Triggers
Though there is not always a trigger for a manic or depressive episode, there can be. Changing jobs, living situations, or other circumstances can be triggers. Certain types of medication can trigger mania, as well. For example, research suggests that stimulants used to treat attention-deficit/hyperactivity disorder can cause or exacerbate mania. Other things, such as drug or alcohol use, traumatic experiences, changes in relationship status, lack of quality sleep, or anything else that causes heightened stress or excitement can initiate an episode. You can familiarize yourself with some of the common warning signs of a potential manic or hypomanic episode to help yourself possibly better mitigate and manage them.
Treatment
Bipolar disorder is a long-term, cyclical disorder, so long-term treatment is recommended for most people. A mixture of psychotherapy and medications, such as mood stabilizers, are typically recommended.
Medication requires careful management from a physician who is experienced in treating bipolar disorder. For example, some people may find it difficult to adhere to their medication treatment plan during phases of mood swings. In these cases, there are medication approaches that can be helpful in reducing rates of “breakthrough symptoms.” Additionally, antidepressant use is not recommended for patients with diagnosed bipolar disorder, so if you have previously been diagnosed with depression and prescribed antidepressants, your care provider may seek to change your medications or you can discuss doing so with them. A medical or mental health professional can explain the efficacy, side effects, and treatment duration of a specific medication.
Therapy can be a helpful strategy for people with bipolar disorder to improve wellbeing and life satisfaction. Through therapy, participants can also address comorbid mental health concerns, such as attention-deficit/hyperactivity disorder (ADHD). You may find therapy modalities such as interpersonal and social rhythm therapy (IPSRT) and FFT may be helpful. If symptoms of bipolar disorder are treatment resistant, a healthcare provider may recommend a brain stimulation therapy, such as electroconvulsive therapy (ECT).
An online therapist can help you learn about your disorder and develop the tools to recognize and navigate your symptoms. Cognitive behavioral therapy (CBT) is effective in reducing the severity of mania and rate of relapsing for people with bipolar disorder. A 2017 study of online CBT, which is offered from sites like BetterHelp, found that it is effective in managing symptoms of bipolar disorder. Additionally, online therapy can be less costly for some, and you may find it easier to stick with therapy sessions because it’s often more convenient.
Takeaway
Bipolar disorder, formerly called manic depression, is very common. When someone exhibits symptoms of mood swings and emotional instability, often transitioning between a manic episode and depressive episode, it's crucial to consult a mental health professional to get a proper evaluation and potentially have bipolar disorder diagnosed and their bipolar disorder treated. Symptoms are characterized by significant mood swings, and an in-person physician can provide a diagnosis and treatment plan to help you manage your disorder. Online therapy can be an effective part of your strategy to manage your symptoms and recognize early signs of a manic or depressive episode.
Frequently asked questions (FAQs)
What does it mean to be manic depressive?
The statement ‘manic depressive’ refers to an individual living with bipolar disorder, which used to be called manic depressive illness or manic depression. Bipolar disorder is a serious mental illness that involves extreme shifts in mood and energy. It involves several different mood episodes: an elated or energized state (called manic episodes) to feeling down or hopeless (depressive episodes).
Under the classification of mood disorders exist several types of bipolar disorder: bipolar I disorder, bipolar II disorder and cyclothymic disorder.
What are the symptoms of a manic depressive personality?
Bipolar disorder is a mental illness that includes several different mood episodes: mania, hypomania, depression, and mixed episodes.
An individual undergoing a manic episode will likely display elevated energy or irritability, increased confidence and talkativeness, decreased need for sleep, loss of appetite and weight loss, racing thoughts and impulsive decision making. Hypomanic episodes involve less severe symptoms of mania.
People with bipolar disorder will then experience depressive episodes. Depression symptoms include feeling sad or down, change in eating or sleeping patterns, loss of interest in usual activities, feelings of hopelessness, and thoughts of death and suicide.
Individuals with bipolar disorder are found to be at increased risk for suicide. It is crucial for those living with bipolar disorder to work with a mental health professional to create a safety plan for suicide prevention.
If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
What is manic behavior?
Manic episodes are associated with a mental illness called bipolar disorder. An individual undergoing a mood episode called mania may display elevated energy, irritability, increased confidence and talkativeness, decreased need for sleep, loss of appetite and weight loss, racing thoughts and impulsive decision making. Consult with a health care professional if you are experiencing symptoms of a manic episode. Mental health information and services are offered online through BetterHelp,
Is manic-depressive personality the same as bipolar disorder?
Yes! Bipolar disorder, formerly referred to as manic depression, is a mental illness that affects about 2.6% of the American population. Under the classification of mood disorders exist several types of bipolar disorder: bipolar I disorder, bipolar II disorder and cyclothymic disorder.
Individuals with a family history of mental illness (such as bipolar disorder or major depression) are more likely to develop it.
There is a significant link between bipolar disorder and substance abuse, The National Institute of Mental Health found that at least 60% of people with bipolar I disorder develop a substance abuse disorder.
Having bipolar disorder is also shown to elevate one’s risk of developing cardiovascular heart disease.
What are the 4 types of bipolar?
Bipolar disorder is a serious mental illness that is common in the American population.
The National Institute of Mental Health describes the four types of bipolar disorder.
The first is bipolar I disorder which is defined by a pattern of manic episodes (which may require hospitalization) and then depressive episodes. Mixed states may also occur, which is when manic symptoms and depressive symptoms occur at the same time.
Bipolar II disorder refers to shifting between hypomanic episodes (as opposed to full-blown mania seen in bipolar I) and depressive episodes.
Cyclothymic disorder is diagnosed when an individual displays hypomanic symptoms and depressive symptoms but they do not fit into the criteria for either a hypomanic or depressive episode.
There may also be individuals who experience symptoms of bipolar disorder that does not fit neatly into one of the major categories.
To diagnose bipolar disorder, a health care professional will examine your medical history and assess signs and symptoms.
Can bipolar go away?
Like any mental illness, there is no cure, but one can learn to manage the symptoms of their disorder. Treatment for bipolar disorder includes psychotherapy, medications (including mood stabilizers and antipsychotics) and support groups.
Who is a famous person with bipolar disorder?
Mariah Carey has been open about her experience living with bipolar II disorder, which is a mental illness that includes hypomanic episodes (as opposed to full-blown mania) and depressive episodes.
What is a bipolar person like?
Bipolar disorder is a serious mental illness where individuals undergo a pattern of manic episodes and depressive episodes.
An individual undergoing a manic episode will likely display elevated energy or irritability, increased confidence and talkativeness, decreased need for sleep, loss of appetite and weight loss, racing thoughts and impulsive decision making. Hypomanic episodes involve less severe symptoms of mania.
People with bipolar disorder will then experience depressive episodes. Depression symptoms include feeling sad or down, change in eating or sleeping patterns, loss of interest in usual activities, feelings of hopelessness, and thoughts of death and suicide.
Individuals with bipolar disorder are found to be at increased risk for suicide. It is crucial for those living with bipolar disorder to work with a mental health professional to create a safety plan for suicide prevention.
If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
How do bipolar people act?
Bipolar disorder is a serious mental illness where individuals undergo a pattern of manic episodes and depressive episodes.
During a manic episode, an individual may appear to have an elevated amount of energy or excitement. They may display irritability or agitation, increased confidence and talkativeness, and make impulsive decisions around spending money or risky sexual behavior.
During a depressive episode, an individual will likely appear sad or down, show loss of interest in usual activities and extreme fatigue.
Can bipolar people tell they are bipolar?
Despite being a common mental illness, many individuals may not be aware that they have bipolar disorder. Health information articles show that it can take up to ten years between the emergence of symptoms and an individual being diagnosed with bipolar disorder! Symptoms often look different in each individual, as different types of bipolar disorder present differently (types include bipolar I disorder, bipolar II disorder and cyclothymic disorder).
If you are experiencing warning signs of bipolar disorder such as mania/hypomania or depression symptoms, seek out the support of a health care professional who can provide health information and help you formulate a treatment plan.
What should you not say to someone with bipolar?
Unhelpful statements for anyone with a mental illness include “just stop feeling so down” or anything that shames the individual or implies that their mental illness is their fault. Instead, try validating their feelings and experiences. Use statements such as “I am here for you” and encourage them to seek out the support they need.
Is bipolar a disability?
Though bipolar disorder is a serious mental illness and is considered a disability, not everyone is guaranteed disability payments. For additional information on whether you might qualify, visit this link.
Does Bipolar get worse as you age?
According to health information articles, it is possible for symptoms of bipolar disorder to become exacerbated over time, particularly if left untreated. Treatment for bipolar disorder includes psychotherapy, medications (including mood stabilizers and antipsychotics), and support groups.
What is a good job for a bipolar person?
It is crucial for people with mental illness to prioritize a consistent sleep pattern. Therefore, jobs that offer flexible daytime hours are typically best. An individual may consider part-time work if a stressful work schedule could create stress that exacerbates symptoms of mental illness.
Can someone with bipolar have a normal relationship?
Absolutely! People living with mental illness can have healthy and happy partnerships. It will likely take effort on both parts to learn more about how symptoms of bipolar disorder might present and working together to ensure both individuals have the support they need.
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