Bipolar Disorder Explained
Bipolar disorder is a psychological condition manifested by pronounced mood swings that include manic episodes and depressive episodes. Manic episodes are characterized as periods of heightened moods, self-esteem, and energy. Opposing depressive episodes are characterized as periods of lowered moods, self-esteem, and energy.
These mood swings can affect sleep, energy levels, activity interest, judgment, behavior, and clarity of thought. Mood swings may occur infrequently, or they may occur multiple times a year. Most people will experience some of the hypomanic episodes or depressive symptoms between actual episodes, although some may not experience any symptoms at all.
Bipolar Disorder Types and Symptoms
Symptoms of bipolar disorder range from person to person and are classified into four types:
- Bipolar I Disorder: Manic episodes may be accompanied by psychosis. Manic episodes typically last a week, whereas depressive episodes last roughly two weeks.
- Bipolar II Disorder: More commonly seen in women, this type experiences major depressive episodes with ‘hypomanic’ episodes. Hypomanic episodes usually last about four days and are milder than full-blown manic episodes. Depressive episodes typically last a couple of weeks.
- Cyclothymic Disorder: People with cyclothymia may experience a month or two of stable moods. Symptoms of hypomania and bipolar depression are usually less severe than the other two types but may occur more often.
- Not elsewhere classified: Any other types that do not meet the above circumstances are listed here (such as bipolar mood changes induced by drugs or another disease).
It may appear that type I is a less severe form of bipolar disorder than type II, but this is not true. Manic episodes of type I are more severe, and sometimes merit hospitalization. However, depressive episodes in type II last longer and can be more debilitating than type I.
Mania and Hypomania
While the two types of episodes are different, they share the same symptoms. Hypomanic symptoms are less severe, while manic symptoms may trigger a break from reality.
Both manic and hypomanic episodes may include a few or more of the following symptoms:
- Extreme uncontrollable energy
- Euphoria and unfitting extreme happiness
- Often getting distracted and bored
- Underperforming at work or school
- Aggressive and unrealistic planning for the future
- Feeling like anything is possible
- Excessive confidence, self-esteem, and sense of self-importance
- Racing thoughts
- Rapid speech that bounces from one topic to another
- Hyper-sexual thoughts, libido, or activity
- Trouble sleeping, but showing no signs of fatigue
- Denial of a manic or hypomanic state
Psychosis in a manic episode may result in delusions such as one believing they have special abilities or supreme social connections.
During depressive episodes, a person may experience:
- Emptiness, emotional darkness, and hopelessness
- Extreme sadness (major depression)
- Changes in appetite and metabolism
- Weight loss or gain
- Fatigue and oversleeping
- Anxiety over insignificant things
- Shortened attention span and problems remembering
- Difficulty facing obligations and responsibilities
- Abnormal irritability, getting triggered by things that are normally tolerated easily
- Guilt, feeling that everything that goes wrong is their fault
- Inexplicable pains or aches
- Lack of interest in activities that usually bring joy
Though not as common, depressive episodes can cause psychosis too. Major depressive episodes can include hallucinations or delusions, such as believing that they are ruined.
Causes and Risk Factors
Bipolar disorders are common mental illnesses, but their exact causes are somewhat a mystery. However, these mental disorders are commonly linked to one’s brain structure and genetics.
It’s most likely that a combination of one’s genetics, brain structure, and environmental factors are to blame for developing bipolar disorder.
Specific genes may be responsible. However, no single gene establishes the illness. These genes include hormonal genes and others accountable for brain chemistry. Those who have family members with a bipolar disorder are more at risk — roughly five times more likely than someone without a family history.
Studies have shown that brain structure in those affected by bipolar disorder differs from those without the disease. Still, symptoms are used for diagnosis rather than brain imaging at this time.
Environmental risk factors may also increase the risk of developing the disease or triggering a manic episode or depressive episode. Such factors include:
- High stress or traumatic events
- Physical illnesses
- Drug or alcohol abuse
- Closely related relatives with a bipolar disorder
People with bipolar disorder likely suffer from other mental health conditions that need to be treated. These additional conditions may worsen Bipolar disorder or make Bipolar treatment less successful. Some of these co-occurring conditions include: