October 10, 2023 is World Mental Health Day.
Medically reviewed by Rena Ferguson, MD
You’ve probably heard of bipolar disorder before. Several celebrities such as Britney Spears, Selena Gomez and Catherine Zeta-Jones have had very public diagnoses. But even with these famous cases, there is still a lot of stigma around this condition. And much of what people think they know about bipolar disorder is riddled with stereotypes.
Knowing what to expect from bipolar disorder and having the resources and skills to manage it can help make a difference, according to Ilana Cohen, MD, psychiatrist in Sheppard Pratt’s The Retreat. “It is a chronic disease, but one that can be controlled very well,” he said. “It’s important to recognize that it’s just part of your brain chemistry and think about how to manage it throughout your life.”
So, let’s clear up the misconceptions and get to know the facts about bipolar disorder, a condition that affects more than 7 million people in the US
What is bipolar disorder and what causes it?
Bipolar disorder is a mental illness that used to be called manic-depressive or manic-depressive illness. The condition is a mood disorder, meaning it can cause changes in a person’s mood that can affect their ability to function and perform everyday tasks. Symptoms may include depression, mania (expansive mood or irritability) or both, at different intensities and for different periods of time. These moods are different than simply being extremely happy or extremely irritable. They cause problems for the sufferer or those around them, are clearly different from the person’s usual mood, and last for most of the day and at least a week.
We don’t know what causes bipolar disorder, but there is a clear genetic component. “People are much more at risk if they have a first-degree relative with a diagnosis of bipolar disorder,” Cohen said.
Read: How do genes affect health? >>
What are the types of bipolar disorder?
- Bipolar I: involves a manic episode of excessive energy or irritability that lasts at least a week and may require hospitalization.
- Bipolar II: implies hypomaniaa less extreme form of mania and a history of at least one major depressive episode.
- Cyclothymic disorder: involves less severe mood swings (compared to bipolar I and bipolar II) between hypomania and depression over two years. The person must never have had a manic episode.
Most people are diagnosed with bipolar disorder around age 25, but symptoms begin much earlier. Women are usually diagnosed later in life..
Mood disorders, including bipolar disorder, have a lower rate in black communities, but there are questions about the accuracy of these rates. Major depressive episodes, a key indicator of bipolar II disorder, are more persistent and severe among black adults than among white adults.
some research notes that diagnostic differences toward blacks can lead to underdiagnosis or misdiagnosis, which can have life-threatening consequences, especially because people with bipolar disorder are in a difficult situation. much higher risk of suicide than the general population. “The correct diagnosis is really important because SSRIs or antidepressants can make bipolar disorder worse,” Cohen said. “Mood stabilizers are the basis of medications for bipolar disorder.”
Read: When stigma kills >>
What are bipolar episodes and how long do they last?
In bipolar disorder, episodes of emotional disturbance tend to alternate between depression and mania or hypomania. Hypomania is a less extreme form of mania. “Mania or hypomania are periods of mood elevation, but they differ,” Cohen said.
What is the difference between a manic episode and hypomania?
- Manic episode: a week-long elevated mood with an abnormally happy mood that may include increased irritability, increased grandiosity (an exaggerated sense of importance, ability or knowledge), risky behavior and sleep problems. Speech and thinking may become less clear and there may be psychotic episodes in which contact with reality is lost.
- Hypomania: A four-day period of increased energy and concentration and an unusually elevated mood, but without impairment of normal functioning.
Bipolar disorder is often associated with mania, but people tend to have more major depressive episodes than manic episodes. These depressive episodes last at least two weeks and can include feelings of hopelessness, fatigue, lack of concentration, and loss of interest in activities. “We tend to think of mania with bipolar disorder, but the burden of depression is high,” Cohen said. “And the cost of depressive episodes increases as we age.” Generally bipolar it doesn’t get worse with age if treated, and manic episodes tend to decrease as we age. However, A study found that depression affects adults over 60 years of age with bipolar disorder more. Untreated or poorly treated bipolar symptoms can cause more frequent and more difficult to treat episodes.
Women and bipolar disorder
Investigation shows that women with bipolar disorder experience more severe symptoms and reduced quality of life compared to men with bipolar disorder. For example, women with bipolar disorder are more likely to report panic disorder, post-traumatic stress disorder, eating disorders, and borderline personality disorder compared to men with bipolar disorder.
Women are also more likely than men to experience:
- Quick cycle between minimums and maximums
- Depression caused by bipolar disorder
- Migraine attacks
- drinking problems
- Thyroid disease
- Obesity due to medications to treat bipolar disorder
- More intense symptoms due to premenstrual symptoms.
How is bipolar disorder treated?
Anyone experiencing symptoms of bipolar disorder should contact their healthcare provider (HCP) immediately. Your doctor will usually refer you to a psychiatrist, psychologist, or clinical social worker who specializes in the diagnosis and treatment of bipolar disorder.
“Like many mental illnesses, bipolar disorder is not curable,” Cohen said. But his health care team can help him manage his symptoms. Treatment includes medications and lifestyle choices. “The best treatments for bipolar disorder are multifactorial,” Cohen said. “Medication has an important role to play. But you also want to ensure good routines, good sleep, good nutrition, and a good medication regimen. And learning to recognize the warning signs is one of the most powerful tools you have.”
Stress and lifestyle changes can be triggers for bipolar symptoms. Substance use can also trigger or worsen bipolar disorder, Cohen said. Therefore, it is important to consider what is going on in your life, what might trigger episodes, and how you can proactively care for yourself during stressful situations.
Read: Why are women so stressed? >>
Having the support of other people in your life who understand you and help you stay on track makes it easier to manage your symptoms. “It’s hard to take medication and do the right thing every day. Offering support and being a safe place is a big help,” Cohen explained. “I have many patients with bipolar disorder who are incredibly successful, thriving, and living wonderful lives.”
If you or someone you know may be experiencing bipolar disorder, talk to your healthcare provider about your options as soon as possible.
If you or someone you know is experiencing a mental health crisis, please call or text the Suicide and Crisis Lifeline at 988.
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