A Psychiatrist for Bipolar Disorder Discusses Symptoms and Treatment
Do You Have Bipolar Disorder?
A number of people come to me suspecting they have bipolar disorder. These patients often report extreme emotional highs and lows, as well as some other common symptoms such as feeling sad or manic. However, not everyone who experiences these symptoms has bipolar disorder. I wanted to write this article to provide some information so that people can learn more about bipolar disorder, and can get the help they need. Although this information will be helpful-nothing is more effective than an in-person session with a trained clinician so that you can be properly screened, and make sure that you can explore all possible treatment options.
Bipolar Disorder Defined
In laymen’s terms, Bipolar disorder (often called manic depression) is a mental health condition whereby people experience extreme highs (mania), as well as intense periods of sadness or depression. The phases of depression and mania are known as “episodes,” and they can shift quickly.
Bipolar Disorder and the Brain
Bipolar disorder is a brain disorder that causes unusual shifts in energy, mood, activity levels, and can affect the person’s ability to carry out daily tasks.
Types of Bipolar Disorder
There are four basic types of bipolar disorder. Each of these types involves distinct changes in energy, mood, and activity levels. These moods range from manic episodes (periods of extremely “up,” elated, and energized behavior), to depressive episodes where the client presents as “down,” very sad, or hopeless. Less severe manic periods are known as “hypomanic episodes.”
Commonalities in Bipolar Disorder
What is common in all types of bipolar disorder is that people with bipolar disorder experience periods of unusually intense emotion, changes in activity levels and sleep patterns, as well as unusual behaviors. These distinct periods are known as “mood episodes.” What is different with bipolar disorder, is that these mood episodes are drastically different from the behaviors and moods that are typical for that particular person. When people experience these mood episodes, we typically see extreme changes in the person’s activity, energy, and sleep patterns.
Sometimes a mood episode includes symptoms of both manic and depressive symptoms. This is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.
Bipolar disorder can be present even when mood swings are less extreme. For example, some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomanic episode, an individual may feel very good, be highly productive, and function well. The person may not feel that anything is wrong, but family and friends may recognize the mood swings and/or changes in activity levels as possible bipolar disorder. Without proper treatment, people with hypomania may develop severe mania or depression.
Diagnostic Criteria for Bipolar Disorder
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing bipolar and related disorders. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. Diagnostic criteria for bipolar and related disorders are based on the specific type of disorder:
For Bipolar I disorder, you have to have had at least one manic episode. The manic episode may be preceded, or followed by hypomanic or major depressive episodes. Mania symptoms cause significant impairment in your life and may require hospitalization or trigger a break from reality (psychosis).
For Bipolar II disorder, you have to have had at least one major depressive episode lasting at least 2 weeks and at least one hypomanic episode lasting at least four days. People with Bipolar disorder II have never had a manic episode. Major depressive episodes or the unpredictable changes in mood and behavior can cause distress or difficulty in areas of your life.
For Cyclothymic disorder you must have had it at least two years, or one year for children and teenagers, where you have had numerous periods of hypomania symptoms (this is the less severe episode than a hypomanic episode) and periods of depressive symptoms (less severe than a major depressive episode). During that time, symptoms occur at least half the time and never go away for more than two months. Symptoms cause significant distress in important areas of your life.
There are other types of Bipolar disorder, which include bipolar and related disorders caused by another medical condition, such as Cushing’s disease, stroke, or multiple sclerosis. There is an additional type called substance and medication-induced bipolar and related disorder.
Note that Bipolar II disorder is not a milder form of Bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be dangerous and severe, individuals with Bipolar II disorder have been known to be depressed for longer periods of time, which can lead to significant impairment in their daily functioning.
Bipolar Disorder Treatment
With proper diagnosis and treatment, people who have bipolar disorder are able to lead healthy and productive lives. Speak with your doctor or a licensed mental health professional if you think you might have Bipolar disorder. We cannot stress enough that you should have a physical exam to rule out other conditions. Some Bipolar disorder symptoms are similar to other illnesses, which can make it hard for a doctor to make an accurate diagnosis.
If the problems are not caused by physical illnesses, a mental health evaluation should be done with a trained mental health professional, such as a psychiatrist, social worker, or psychologist who has experience in diagnosing and treating bipolar disorder.
Bipolar disorder can sometimes co-occur with another illnesses such as an anxiety disorder, eating disorder or with substance abuse. In addition, some people with Bipolar disorder are at higher risk for obesity, diabetes, thyroid disease, heart disease, migraine headaches, and other illnesses.
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