Overview of Bipolar Disorder
People who have bipolar disorder experience “mood episodes”—periods of time when their mood is very different from normal.
Sometimes, they may have a “depressive episode,” where they feel very sad for a long period of time. (link to depression comic?)
Other times, they may have a “manic episode.”
During manic episodes, a person may feel much happier than usual. They may feel so happy that they start to believe things that aren’t true (like thinking that they have special powers)
They may have more energy than usual, which can make them sleep less, talk fast, and act in ways that they normally wouldn’t (such as spending a lot of money or taking on large projects)
Sometimes, their brains may move so quickly that they talk faster, or their thoughts may become jumbled and hard to understand
Instead of feeling happy, some people have different feelings during manic episodes—they may get mad easily, or may be afraid of things that aren’t real
With treatment, the episode can become much less frequent, and they may go away entirely
More Information on Bipolar Disorder
Bipolar Disorder is arguably one of the most misunderstood diagnoses in the field of mental health. Often, the term “bipolar” is used to describe someone who experiences frequent mood swings. While mood swings can be serious and may often require help from a mental health professional, the term “Bipolar Disorder” actually refers to something different.
There are several types of Bipolar Disorders described in the DSM.* This article will focus on the most severe type, “Bipolar I Disorder.” In Bipolar I Disorder, people experience discrete “episodes,” during which their mood is very different from normal. There are two main types of mood episodes in Bipolar I Disorder: “manic” and “depressive.” Technically, anyone who has had a manic episode can be considered to have Bipolar I Disorder, whether or not they have ever been depressed. However, most people with this illness experience both types of episodes.
In manic episodes, a person’s mood is either unusually elevated (some people describe this as feeling “high” without taking any drugs), or unusually irritable-- and it remains that way for most of the day, almost every day, for at least a week. A person experiencing a manic episode will usually act very differently than they normally do. They often have an unusually high amount of energy, and may only feel that they need to sleep for a few hours each night. They may speak very quickly, and at times their thoughts may move so quickly that they have difficulty keeping up with them. When this happens, other people may have trouble understanding what they are saying, because they jump from topic to topic very quickly.
During manic episodes, people will tend to become more active than usual. Sometimes, this may appear to be a general sense of restlessness, but often, their activity becomes directed towards a particular goal. It is not uncommon for people who are experiencing mania to decide to take on new projects, which may range from small home improvements to major business ventures. However, they tend to get distracted easily, and because their thoughts are sometimes disorganized, it can be difficult to carry out their plans successfully. Manic episodes may cause someone to become less inhibited than they normally are, and to make unwise decisions. They may start to dress in a more sexualized way, and may engage in risky behaviors such as gambling, having unprotected sex, or spending large sums of money
Additionally, during mania, people frequently experience an increase in their sense of self-esteem, beyond what would typically be expected. This is referred to as “grandiosity,” and can be viewed as the opposite of the low self-esteem that often occurs during depressive episodes. During manic episodes, individuals sometimes mistakenly believe that they have special talents or abilities; for instance, someone may believe that they are a rare genius, or that they have an exceptional athletic ability, even if this is not actually the case. In its most extreme form, grandiosity can cause someone to believe things that are completely disconnected from reality. This disconnect from reality is referred to as “psychosis,” and in these instances, an individual will receive a diagnosis of “Bipolar I Disorder With Psychotic Features.” In some cases of Bipolar I Disorder with Psychotic Features, a person may incorrectly believe that they are being targeted or threatened in some way, which may or may not be related to their grandiose beliefs. This is referred to as “paranoia.”
Depressive episodes in Bipolar I Disorder are very similar to those in Major Depressive Disorder (link to depression text), though they often require different types of treatment. Depression after a manic episode can be especially severe, and is often made worse by the fact that a person may be forced to confront the consequences of the poor decisions they made while they were manic. In some cases, individuals will experience suicidal thoughts during these episodes, making treatment absolutely essential.
Bipolar I Disorder is serious, but highly treatable. Many manic and depressive episodes require treatment in a hospital, but not all. When an individual is receiving appropriate treatment, they can go for many years without an episode of depression or mania, and can lead very happy lives.
***If you or someone you know is having thoughts about hurting yourself or someone else, call 911 or go to the nearest emergency room immediately. Individuals who are experiencing suicidal thoughts may also call the National Suicide Prevention Lifeline at 1-800-273-8255. This content is not a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.***
For more information and resources, please consider visiting:
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder
*Information related to specific diagnostic criteria is based on the DSM. For a complete, formal description of diagnostic criteria, please consult the original text:
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.