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Bipolar Disorder

(also known as Manic Depression, includes Bipolar I and Bipolar II) Bipolar disorder is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy). What is the difference between Bipolar I, Bipolar II, and Cyclothymia? Mood episodes are the hallmark of both types of bipolar disorder. The highs are known as manic episodes. The lows are known as depressive episodes.

Not all types of bipolar disorder have episodes of depression.

The main difference between bipolar I and bipolar II disorders is in the severity of the manic episodes.

A person with bipolar I will experience an episode of mania, while a person with bipolar II will experience a hypomanic episode (a period less severe than a full manic episode).

A person with bipolar I may or may not experience a depressive episode, while someone with bipolar II will experience a major depressive episode. Cyclothymia is another type of bipolar disorder. People with cyclothymia also experience high and low moods, though they are not often as severe. Your moods may be high or low, but they don’t meet the criteria for a full hypomanic or depressive episode. The following chart summarizes the key differences in symptoms:


Mania

Hypomania

Depression

Bipolar I disorder

yes

maybe

maybe

Bipolar II disorder

no

yes

yes

Cyclothymia

no

mild; not full episode

mild; not full epsidoe


Symptoms

Bipolar I disorder involves episodes of mania and may involve depression, while Bipolar II disorder includes hypomania and depression. Here’s what these symptoms mean:

Mania
A manic episode is more than just a feeling of elation, high energy, or distraction. During a manic episode, mania can interfere with daily activities.

People having an episode of mania may make some “irrational” decisions, such as spending large amounts of money they can’t afford. They may also engage in behaviors that could have harmful consequences.

An episode is not considered manic if caused by outside influences such as alcohol, drugs, or another health condition.

Hypomania
A hypomanic episode is a period of mania less severe than a manic episode. However, in a hypomanic episode, behaviors still differ from your usual state. The differences will be extreme enough that people around you may notice.

Officially, an episode isn’t considered hypomania if it’s influenced by drugs or alcohol.

Depression
Depressive symptoms in someone with bipolar disorder are like those of someone with major depressive disorder. They may include extended periods of sadness and hopelessness. You may also experience a loss of interest in people you once enjoyed spending time with and activities you used to like.

Other symptoms include:

tiredness
irritability
trouble concentrating
changes in sleeping habits
changes in eating habits
thoughts of suicide

Treatment Options

Doctors usually treat bipolar disorder with a combination of medications and psychotherapy.

Medications may include:

mood stabilizers, such as lithium
anticonvulsants that stabilize mood, such as lamotrigine
antidepressants
Doctors may also prescribe antipsychotics to treat manic episodes or psychosis. While people with either type of bipolar disorder can experience psychosis, it’s more common in Bipolar I disorder.

Your doctor may start you on a low dose of whichever medication you both decide to use to see how you respond. You may eventually need a stronger dose than what they initially prescribe. You may also need a combination of medications or different medications to manage symptoms.

All medications have potential side effects and interactions with other drugs. If you’re pregnant or taking other medications, be sure to tell your doctor before taking any new medications.

Writing in a diary can be an especially helpful part of your treatment. Keeping track of your moods, sleeping and eating patterns, and significant life events can help you and your doctor understand if therapy and medications are working.

If your symptoms worsen or don’t improve, your doctor may order a change in your medications or a different type of psychotherapy.

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