Bipolar disorder, what is bipolar disorder, Bipolar disorder symptoms, Bipolar disorder diagnoses, Bipolar disorder treatment,

 What is Bipolar Disorder?

Bipolar disorder, formerly known as manic-depressive illness, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These mood swings can affect a person's energy levels, activity, judgment, behavior, and ability to carry out daily tasks.

Types Of Bipolar Disorder

There are several types of bipolar disorder. 

Bipolar I Disorder

This type is characterized by at least one manic episode, with or without a depressive episode. A manic episode involves a period of elevated or irritable mood and increased energy or activity that lasts for at least a week and causes significant impairment in daily life.

Bipolar II Disorder

This is defined by at least one hypomanic episode (a less severe form of mania that lasts at least four days) and one major depressive episode. People with Bipolar II don’t experience full-blown manic episodes.

Cyclothymic Disorder (Cyclothymia)

This is a milder form of bipolar disorder. It involves periods of hypomanic symptoms and periods of depressive symptoms that are not severe enough to meet the criteria for full-blown hypomanic or depressive episodes.

A guide on Bipolar Disorder

Causes Of Bipolar Disorder

Bipolar disorder is a complex condition, and its exact causes aren't fully understood. However, research suggests that a combination of several factors contributes to its development. Here are the main factors believed to play a role:


If a close family member has bipolar disorder, there's an increased chance of developing the condition. Specific genes might increase the risk, but no single gene is the direct cause.

Brain Structure and Functioning

Some studies using brain imaging techniques, such as MRI or PET scans, have shown possible differences in the brain structures or functions of people with bipolar disorder compared to those without the condition.

Neurotransmitter Imbalance

Neurotransmitters are brain chemicals that play a significant role in regulating mood and behavior. An imbalance in these chemicals can contribute to the onset of bipolar disorder.

Hormonal Imbalances

Abnormal levels of certain hormones might increase the risk of bipolar disorder.

Environmental Factors

Experiences such as trauma, significant loss, high levels of stress, or abuse can be risk factors or triggers for bipolar onset, especially when combined with other factors.

Drug or Alcohol Abuse

Substance abuse doesn't directly cause bipolar disorder, but it can bring about an episode and worsen the progression of the disease.

Physical Illness

Some illnesses, such as thyroid disorders or neurological conditions, might increase the risk or act as triggers.

Traumatic or Stressful Events

Events such as the death of a loved one, a breakup, or other significant life changes might act as triggers, especially in those already genetically predisposed.

Bipolar Disorder Symptoms

Bipolar disorder is characterized by mood episodes, which can be manic, hypomanic, or depressive. The specific symptoms vary based on the type and severity of the episode:

Manic Episode

Elevated, expansive, or irritable mood for most of the day, nearly every day.

Increased goal-directed activity or psychomotor agitation.

Decreased need for sleep (feeling rested after only a few hours of sleep).

More talkative than usual or feeling pressure to keep talking.

Racing thoughts.

Distractibility (easily sidetracked).

Inflated self-esteem or grandiosity (may have delusions of grandeur).

Engagement in risky behaviors such as excessive spending, impulsive sexual encounters, or making unwise business investments.

For a diagnosis of a manic episode, the symptoms must last at least one week, or any duration if hospitalization is necessary.

Hypomanic Episode (symptoms are similar to mania but less severe)

Elevated, expansive, or irritable mood.

Increase in activity or energy.

The episode is a clear change from the person's usual behavior.

Symptoms must last for at least four consecutive days.

The disturbance in mood and change in functioning are observable by others.

The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization.

Bipolar Depression Symptoms

Bipolar depression refers to the depressive episodes that a person with bipolar disorder experiences. The symptoms of bipolar depression can be quite similar to those of unipolar depression (major depressive disorder). Here are the primary symptoms of bipolar depression:

Depressed Mood

Feeling sad, empty, or hopeless for most of the day, nearly every day.

Loss of Interest or Pleasure

Marked disinterest in activities that one used to enjoy, including sexual activities.

Weight and Appetite Changes

This could manifest as significant weight loss (when not dieting) or weight gain. There may also be a decrease or increase in appetite.

Sleep Disturbances

Experiencing insomnia (difficulty falling or staying asleep) or hypersomnia (excessive sleeping).

Psychomotor Agitation or Retardation

Feeling restless and unable to sit still or being slowed down in thought and movement. This symptom should be observable by others.

Fatigue or Loss of Energy

Feeling persistently tired or drained.

Feelings of Worthlessness or Excessive Guilt

These feelings might be delusional, meaning they're not based in reality.

Diminished Ability to Think or Concentrate

This can also manifest as indecisiveness.

Recurrent Thoughts of Death or Suicide

This can range from a passive wish to die to active suicidal ideation with a plan or suicide attempts.

For a diagnosis of a major depressive episode, symptoms must last at least two weeks.

Diagnosing Bipolar Disorder

A Guide to Diagnosing Bipolar Disorder Accurately

Diagnosing bipolar disorder can be challenging because its symptoms can be similar to other mood disorders, particularly unipolar depression. Additionally, individuals may seek treatment primarily for depressive symptoms without recognizing or reporting periods of mania or hypomania. Nonetheless, a proper diagnosis is essential, as treatment for bipolar disorder may differ from other conditions.

Here's a general process for diagnosing bipolar disorder

Clinical Interview

This is the most crucial tool for diagnosis. A psychiatrist or psychologist will ask about:

Presenting symptoms.

Duration and severity of symptoms.

Patterns of mood episodes.

Family history of mental health disorders.

Past and current medical conditions and medications.

Substance use.

Any suicidal thoughts or behaviors.

Mood Charting

Sometimes, patients might be asked to keep a daily record of their moods, sleep patterns, and other symptoms. This can help identify patterns and support a diagnosis.

Physical Examination

While there's no lab test for bipolar disorder, a doctor may do a physical exam and order lab tests to rule out other conditions that might be causing the symptoms, such as thyroid disease or substance abuse.

Psychological Evaluation

This involves discussing thoughts, feelings, and behavior patterns. It might also include a questionnaire or other formal test.

Diagnostic Criteria from the DSM-5

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, provides criteria for diagnosing bipolar and related disorders. For example:

Bipolar I Disorder

Requires at least one episode of mania lasting a week or longer or that requires hospitalization. Depressive episodes are common but not required for diagnosis.

Bipolar II Disorder

Requires at least one hypomanic episode and one major depressive episode. No full-blown manic episodes are present.

Cyclothymic Disorder

Requires at least two years (or one year in children and adolescents) of hypomanic and depressive symptoms that don't meet the criteria for hypomanic or depressive episodes.

Differentiating from Other Disorders

It's essential to distinguish bipolar disorder from other conditions, such as:

Unipolar depression.

Attention-deficit/hyperactivity disorder (ADHD).

Anxiety disorders.

Schizophrenia or other psychotic disorders.

Personality disorders.

Substance-induced mood disorders.

Family Input

Sometimes, with permission, clinicians might gather information from family or close friends to get a fuller picture of the symptoms and their impact.

It's worth noting that even with a thorough evaluation, it can sometimes take years for individuals with bipolar disorder to receive an accurate diagnosis, mainly if they primarily seek treatment for depressive episodes. Nonetheless, an accurate diagnosis is crucial for guiding effective treatment and management of the disorder.

Bipolar Disorder Treatments

Bipolar disorder is a lifelong condition, but it's manageable with the right treatment. The primary goals of treatment are to stabilize mood, reduce the severity and frequency of manic and depressive episodes, and help the individual lead a productive and fulfilling life. Treatment typically involves a combination of medications and psychotherapy.


Mood Stabilizers

These are the cornerstones of treatment. Examples include lithium (Lithobid), valproic acid (Depakote), divalproex sodium (Depakene), carbamazepine (Tegretol, Equetro, others), and lamotrigine (Lamictal).


Certain antipsychotic medications are helpful in treating bipolar disorder. Examples include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda), and cariprazine (Vraylar).


They can be effective for bipolar depression, but they're usually prescribed alongside a mood stabilizer or antipsychotic to prevent triggering a manic episode.


A combination drug like Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine and acts as a treatment for both bipolar depression and as a mood stabilizer.

Anti-anxiety Medications

Benzodiazepines can be effective in treating anxiety and improving sleep but should be used judiciously due to the potential for dependence and addiction. Examples include alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).

Other Treatments

Some individuals benefit from other medications like anticonvulsants.


This can be an essential part of treatment. Types include:

Cognitive Behavioral Therapy (CBT)

Helps identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.

Family-focused Therapy

Addresses family dynamics that might contribute to bipolar disorder and its treatment.

Interpersonal and Social Rhythm Therapy (IPSRT): Focuses on the stabilization of daily rhythms, such as sleeping, waking, and eating.


Teaches the patient about bipolar disorder, its treatments, and strategies for recognizing signs of relapse.

Electroconvulsive Therapy (ECT)

This can be an option for severe bipolar disorder cases where other treatments haven't worked. It involves passing electrical currents through the brain to impact neurotransmitter levels positively.

Transcranial Magnetic Stimulation (TMS)

Uses magnets to activate the brain. It's been approved by the FDA for treating depression.

Lifestyle and Coping Strategies

Regular routines, sleep hygiene, stress reduction techniques, avoidance of alcohol and illicit drugs, and regular medical check-ups can help manage symptoms and prevent relapses.


In cases of severe manic or depressive episodes, or if there's a risk of self-harm, hospitalization can be necessary to stabilize the individual.

Managing Bipolar Disorder Daily

Managing bipolar disorder on a daily basis requires a combination of medical treatment, lifestyle adjustments, self-awareness, and support. Here are some strategies to consider for daily management:

Medication Adherence

Always take your medications as prescribed.

Keep track of side effects and discuss them with your healthcare provider. Sometimes adjustments are needed. Use pill organizers or alarms to remind you to take your medications.

Monitor Your Mood

Keep a mood journal or use mood-tracking apps. This can help identify patterns or triggers for mood swings. Be mindful of early signs of a manic or depressive episode so you can take proactive steps.

Establish Routines

Regular routines, especially for sleep and daily activities, can provide stability.

Try to wake up, eat, work, exercise, and sleep at the same time each day.

Healthy Lifestyle Choices

Eat a balanced diet.

Engage in regular physical activity.

Prioritize sleep hygiene to ensure a good night's sleep.

Avoid caffeine or nicotine close to bedtime, as they can disrupt sleep.

Avoid Drugs and Alcohol

Substance abuse can trigger mood episodes and interfere with the effectiveness of medications.

Manage Stress

Learn relaxation techniques such as deep breathing, meditation, or yoga.

Consider seeking therapies like Cognitive Behavioral Therapy (CBT) to develop coping skills.

Stay Connected

Build and maintain a strong support system of friends and family.

Consider joining a support group for people with bipolar disorder.

Educate Yourself

The more you know about bipolar disorder, the better equipped you'll be to deal with challenges.

Psychoeducation can be beneficial.

Avoid Triggers

Be aware of potential triggers, such as lack of sleep, high stress, or significant changes in routine.

Limit caffeine and avoid recreational drugs.

Establish an Emergency Plan

Identify warning signs of a severe mood shift and have a plan in place, such as who to call or where to go for help.

Share this plan with loved ones.

Regular Medical Check-ups

Regularly see your doctor or psychiatrist to discuss how you're feeling, any side effects, and the effectiveness of treatment.

Monitor physical health as well, as some medications can affect organs like the liver or kidneys.

Limit Major Changes

While it's not always possible, try to avoid making impulsive decisions during mood episodes. This includes major life changes like relocating, changing jobs, or making significant financial decisions.

Stay Hopeful

Recognize and celebrate small victories. Even during challenging times, it's important to remember that with proper management, many people with bipolar disorder lead full, productive lives.

Remember, everyone's experience with bipolar disorder is unique. What works for one person might not work for another. It's essential to find what's effective for you and to seek support when needed.

Bipolar Treatment Centers

Mayo Clinic

Mayo Clinic in Rochester, Minnesota. The Mayo Clinic is a world-renowned medical center with a long history of excellence in the treatment of bipolar disorder. They offer a variety of treatment options, including medication, psychotherapy, and complementary therapies.

Sierra Tucson

 Sierra Tucson in Tucson, Arizona is a private residential treatment center that specializes in the treatment of bipolar disorder and other mental health conditions. They offer a variety of evidence-based therapies, including individual and group therapy, medication management, and holistic therapies.

Newport Institute

Newport Institute in Newport, Virginia is a private residential treatment center that offers a comprehensive approach to the treatment of the bipolar disorder. They offer a variety of therapies, including individual and group therapy, medication management, and family therapy.

The Meadows

The Meadows in Wickenburg, Arizona is a private residential treatment center that offers a holistic approach to the treatment of bipolar disorder. They offer a variety of therapies, including individual and group therapy, medication management, and complementary therapies such as yoga and meditation.

Zinnia Health

Zinnia Health in Lake Okeechobee, Florida is a private residential treatment center that offers a variety of treatment options for bipolar disorder, including medication, psychotherapy, and complementary therapies.

When choosing a bipolar treatment center, it is important to consider the following factors:

The level of care you need. Do you need inpatient or outpatient treatment?

The types of therapies offered. Make sure the center offers the therapies that are right for you.

The cost of treatment. Be sure to factor in the cost of treatment when making your decision.

The location of the center. Choose a center that is convenient for you to travel to.

The reputation of the center. Do some research to make sure the center has a good reputation.