“They’re so bipolar.”
People often use this phrase to describe someone who is moody, flighty, or frequently changes their mind. However, using this term with a negative connotation contributes to the stigma that people diagnosed with bipolar disorder face.
What Is Bipolar Disorder?
About 2% of the global population has bipolar disorder, and people most often begin to experience symptoms between ages 15 and 30.
People with bipolar disorder experience ups and downs to a greater extent than your average mood swings — rather than quick changes in mood, these episodes can last days, weeks, or months at a time. The ups, called mania or hypomania, include feelings of euphoria that can lead to risk-taking without fear of consequence. The downs, called depression, include intense sadness, lack of pleasure, disrupted sleep and eating, and even suicidal thoughts. In addition to these ups and downs, people can experience periods of neutral mood.
Understanding the Poles
Mania and Hypomania
Mania is a period of time where someone experiences an extremely high mood. To many, this might sound like a positive thing, but it lacks control and can get out of hand quickly.
People experiencing mania may find that they don’t need sleep and have a lot of energy, feel invincible and behave recklessly, and are very distractible and experience thoughts moving too fast. In its extremes, mania can cause people to experience hallucinations or delusions or other loss of contact with reality.
Hypomania is a milder form of mania in which people may experience some of the extra energy, racing thoughts, elated mood, and changes in thinking, but it typically doesn’t last as long or get to the point of losing contact with reality. It also tends not to be as obvious to an outsider.
The depressive episodes in bipolar disorder are similar to those of any clinical depression. This can manifest as sadness, apathy, irritability, or an individual just not enjoying the things they used to. People may have difficulty getting out of bed or doing other normal daily activities. Depression can affect their concentration, thinking, appetite, and sleep, and they may move more slowly. They may see the world and themself through a more negative lens and have a lot of trouble motivating themselves.
Types of Bipolar Disorder
There are four main diagnoses that fall under the bipolar disorder umbrella – Bipolar I, Bipolar II, Cyclothymia, and Unspecified. They all include periods of ups and downs, but with slight differences.
- Someone diagnosed with Bipolar I experiences the height of mania as well as the depths of depression.
- A person with Bipolar II experiences hypomania —the shorter, less severe form of mania described above —and depression.
- Someone with Cyclothymia experiences hypomania and a milder form of depression.
- Unspecified bipolar disorder is the catch all for anyone who doesn’t quite fit into any of the previous three diagnoses.
It can be helpful to think about this visually. If the middle black line represents a neutral mood, the average person has their ups and downs but hovers right around it, like the dotted line in the picture. You can also see roughly where someone with Bipolar I, Bipolar II, Cyclothymia and major depressive disorder (sometimes called unipolar depression) might fall.
Bipolar disorder is typically managed best with a combination of psychotherapy and medication and can benefit from family support, self-care and a general healthy approach to life and scheduling. While these are chronic disorders, working with a mental health team can help to make bipolar disorder manageable and lessen the impact it has on one’s life.
To learn more about evidence-based treatments for bipolar disorder, click here.
To learn more about managing bipolar disorder or supporting a loved one with the disorder, check out The Bipolar Disorder Survival Guide by David J. Miklovitz, PhD.
We all can contribute to lessening the stigma and barriers to treatment for bipolar disorder by refraining from using “bipolar” negatively or to represent anything but what it truly is. As with any of our misused mental health terms, what we say matters!
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