Bipolar Disorder: Symptoms, Causes and Treatment

Bipolar disorder is characterized by significant mood swings that include emotional highs (mania or hypomania) and lows (depression).  These mood swings affect sleep, energy levels, judgment, behavior, and the ability to think clearly. There are several types of bipolar disorder, with the two most common being Bipolar I and Bipolar II.

People with bipolar disorder have symptoms like euphoria or feeling extremely irritable during manic episodes and persistent feelings of sadness, hopelessness, or loss of interest during depressive episodes. These mood disturbances interfere with daily life, relationships, and work.

Rowland, T. A., & Marwaha, S. (2018). “Epidemiology and risk factors for bipolar disorder.” Therapeutic Advances in Psychopharmacology suggest that some causes of bipolar disorder include genetics, environmental factors, and brain chemistry. Individuals with a family history of bipolar disorder are more likely to develop the condition. Additionally, stressful life events or traumatic experiences can trigger symptoms in those who have a genetic predisposition.

Treatment methods for bipolar disorder involve a combination of medication and psychotherapy. Mood stabilizers, antipsychotic drugs, and antidepressants are prescribed to manage symptoms. Psychotherapies include cognitive behavioral therapy (CBT) and interpersonal and social rhythm therapy (IPSRT) to assist patients in understanding their condition, reducing stress, and improving relationships.

What is Bipolar Disorder?

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings between emotional highs (mania or hypomania) and lows (depression), as suggested by the National Institute of Mental Health’s 2024 post “Bipolar Disorder.” These mood swings affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.

There are several types of bipolar disorder, including bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Bipolar I disorder involves at least one manic episode that is preceded or followed by hypomanic or major depressive episodes. Bipolar II disorder is characterized by at least one major depressive episode and at least one hypomanic episode but no full-blown manic episodes.

Symptoms of mania include feeling unusually upbeat, jumpy, weird, or irritable, having increased activity and agitation, decreased need for sleep, racing thoughts, and poor decision-making. Depressive episodes involve feeling depressed and hopeless, losing interest in activities, significant weight loss or gain, insomnia or sleeping too much, fatigue, feelings of worthlessness, and thoughts of suicide.

Although bipolar disorder is a lifelong condition, it is managed with proper treatment, which often includes medications and psychotherapy. 

What are The Types of Bipolar Disorder?

Dembek C and Mackie D’s 2023 report in the Ann Gen Psychiatry states that different types of bipolar disorder affect approximately 2.8% of the United States population. The three main types of bipolar disorder are Bipolar I, Bipolar II, and Cyclothymia, as suggested by McIntyre RS and colleagues’ 2020 review “Bipolar disorders.” Lancet.

Bipolar I

Bipolar I disorder is characterized by severe manic episodes that last at least seven days and depression periods that last at least two weeks. During manic episodes, individuals experience symptoms such as increased energy, reduced need for sleep, racing thoughts, and impulsive or risky behavior. 

Harvey AG, Talbot LS, and Gershon’s 2009  study “A. Sleep Disturbance in Bipolar Disorder Across the Lifespan.” Clin Psychol (New York) reviewed various aspects of sleep patterns in individuals with bipolar disorder, revealing that during manic episodes, a staggering 69–99% of patients reported a reduced need for sleep.

Depressive episodes involve feelings of sadness, hopelessness, and loss of interest in activities. Bipolar I is treated with a combination of mood stabilizers, antipsychotics, and psychotherapy.

Bipolar II

In contrast to the intense manic periods observed in Bipolar I, bipolar II disease is characterized by a pattern of depressive and hypomanic episodes. 

Hypomanic episodes last at least four days and involve symptoms like increased energy, elevated mood, and increased activity, still without the severe impairment or psychosis that can occur in Bipolar I. 

Datto C, Pottorf WJ, Feeley L, LaPorte S, and Liss C.’s  2016 study “Bipolar II compared with bipolar I disorder”  in Ann Gen Psychiatry Journal suggests that the depressive episodes in Bipolar II are just as severe as those in Bipolar I. Treatment for Bipolar II often includes mood stabilizers, antidepressants, and psychotherapy. 

Cyclothymia

A less severe variation of bipolar illness known as cyclothymia is marked by persistent, erratic moods that alternate between episodes of hypomanic and depressive symptoms. Though not as severe as in Bipolar I or II, the mood fluctuations can nevertheless have a significant effect on day-to-day functioning.

Cyclothymia is often treated with mood stabilizers, antidepressants, and psychotherapy to stabilize mood fluctuations.

Other Specified and Unspecified Bipolar and Related Disorders

These disorders are not classified directly as bipolar disorders because they do not fit the specific criteria for Bipolar I, II, or Cyclothymia. They have similar symptoms and characteristics but do not fully meet the diagnostic criteria, according to Jain A and Mitra P’s 2023 review “Bipolar Disorder.”StatPearls Publishing.

• Rapid cycling bipolar involves having at least four mood episodes within a year, with periods of both mania and depression occurring frequently.
• Bipolar with mixed features is when an individual experiences symptoms of both mania and depression simultaneously.
• Bipolar disorder follows a seasonal pattern where depressive episodes occur during certain times of the year, typically in the fall or winter.
• Unspecified bipolar disorder does not fit into any of the specific categories but still involves significant mood swings and impairment in daily life.

These disorders are related to bipolar disorder as they share similar characteristics and symptoms, including mood swings, changes in energy levels, and disruptions in daily functioning.

What are the Symptoms of Bipolar Disorder?

The symptoms of bipolar disorder tend to vary from person to person, and can also change over time. At times, they are subtle or extreme and differ depending on the type of bipolar disorder a person has.

The symptoms of bipolar disorder include extreme mood swings, changes in energy levels and sleep patterns, difficulty concentrating, and impulsive or risky behavior, according to a Medical News Today article titled “Bipolar disorder types and definitions”  by Jayne Leonard (December 2023). The intensity and length of these symptoms can vary, which makes it challenging for people with bipolar illness to lead stable lives.

What are the Symptoms of Bipolar Disorder in Females? 

Bipolar disorder in females is characterized by mood swings, energy fluctuations, and difficulties with day-to-day tasks, as reported by Parial’s 2015 review “Bipolar disorder in women.” by the Indian J Psychiatry Journal.

Mood swings manifest as sudden shifts between extreme highs (mania or hypomania) and lows (depression). During a manic episode, females feel excessively happy, energetic, and talkative. On the other hand, during a depressive episode, they experience feelings of sadness, hopelessness, and fatigue.

Changes in energy levels are also common in females with bipolar disorder. These fluctuations are intense and unpredictable. For instance, females experience periods of increased productivity and activity during a manic episode but struggle with low energy levels during a depressive

What are the Symptoms of Bipolar Disorder in Children and Teens?

Children with bipolar disorder experience extreme mood swings, impatience, and problems controlling their impulsivity, according to a study titled “Bipolar Disorder in Children and Teens” by Boris Birmaher (September 2013). They also experience physical symptoms such as stomach aches or headaches, which are indicators of underlying emotional distress. As children enter their teenage years, they may exhibit more classic bipolar disorder symptoms similar to adults, including dramatic mood swings and risky behaviors.

There are specific differences in how bipolar disorder presents in females compared to males. For instance, females may experience more rapid cycling between manic and depressive episodes compared to males. They also have stronger associations with anxiety disorders and eating disorders.

What are The Treatments For Bipolar Disorder?

Treating bipolar disorder helps to manage symptoms and improve quality of life. There is no one-size-fits-all treatment for bipolar disorder, as each individual’s experience with the disorder varies. The 6 main treatment options for bipolar disorder are medications, psychotherapy, electroconvulsive therapy, transcranial magnetic stimulation, and Light therapy, according to a World Health Organization article titled “Bipolar disorder” (July 2024).

Medications

Medications are essential for treating bipolar disorder as they help manage acute episodes of mania and depression and prevent relapse. The main classes of drugs used include mood stabilizers such as lithium, valproate, carbamazepine, and lamotrigine, which help to maintain a balanced mood and prevent extreme mood swings. 

Antipsychotics like olanzapine, aripiprazole, quetiapine, and risperidone are also commonly prescribed to manage symptoms of mania and, in some cases, depression. Additionally, antidepressants are used cautiously in combination with a mood stabilizer to treat depressive episodes, as they sometimes trigger manic episodes if used alone. Medication plays a significant role in the brain stimulation process for bipolar disorder by serving as either an adjunct or alternative treatment.

Psychotherapy

Psychological therapies play a crucial role in managing bipolar disorder, complementing medication-based treatments. Cognitive behavioral therapy (CBT) is particularly effective, helping to reduce depressive symptoms and lower the risk of relapse. 

Psychoeducation is another valuable approach, providing patients and their families a deeper understanding of the condition. Family therapy focuses on improving relationships and encourages collaborative efforts to enhance mental health. 

Additionally, support groups offer a platform for individuals to develop coping skills and share experiences with others facing similar challenges. These therapeutic interventions, when combined with appropriate medication, can significantly improve the quality of life for those living with bipolar disorder.

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is a psychiatric treatment that involves the electrically induced seizure of the brain to alleviate severe mental health conditions. Typically performed under general anesthesia, ECT delivers small electric currents to the brain, causing a brief seizure that can lead to significant changes in brain chemistry, often resulting in rapid improvement of symptoms in conditions such as major depressive disorder, bipolar disorder, and catatonia. 

ECT is beneficial for patients who have not responded to other treatments, offering a quick response in critical situations, such as severe depression with suicidal ideation or acute mania. This is recommended when medications are ineffective.

Transcranial magnetic stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that utilizes magnetic fields to influence brain activity, primarily targeting areas involved in mood regulation. It is particularly effective for individuals with treatment-resistant depression, offering an alternative to more invasive procedures like Electroconvulsive Therapy (ECT) without the associated cognitive side effects. TMS has also shown promise in treating other conditions such as bipolar disorder, anxiety, and obsessive-compulsive disorder (OCD).

Light Therapy

Light therapy is a treatment that involves exposure to direct sunlight or artificial light at controlled wavelengths to treat various medical conditions. It is commonly used to treat skin conditions, mood disorders, and circadian rhythm sleep-wake disorders.

Even C, Schröder CM, Friedman S, Rouillon F.’s 2008 study on “Efficacy of light therapy in nonseasonal depression systematic review also found that “overall, bright light therapy is an excellent candidate for inclusion into the therapeutic inventory available for the treatment of nonseasonal depression today, as adjuvant therapy to antidepressant medication, or eventually as stand-alone treatment for specific subgroups of depressed patients.

Managing bipolar disorder requires a comprehensive approach that combines various treatment modalities tailored to the individual’s needs. These treatment options play a vital role in alleviating symptoms and enhancing the quality of life for those affected.

What are The Causes of Bipolar Disorder?

The leading causes of bipolar disorders include genetic factors, chemical imbalances in the brain, and environmental triggers, according to an article in the American Psychiatry Association titled “What Are Bipolar Disorders?” by Adrian Preda, M.D. (April 2024). 

The risk factors that cause bipolar disorders are given below.

• Genetic Factors: Genetic factors are the hereditary information that is passed down from parent to child. LaPalme, Hodgins, & LaRoche’s, 1997)  meta-analysis of research published in Dev Psychopathol Journal suggests that before 1997, children of bipolar parents had a 4 times higher chance of developing a mood disorder and a 2.7 times higher risk of developing any psychiatric disorder compared to children of parents who were not mentally ill.
• Chemical Imbalances in the Brain: Chemical imbalance is the disruption of natural chemical substances, also known as neurotransmitters, in the brain. These chemicals are important for transmitting signals between neurons and regulating mood and behavior.  A 2003 research by Manji HK, Quiroz JA, Payne JL, Singh J, Lopes BP, and Viegas JS, Zarate CA. “The underlying neurobiology of bipolar disorder. ” World Psychiatry points out that individuals with bipolar disorder often have imbalances in neurotransmitters such as serotonin, dopamine, and norepinephrine. These imbalances can affect the brain’s communication and lead to symptoms of bipolar disorder.
• Environmental Triggers: Environmental triggers are external factors that can worsen or trigger an episode of bipolar disorder. These triggers include stressful life events, such as a major loss or change, trauma, substance abuse, or hormonal changes. A notable 2016 study by Dr Aldinger F and Dr. Schulze TG. “Environmental factors, life events, and trauma in the course of bipolar disorder.” 

Psychiatry Clin Neurosci found that environmental stressors can not only increase the risk of developing bipolar disorder but also contribute to the severity and frequency of episodes.

These factors play a significant role in the development of bipolar disorder. It is essential to seek professional help and support to manage and treat this complex mental health condition effectively.

How is Bipolar Disorder Diagnosed?

Bipolar disorder is diagnosed through a combination of physical exams, psychological evaluations, and interviews with the patient and their family members or loved ones. According to a Healthline article titled “Diagnosis Guide for Bipolar Disorder” by Brian Krans (March 2022). 

A single test cannot provide a precise diagnosis of bipolar illness. Instead, medical professionals depend on thoroughly assessing the patient’s medical background, family history, and symptoms. During physical exams, doctors look for any underlying medical conditions that could be causing or contributing to the symptoms of bipolar disorder. They also perform laboratory tests to rule out other potential causes, such as thyroid problems or drug use.

Psychological evaluations involve a series of assessments that measure cognitive functioning, emotional state, and behavior. A psychiatrist or psychologist conducts these evaluations, including standardized tests, interviews, and patient behavior observation.

Interviews with the patient and their family members or loved ones play an essential role in diagnosing bipolar disorder. The patient’s symptoms, habits, and emotional swings will be the subject of targeted questions from the doctor. They also ask for information about any previous manic or depressive episodes.

How Do You Cope With Bipolar Disorder?

Coping with bipolar disorder involves a comprehensive treatment plan that includes medication, therapy, lifestyle changes, and social support, according to The WHO’s July 2024 article “Bipolar disorder.”

Medications such as antipsychotics, mood stabilizers, and antidepressants are frequently administered to treat bipolar disorder symptoms. Individuals with bipolar disorder also use therapy to develop coping mechanisms and symptom management techniques. Bipolar disorder is effectively treated with psychoeducation and cognitive-behavioral therapy (CBT). 

These treatments recognize unfavorable mental patterns, strengthen problem-solving abilities, and enhance communication. Maintaining a healthy lifestyle is important for managing bipolar disorder. This entails regular exercise, a nutritious diet, and getting enough sleep. It’s also essential to abstain from alcohol and drugs because they can upset your equilibrium.

Building a solid support system of family and friends provides emotional support and practical help in coping with bipolar disorder.