How to Tell If You’re Bipolar?Anna Ciulla
If you are prone to extremes of emotion and have experienced periods or cycles of heightened elation and then its polar opposite, deep depression, you may fear that you’re bipolar. Instead of allowing this gnawing uncertainty to add to your anxiety, it’s better to learn the facts about bipolar, what its symptoms are, who develops it, what causes it, and what the treatment is.
WHAT IS BIPOLAR?
The official term is bipolar disorder, although slang terminology often uses bipolar to describe someone who exhibits known or suspected behavioral traits of the mental illness. The American Psychological Association (APA) defines bipolar disorder as a “serious mental illness in which common emotions become intensely and often unpredictably magnified.” According to the APA, those who have bipolar disorder can “quickly swing from extremes of happiness, energy and clarity to sadness, fatigue and confusion.” Furthermore, these abrupt shifts can be so “devastating that individuals may choose suicide.”
You may be troubled by dramatically shifting emotions such as elation, feeling on top of the world, everything in absolute clarity, to the extreme opposite – feeling sad or blue for no apparent reason, no energy, not able to make decisions, feeling hopeless. You could be bipolar, but not necessarily. What you’re experiencing may be something else entirely. A closer look at the symptoms associated with bipolar disorder may be helpful before you leap to conclusions.
SYMPTOMS OF BIPOLAR DISORDER
Since individuals with bipolar disorder have distinct periods of mania and depression, the symptoms for each differ. There is also no set pattern for these dramatic episodes of high and low moods. If you have bipolar disorder, you may be in the same depressed or manic mood several times before switching to the opposite mood. Such episodes may occur during a period of weeks or months, and sometimes years. Furthermore, it’s important to know that the severity of these episodes (becoming more or less severe) both differs from one person to another and can change over time in the same person.
Symptoms for Periods of Mania
WebMD says that during the period of mania (called “the highs”), individuals with bipolar disorder may exhibit the following symptoms:
- Alcohol and drug abuse
- Excessive excitement, happiness, and hopefulness
- Increased energy and less need to sleep
- Increasing impulsiveness
- Making plans that are grand and unrealistic
- Poor coordination
- Poor judgment
- Rapid speech
- Sex drive that’s unusually high
- Sudden mood swings: joyful to irritable, angry or hostile
Healthline adds these other symptoms of the mania period: feeling overconfidence, being easily distracted, and talking very fast, often with racing thoughts.
Symptoms for Depressive Periods
On the other hand, when the individual with bipolar disorder goes into a depressive period (called “the lows”), the following symptoms may be exhibited, according to WebMD:
- Appetite changes – losing or gaining weight
- Feelings of hopelessness or worthlessness
- Finding it hard to make decisions
- Difficulty concentrating
- Lack of enjoyment in things once liked
- Loss of energy
- Requiring more sleep
- Suicide attempts
- Thoughts of death or suicide
- Uncontrolled crying
Withdrawing from family and friends, says Healthline, can also be a sign of the depressive period of bipolar disorder.
Some individuals with bipolar disorder may become suicidal. For this reason, it’s important to know these warning signs and seek immediate medical help if you have any of them:
- Abuse of drugs or alcohol
- Acting in a reckless manner
- Deliberate self-isolation
- Depression (noticeable changes in activities, eating, and sleeping)
- Dwelling on morbid thoughts and negative themes
- Giving away your possessions
- Increased risk taking
- Being involved in more accidents
- Repeated crying, or changing to being less emotionally expressive
- Talking about death, dying
- Talking about suicide, helplessness, or hopelessness
Help is available 24/7 from the National Suicide Prevention Lifeline at 1-800-273-8255. If at any time you experience suicidal thoughts, talk about or seriously consider suicide, call for help immediately. Trained counselors are there to help you through this crisis and recommend sources for you to get further assistance.
WHO DEVELOPS BIPOLAR DISORDER?
Mental health experts say that bipolar disorder usually develops during a person’s late adolescent or early adult years. Although rare, it can also occur during childhood. Bipolar disorder can also run in families, so if there is a family history of bipolar disorder, you may be at higher risk of developing it.
According to a 2005 study, about 2.6 percent of the population of the United States – or 5 million people – had some form of bipolar disorder. The APA, meanwhile, puts the percentage at 6 million people diagnosed with the mental illness.
As for male-female incidence of bipolar disorder, both men and women are equally likely to develop it. Women, however, tend to be somewhat more likely to go through “rapid cycling” than men. Rapid cycling refers to four or more distinct episodes in a year. Another distinction between men and women with bipolar disorder is that women tend to experience more time in the depressed period than men.
Using drugs or alcohol to cope with feelings during the manic or depressive periods of bipolar disorder is also common. In addition, those diagnosed with bipolar disorder may also have other mental health disorders, including co-existing anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and seasonal depression.
CAUSES OF BIPOLAR DISORDER
While there is no single identifiable cause of bipolar disorder, experts believe that brain changes, genes, and stress play a role in its development. Mental health researchers are conducting ongoing studies to determine how these may influence or contribute to developing bipolar disorder.
DIAGNOSING BIPOLAR DISORDER
You may strongly believe that the abrupt and dramatic mood changes you’ve been experiencing for some time are indicative of bipolar disorder. The only way to know for certain is to see a psychiatrist or a psychologist, or go to your family doctor for a referral to a medical doctor with specialized training in the diagnosis, treatment and prevention of mental illnesses. As part of the visit, the medical professional will ask about any family history of mental illnesses, and you will get a complete psychiatric evaluation to determine if you have bipolar disorder or some other mental health condition.
Two guidelines are currently used in diagnosing bipolar disorder. These are the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Both guidelines are used by the American Psychiatrists’ Association and the World Health Organization, and both classify the disorder into subsets.
Under DSM-V, bipolar disorder has four major subsets: Bipolar I Disorder, Bipolar II Disorder, Cyclothymia, and Bipolar Disorder Not Otherwise Specified (BPD NOS). Current diagnosis of bipolar disorder is based on clinical presentation, which includes functional capacity and symptomatology. Clinicians must regularly observe patients during inpatient or outpatient settings.
During the assessment and evaluation, the medical professional is looking at the symptoms you’ve said you experience, their severity, how long they last, and how often they happen. He or she will try to determine if those symptoms might be due to some other cause — for example, symptoms that may be caused by drug or alcohol abuse, or symptoms of low thyroid.
Symptoms involving mood changes (highs and lows), and changes in behavior, energy, sleep, and thinking are considered most indicative of bipolar disorder – although this is not always the case as they could result in another diagnosis. Your doctor may also speak with family members to learn about patterns of changes in your mood, behavior or thinking. This will help in distinguishing what may be bipolar disorder from other psychiatric conditions that also involve such changes. You may also have underlying or co-occurring anxiety or depression, which will need to be treated simultaneously with any diagnosed bipolar disorder.
TREATMENT FOR BIPOLAR DISORDER
If you are diagnosed with bipolar disorder, you will require ongoing treatment. This shouldn’t be cause for alarm, though, as treatment can allow you to resume a normal life without being sidelined with frightening and dramatic highs and lows characteristic of bipolar disorder. Treatment for bipolar disorder usually involves a combination of pharmacological and psychotherapeutic approaches.
You may be prescribed medications called mood stabilizers, which include lithium. The use of antidepressants and/or antipsychotic medications may also be used in treatment, as well as combinations of drugs.
Psychotherapy, also called talk therapy, is a recommended approach for treating bipolar disorder. As worse adherence to medication regimens is more common right after diagnosis, psychotherapy can help both their patients and family members to accept the diagnosis and the recommended treatment. Since the episodes of mania and depression can be very disruptive and stressful to the individual in treatment for bipolar disorder, this is another area where psychiatrists and psychologists can play an important role by helping the person to recover from the episode, validating what they’re going through, and encouraging consideration of solutions to help them move forward.
In addition, three varieties of psychosocial treatments, which can be adjunct to medication for treating bipolar disorder include cognitive behavioral therapy (CBT), family focused therapy, and interpersonal and social rhythm therapy. Research studies point to consistent routines as helping to ease symptoms of bipolar disorder, with some researchers finding good results with interpersonal and social rhythm therapy, both of which work to regulate daily routines so that circadian rhythm is more balanced.
Psychoeducation is another aspect of treatment for bipolar disorder, important for both the person diagnosed with the mental illness and his or her family.
Those who experience four or more episodes of mood changes in a year, and/or those who have co-occurring substance abuse (problems with drugs or alcohol), may require longer or different treatment, as these forms of bipolar disorder (more frequent episodes/year, dual diagnosis of bipolar disorder and substance abuse) are harder to treat. Indeed, as a 2009 study published in the Journal of Clinical Psychiatry noted, substance abuse is known to negatively affect treatment outcomes for bipolar disorder, contributing to greater nonadherence to treatment, increased hospitalizations, more lifetime mood episodes, lower remission rates, and decreased quality of life.
The most important point to keep in mind is that bipolar disorder can be treated. If, indeed, what you’re experiencing turns out to be diagnosable bipolar disorder, you can move ahead with targeted and personalized treatment to help you live a normal life that’s more balanced and freer from the turmoil of constantly changing high and low emotional episodes.
For more about bipolar disorder, other mental health conditions, addiction and recovery, check out these articles:
- American Journal of Psychiatry. “Current Status of Co-Occurring Mood and Substance Use Disorders: A New Therapeutic Target.” Retrieved from https://ajp.psychiatryonline.org/doi/pdfplus/10.1176/appi.ajp.2012.12010112
- American Psychological Association. “Bipolar disorder.” Retrieved from https://www.apa.org/topics/bipolar/
- American Psychological Association. Monitor on Psychology. “Bipolar support. ” Retrieved from https://www.apa.org/monitor/2016/07-08/bipolar-support
- American Psychological Association. Monitor on Psychology. “Consistent routines may ease bipolar disorder.” Retrieved from https://www.apa.org/monitor/feb08/consistent
- Archives of General Psychiatry. “Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R).” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847357/
- Bipolar Disorder. “Could It Be Bipolar? 14 Signs to Look For.” Retrieved from https://www.healthline.com/health/could-it-be-bipolar-signs-to-look-for
- Bipolar Disorders. “Impulsivity: a link between bipolar disorder and substance abuse.” Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1399-5618.2004.00110.x
- Brain Science. “Digital Platforms in the Assessment and Monitoring of Patients with Bipolar Disorder.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704157/
- Depression and Bipolar Support Alliance. “Bipolar Disorder.” Retrieved from https://www.dbsalliance.org/education/bipolar-disorder/
- Journal of Clinical Psychiatry. “A 6-Month, Double-Blind, Maintenance Trial of Lithium Monotherapy Versus the Combination of Lithium and Divalproex for Rapid-Cycling Bipolar Disorder and Co-Occurring Substance Abuse or Dependence.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3587136/
- Journal of Psychopharmacology. “Evidence-based guidelines for treating bipolar disorder: revised third edition. Recommendations from the British Association for Psychopharmacology.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922419/
- National Institute on Drug Abuse. “Common Comorbidities with Substance Use Disorders.” “Part 1: The Connection Between Substance Use Disorders and Mental Illness.” Retrieved from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
- National Institute on Drug Abuse. “Common Comorbidities with Substance Use Disorders.” “What are some approaches to diagnosis?” Retrieved from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/what-are-some-approaches-to-diagnosis
- National Institute on Drug Abuse. “Common Comorbidities with Substance Use Disorders.” “Why is there comorbidity between substance use disorders and mental illnesses?” Retrieved from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/why-there-comorbidity-between-substance-use-disorders-mental-illnesses
- National Suicide Prevention Lifeline. “National Suicide Prevention Lifeline.” Retrieved from https://suicidepreventionlifeline.org/
- WebMD. “Bipolar Disorder.” Retrieved from https://www.webmd.com/bipolar-disorder/mental-health-bipolar-disorder#1