Bipolar is one of those words that has crossed over into our everyday lives and our everyday language. However, the term is misused and as a mental health diagnosis, it means very specific things.
How do Therapists Diagnose Bipolar Disorder?
In order to diagnose someone with a mental health disorder, clinicians use a book called the DSM V TR which lists out all the mental health disorders and the criterion needed to be able to diagnose someone with that particular disorder. If you look at this, there are certain characteristics that all people with bipolar share. First off, all people who have Bipolar must have at least 1 episode of depression, and at least 1 episode of mania. These episodes can be fairly short or can last up to months, but you must have a distinct period of depression and a distinct period of mania in order to be diagnosed.
I’ve listed the most common symptoms of these below:
Depression
Depressed mood (ie feeling sad or empty)
Decreased level of interest or pleasure in activities that previously made you happy
Decreased appetite, and weight loss without trying to
Change in sleep- either insomnia or excessive sleep
Change in energy level (usually low when depressed, though at times you might be agitated instead); fatigue
Feeling worthless, or having excessive guilt
Difficulty thinking clearly
Thinking of death or dying
Mania
Increased feelings of self-esteem
Decreased need for sleep
Speech is faster than usual, the person is more talkative
Racing thoughts. Feeling like your thoughts are jumping from subject to subject.
Easily distracted
Increase in goal-directed activity such as cleaning, homework, increased productivity at work, or sexual behavior. Agitation.
Increased engagement in risky behavior such as spending, sex, gambling, poor business decisions, driving too fast, etc.
Different Types of Bipolar Disorder
There are several different diagnoses that can come under the umbrella of Bipolar Disorder and so I’ll briefly describe them below.
Bipolar I Disorder
This means you’ve had a least one manic episode in your life and have had episodes of depression as well. Sometimes, mania can lead to a psychotic break, which is a break from reality.
Bipolar II Disorder
This is similar to type I Bipolar, but instead of a manic episode, you’ve had at least one hypomanic episode instead. Hypomania is when your symptoms are like mania, but not severe enough to be diagnosed as having a manic episode. By definition, you can not be diagnosed with Bipolar II Disorder if you have ever had a full-fledged manic episode.
Cyclothymic Disorder
Cyclothymic Disorder is characterized by the cycling of mood that you see in Bipolar Disorder, but the symptoms of depression and mania are less than would be needed to diagnose major depression or mania.
The different types can become confusing, so I think I’ll leave it at this.
Causes of Bipolar Disorder
For many years, the dominant theory is that neurotransmitters are what cause mood disorders such as Bipolar Disorder. The mechanism is not known though, so it may be an imbalance of these neurotransmitters, or that the level of these neurotransmitters is low, or maybe for some reason, the brain is unable to properly utilize these chemicals.
We do know that if you have a close family member with Bipolar Disorder, you are more likely to develop Bipolar Disorder, so there is certainly some genetic component to the disease.
It is also interesting to note that the onset of symptoms is often preceded by a time of stress in the person’s life. Bipolar Disorder can also be triggered by drug or alcohol use.
How to Treat Bipolar Disorder
If left untreated, episodes of mania can last from 3 to 6 months. Episodes of depression can last even longer- 6-12 months without treatment. And the symptoms can cause severe disruption in your life including difficulty maintaining relationships, difficulty holding down a job, and maintaining basic life functions such as keeping a clean house, paying bills on time, and caring for your basic needs. It can also lead to suicidal thoughts or even attempts.
However, Bipolar Disorder is treatable. With treatment, symptoms generally start to improve in 3 months or less.
Bipolar Disorder is generally treated with a combination of medications and therapy.
Medications are important because they seek to balance out brain chemistry. The medications that are used are often a combination of mood stabilizers, anti-depressants, and anti-anxiety medications. You need to work together with your doctor to find the best combination that works for you. Because of this, do not be afraid to tell your doctor what is happening with your moods and any side effects you’re experiencing.
Therapy
Therapy will focus on learning about bipolar disorder and what its symptoms are, learning what your personal triggers are, learning the signs that you are becoming symptomatic, and learning ways of coping with your symptoms. CBT is especially helpful in learning to cope with depression. Other forms of counseling might include family therapy, interpersonal therapy, or social rhythm therapy.
Closing Thoughts
If you think you might have Bipolar Disorder, you first need to talk with your doctor about it and see about getting diagnosed. Know that it is treatable and that you can get your life back on track! But remember, treatment will vastly shorten your recovery time and help you return to normal much faster.
If you’d like to talk more about Bipolar Disorder, or would like to get information on depression treatment, please follow the link.