What is Bipolar Disorder?

What is Bipolar Disorder?
Written By: Clinical Psychologist
Reviewed By: Counselling Psychologist
MA Psychology Pennsylvania State University, USA
Last Updated: 22-11-2023

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Bipolar Affective Disorder (BPAD): Extreme mood swings, characterized by emotional highs (mania or hypomania) and lows (depression), are the hallmark of bipolar illness, formerly known as manic depression.

When someone is depressed, he or she could experience sadness or hopelessness as well as lose interest in or enjoyment from most things. Mania or hypomania, which is less severe than mania, can cause mood swings that include euphoria, excessive energy, or extraordinary irritability. Sleep, energy, activity, judgement, conduct, and the capacity for clear thought can all be impacted by these mood changes.

It is typical for bipolar disorder to run in families: 80–90% of those who have the illness have a relative who also has depression or bipolar disorder. Vulnerable individuals may experience mood episodes brought on by environmental variables such as stress, sleep disturbances, medications, and alcohol. It is thought that dysregulated brain activity results from a chemical imbalance in the brain, even if the precise causes of bipolar disease are unknown. Twenty-five is the average age of onset.

Mood swing episodes might happen infrequently or frequently throughout the year. Some people may not have any emotional symptoms in between bouts, but most people will.

Even though bipolar disorder is a lifelong diagnosis, you can control other symptoms like mood swings by adhering to a treatment plan. The majority of the time, psychotherapy and medication are used to manage bipolar disorder.


Bipolar disorder and its linked disorders come in various forms. Depression and mania or hypomania may be among them. The unpredictability of mood and behavioural swings brought on by symptoms can cause severe discomfort and make living challenging.

Bipolar I Disorder: The person has experienced at least one manic episode, which may have been followed or preceded by serious depression or hypomanic episodes. Mania can sometimes lead to psychosis or a detachment from reality.

Bipolar II Disorder: The person has never experienced a manic episode, but you have experienced at least one major depressive episode and one hypomanic episode.

Cyclothymic Disorder: The person has experienced multiple episodes of hypomania symptoms and depressed symptoms (but not as severe as major depression) for at least two years, or one year in adolescents and teenagers.

Other types: These comprise, for instance, bipolar illness and associated disorders brought on by specific medicines or alcohol, or resulting from a physical ailment like multiple sclerosis, stroke, or Cushing s disease.

Bipolar II disorder is a distinct diagnosis rather than a less severe variation of bipolar I illness. People with bipolar II condition may experience prolonged periods of depression, which can significantly hinder their lives, in contrast to the extreme and hazardous manic episodes associated with bipolar I disorder.

While bipolar disorder can strike at any age, it is usually identified in adolescence or the early twenties. Individual differences in symptoms as well as changes in symptoms over time are possible.

Mania and Hypomania
Although manic and hypomanic episodes are different, they share similar characteristics. Mania is more severe than hypomania and results in more obvious issues with relationships, employment, school, and social activities. Additionally, psychosis—a detachment from reality—caused by mania may necessitate hospitalization.

An episode of manic or hypomanic behaviour involves three or more of the following symptoms:

  1. Unusually Happy, Jittery, or Wired
  2. Increased Goal-Directed Activities
  3. Inflated Self-Esteem or Grandiosity
  4. Decreased Need for Sleep 
  5. Overtalkitiveness or Pressure to keep talking
  6. Flight of Ideas or Racing Thoughts
  7. Distractibility
  8. Making Poor Decisions, such as going on shopping binges, taking chances with your partner, or making stupid investments

Major Depressive Episode
When symptoms of a major depressive episode are severe enough to interfere noticeably with daily activities, such as relationships, work, school, or social activities, it is considered a major episode. At least five of these symptoms are present during an episode:

  1. Depression, is characterized by feelings of melancholy, emptiness, hopelessness, or tears (among kids and teenagers, depression can manifest as impatience).
  2. Marked Disinterest in or Lack of Enjoyment from all or nearly all activities
  3. Not gaining weight, losing weight while not dieting, or experiencing an increase or reduction in appetite (in youngsters, not gaining weight as planned can indicate depression)
  4. Insomnia or Hypersomnia
  5. Psychomotor Agitation or Retardation 
  6. Fatigue or Loss of Energy
  7. Feelings of Worthlessness or Excessive or Inappropriate Guilt
  8. Diminished Ability to Think or Concentrate or Indecisiveness 
  9. Recurrent Thoughts of Death or Suicidal Ideations

Cyclothymic Disorder
Cyclothymic disorder is a milder variation of bipolar illness that has a lot of "mood swings," including frequent episodes of hypomania and depression. Emotional ups and downs are a feature of cyclothymia, but the symptoms are not as severe as those of bipolar I or II illness.

The following are some symptoms of cyclothymic disorder:

  1. Numerous episodes of hypomanic and depressive symptoms spanning at least two years, however, the symptoms don t fit the description of a hypomanic or depressive episode.
  2. The symptoms (mood swings) have persisted for at least half of the two-year period and have never stopped for longer than two months.

Other features of bipolar disorder
Bipolar I and II illnesses might present with other signs and symptoms, such as anxiety, sadness, psychosis, or other conditions. When symptoms first appear, they may be diagnosed with mixed or rapid cycling, among other classifications. Moreover, bipolar symptoms might fluctuate with the seasons or manifest during pregnancy.

Symptoms in children and teens
Bipolar illness symptoms in children and teenagers might be challenging to recognize. It might be challenging to determine whether these are symptoms of stress or trauma, typical ups and downs, or any mental health issue other than bipolar disorder.

While major depressive, manic, or hypomanic episodes can occur in children and teens, the pattern of these episodes may differ from that of adults with bipolar disorder. And throughout episodes, feelings can change quickly. Between bouts, certain youngsters may experience periods free of mood disorders.

Severe mood fluctuations that differ significantly from the patient s typical mood swings may be one of the most noticeable symptoms of bipolar illness in children and teenagers.

When to seek therapy

Even though bipolar disease causes dramatic mood swings, many sufferers are unaware of how much their emotional instability affects them and their loved ones, and they frequently go untreated.

Additionally, if someone has bipolar disorder, they might find that the cycles of increased productivity and exhilaration are enjoyable. But this exhilaration is invariably followed by an emotional collapse that can leave them exhausted, unhappy, and possibly in problems with the law, money, or relationships.

Visit a physician or a mental health professional if you have any signs of mania or depression. Bipolar disorder does not improve by itself. If suffering from Bipolar Disorder, they can manage their symptoms by seeking treatment from a mental health specialist who specializes in treating bipolar illness.

Treatment and Management

Treatment usually makes bipolar illness symptoms better. Bipolar disorder treatment primarily consists of medication, though many patients find that talk therapy, also known as psychotherapy, helps them understand their condition and take their meds as prescribed, which helps to prevent more episodes of moodiness.

Medications referred to as "mood stabilizers," such as lithium, are the kind most frequently used for bipolar disorder. It is thought that these drugs balance out abnormal brain signals. As bipolar disorder is a chronic condition with recurrent mood episodes, it is advised to receive preventive treatment continuously. Treatment for bipolar disorder is personalized, and patients may need to try a variety of drugs before settling on one that is most effective for them.

Psychosocial treatment does not eliminate the need for medication. Long-acting injectable antipsychotics are now available and may offer benefits to those who take them: early detection of medication nonadherence, no daily medication intake, and reduced rates of relapse and rehospitalization. However, these drugs (such as aripiprazole, olanzapine, paliperidone and risperidone) are indicated for schizophrenia.

Electroconvulsive therapy (ECT) is a useful therapeutic option that may be utilized in some situations when medicine and psychotherapy have failed to provide the desired results. ECT causes a brief, controlled seizure by applying a brief electrical current to the patient s head multiple times while they are unconscious. Seizures brought on by ECT are thought to alter brain signalling networks.

Family members of someone with bipolar disorder may find it helpful to access professional resources, especially mental health advocacy and support groups, as the illness can seriously disrupt a person s daily routine and stress out the family. Families can get information about coping mechanisms, active treatment participation, and finding support from various sites.

Psycho-Social Treatment Modalities for Bipolar Affective Disorder (BPAD)

Cognitive Behaviour Therapy (CBT): Cognitive behavioural therapy, which involves changing your thinking patterns, is effective in treating bipolar disorder, according to the American Psychological Association. Strategies used in CBT include role-playing to prepare for interactions that may be problematic, rather than avoiding facing fears directly, and learning techniques to calm and relax the mind and body.

Interpersonal and Social Rhythm Therapy (PSRT): IPSRT, an adjunctive treatment for people with mood disorders, describes methods that help improve medication adherence, manage stressful life events, and reduce disruptions in social rhythms. Through this form of treatment, patients learn skills to help them protect themselves from future episodes. IPSRT focuses on managing the patient and their symptoms and improving interpersonal relationships.

Family-Focused Therapy (FFT): Family-focused therapy (FFT) involves both the BD patient and their parents, spouse, or other family members. FFT usually takes about 12 sessions (depending on the needs of the family) given by a single therapist. Early sessions focus on education about the disease: its symptoms and their cycle over time, its causes, recognizing the early warning signs of new episodes, and what to do as a family to prevent episodes from getting worse. Later sessions focus on communication and problem-solving skills, especially for resolving family conflicts. In several randomized trials conducted by my labs at the University of Colorado and UCLA, we found that BD patients who received FFT and medication after an episode had fewer mood symptoms and better functioning over 1-2 years than those who received medicine and a shorter time. . treatment or case management.

Dialectical behaviour therapy (DBT): Dialectical behaviour therapy is a skills-based approach that includes both individual and group therapy. It teaches mindfulness and acceptance skills, such as the ability to experience moment-to-moment thoughts, feelings, and associated physical sensations from the attitude of an observer without negative judgment. It also teaches anxiety tolerance, emotional regulation and interpersonal effectiveness.


Bipolar disorder is a chronic mental health condition that causes extreme mood swings, from mania to depression. Mania is a period of high energy, irritability, and reduced need for sleep. Depression is a period of low energy, sadness, and loss of interest in activities.

There is no cure for bipolar disorder, but it can be managed effectively with medication and therapy. Medications called mood stabilizers are the first line of treatment. They help to level out mood swings and prevent episodes of mania and depression. Other medications, such as antipsychotics and antidepressants, may also be used.

Therapy can also help people with bipolar disorder manage their symptoms. Cognitive-behaviour therapy (CBT) is a type of therapy that helps people identify and change negative thoughts and behaviours. Psychoeducation is another type of therapy that teaches people about bipolar disorder and how to manage it.

The goal of bipolar disorder management is to achieve and maintain euthymia, which is a state of normal mood and functioning. This can be achieved through a combination of medication and therapy.

In addition to medication and therapy, there are a number of lifestyle changes that people with bipolar disorder can make to help manage their condition. These include:

  • Getting regular sleep
  • Eating a healthy diet
  • Exercising regularly
  • Avoiding alcohol and drugs
  • Managing stress
  • Having a strong support system

Bipolar disorder is a serious mental health condition, but it can be managed effectively with medication and therapy. People with bipolar disorder can live full and productive lives with the right support.

Here are some additional tips for managing bipolar disorder:

  • Keep a mood journal to track your mood swings and identify triggers.
  • Develop a crisis plan for what to do if you start to experience a manic or depressive episode.
  • Talk to your doctor about any side effects you are experiencing from your medication.
  • Be patient with yourself and don t give up on your treatment plan.
  • With the right support, people with bipolar disorder can live full and healthy lives.

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  • Bipolar Disorder: Symptoms and Treatment - Mayoclinic
  • Recognising signs of bipolar disorder - Apa.org
  • What are bipolar disorders? - Psychiatry

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