bipolar

By: Claire Butcher

World Bipolar Day, or WBP, was founded by the International Bipolar Foundation (IBPF). WBP is celebrated on Vincent Van Gogh’s birthday, March 30th, who was believed to have the disorder. This international day strives to build awareness and reduce stigma of the often misunderstood diagnoses that millions of people experience. 

Misinformation surrounding these conditions only spreads the shame and guilt that can come with being diagnosed with bipolar disorders. This article will provide a simple outline of bipolar diagnoses, symptoms, treatment, and resources to access.

What is “Bipolar”?

“Bipolar” can act as an umbrella term for multiple diagnoses, differentiated by the pattern and intensity of manic and depressive “episodes”. We’ll first touch on what types of manic and depressive episodes people can experience, then learn about the types of bipolar diagnoses. 

“Mania” can be defined as a period of time, lasting a minimum of one week where one’s mood and behaviors are elevated, irritable, or overall abnormal, often presenting with increased energy or activity. Manic episodes often require hospitalization or other mental health interventions due to impaired social or occupational functioning, harm to self, or psychotic features. Some cues of mania can look like:

• Inflated self-esteem or grandiosity
• Decreased need for sleep 
• Being more talkative than usual, or fast speech
• Experiencing a ‘flight of ideas’ or racing thoughts
• Distractibility 
• Increase in goal-directed activity (in school, work, social life, etc)
• Excessive involvement in high-risk activities (i.e.: buying sprees, drug use, unprotected sex, extreme life changes, etc)

“Hypomania” is a less intense or milder form of manic episodes. Criteria listed above for a full-blown manic episode are the same criteria as a hypomanic episode, however hypomanic episodes generally last four days minimum, and usually do not require intense medical or mental health intervention or hospitalization due to the lack of impairment in functioning, risk of harm to self, psychosis, etc.

A depressive episode is characterized by a two-week or longer period of time where one’s functioning is impaired due to depressed mood, or loss of pleasure in most/all activities. Here are some cues and criteria for a depressive episode:

• Depressed mood most of the day, every day (feeling empty, hopeless, numb, tearful)
• Diminished interest in most or all activities
• Significant change in weight or appetite 
• Insomnia or hypersomnia
• Psychomotor agitation or retardation (visible changes in one’s movement and speed observed by others)
• Fatigue, or loss of energy
• Feelings of worthlessness, hopelessness, or guilt
• Concentration struggles, difficulty making decisions
• Recurrent thoughts of death (“suicidal ideation”) 

Bipolar 1, 2, and Cyclothymia

Now that we’ve learned about the different types of episodes people can experience, we can explore the types of bipolar diagnoses people can receive based on those episodes. 

Bipolar 1 is characterized by experiencing manic and depressive episodes, and is considered the most severe type of bipolar disorder. As stated earlier, manic episodes are more severe and longer-lasting than hypomanic episodes, and can require hospitalization. To be diagnosed with Bipolar 1, at least one lifetime manic episode is required. Experiencing a depressive episode is not required for this diagnosis, but oftentimes still occurs. Along with manic episodes, people with Bipolar 1 can experience hypomanic episodes. 

Bipolar 2 is characterized by experiencing hypomanic and depressive episodes. The criteria for diagnosis is one hypomanic episode and one depressive episode in your lifetime. If one were to experience a manic episode (more severe symptoms, impairment in functioning, symptoms lasting seven days or longer, experiencing psychosis, requiring hospitalization), one would no longer meet Bipolar 2 criteria, as these are symptoms of Bipolar 1. 

Cyclothymia is a combination of hypomanic and mild depressive episodes, and is considered a milder form of bipolar diagnosis. It’s characterized by ‘cyclical’ mood swings, where symptoms are not severe enough to meet manic, hypomanic, or depressive episode criteria. This pattern must span at least two years to meet the criteria of cyclothymia. Monitoring symptoms and engaging in treatment is important – people with cyclothymia are at risk for developing full-blown bipolar disorder. 

Treatment

There are a handful of routes people can take to help manage bipolar symptoms, such as medication, therapy, and lifestyle changes. Medication can help stabilize or minimize the highs of manic episodes and the lows of depressive episodes. Psychotherapy is also considered essential to treating bipolar symptoms – learning to cope with difficult symptoms and emotions, building healthy relationships, and regulating stress. 

Support, whether found in support groups, group therapy, or a strong social circle, can help manage difficult chapters of bipolar symptoms, as well as challenge the ever-present stigma stemming from misinformation. 

Healthy lifestyle changes can include prioritizing sleep hygiene, avoiding alcohol and drugs, exercising regularly, minimizing stress, and getting consistent sunlight exposure. With these interventions, people experiencing bipolar symptoms can build healthy, happy lives. 

Resources for Learning More about Bipolar Diagnoses

• Keep up with educational books and videos
• Save and share bipolar hotlines and resources, and the National Suicide Hotline

References:

• International Bipolar Foundation
• International Bipolar Foundation – World Bipolar Day
• World Health Organization – Key Facts of Bipolar Disorders
• Healthline – Bipolar Psychosis
• International Bipolar Foundation – Treatment
• International Bipolar Foundation – Resources
• National Suicide Hotline