What Are Bipolar Disorders
Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic or depressive . People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.
People without bipolar disorder experience mood fluctuations as well. However, these mood changes typically last hours rather than days. Also, these changes are not usually accompanied by the extreme degree of behavior change or difficulty with daily routines and social interactions that people with bipolar disorder demonstrate during mood episodes. Bipolar disorder can disrupt a persons relationships with loved ones and cause difficulty in working or going to school.
Bipolar disorder is a category that includes three different diagnoses: bipolar I, bipolar II, and cyclothymic disorder.
People with bipolar I disorder frequently have other mental disorders such as anxiety disorders, substance use disorders, and/or attention-deficit/hyperactivity disorder . The risk of suicide is significantly higher among people with bipolar I disorder than among the general population.
Bipolar Disorder And Depression
Bipolar disorder and major depressive disorder are mental health conditions that share some similar features. In some cases, people may confuse the two. However, they are separate disorders that require different treatment approaches.
Some of this misunderstanding may be attributed to the term bipolar depression, which is a name given to the depressive episodes that are a part of bipolar disorder. To understand the difference between bipolar and depression, each disorder must be examined on its own. Once a person understands both disorders separately, it becomes easier to identify differences between bipolar and depression.
Antidepressants For Bipolar Depression
Ease and relative safety of treating depressive episodes with modern antidepressants, and strenuous efforts to minimize or avoid depression by BD patients and clinicians, have made antidepressants the leading treatment provided to BD patients . Nevertheless, there is a striking paucity of therapeutic experimentation and inconsistent findings, despite more than a half-century of use of antidepressant drugs to treat depression, with particularly serious gaps regarding dysthymia and dysphoria, mixed features, and long-term prophylaxis for bipolar depression . Many experts advise caution in using antidepressants, particularly for BD-I patients to avoid potentially dangerous mood-switches, and encourage their use, if necessary, only with mood-stabilizing agents or SGAs, and without current mixed features or agitation .
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Treatment For Bipolar And Depression
Left untreated, both bipolar disorder and major depressive disorder can have a major impact on social and occupational functioning. Both include the risk of suicide. The good news is that both conditions are treatable. Combination treatment often works best in both cases. Possible treatment modalities include:
Accurate diagnosis is crucial if antidepressants or other depression medications are prescribed, because some can worsen bipolar disorder symptoms.
Patients with both depression and bipolar disorder respond well to highly structured routines. Creating a routine helps patients know what to expect and follow through with medication management independently.
What Is Mixed Bipolar Disorder
Mixed bipolar disorder is a type of bipolar disorder that is characterized by both manic and depressive episodes. This can make it difficult to diagnose and treat, as the symptoms may mimic other mental health conditions.
The most common symptom of mixed bipolar disorder is feeling extreme swings in mood. These mood swings can go from feeling extremely happy or elated to feeling very sad or down . In between these two extremes, people with mixed bipolar disorder may also experience periods of normalcy.
Mixed bipolar disorder is thought to be relatively rare, occurring in about 1-2% of the population. However, this estimate may be skewed as the condition can often be misdiagnosed. For example, someone who experiences a depressive episode may be diagnosed with major depression, while someone who experiences a manic episode may be diagnosed with bipolar I disorder.
Mixed bipolar disorder can be difficult to treat as the symptoms can vary greatly from person to person. Treatment typically involves a combination of medication and therapy. If you think you or a loved one may be struggling with mixed bipolar disorder, its important to reach out to a mental health professional for help.
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What Other Disorders Are Tied To Bipolar Disorder
Major Depressive Disorder. Bipolar disorder is most frequently misdiagnosed as unipolar depression in a whopping 40 percent of cases.
What are the stages of bipolar disorder?
There are six distinct stages of bipolar: Crisis, Managed, Recovery, Freedom, Stability, and Self-Mastery. The first three are considered Disorder, while the last three are clearly IN Order once you understand the difference.
Bipolar 1 Vs Bipolar 2
All types of bipolar disorder are characterized by episodes of extreme mood. The highs are known as manic episodes. The lows are known as depressive episodes.
The main difference between bipolar 1 and bipolar 2 disorders lies in the severity of the manic episodes caused by each type.
A person with bipolar 1 will experience a full manic episode, while a person with bipolar 2 will experience only a hypomanic episode .
A person with bipolar 1 may or may not experience a major depressive episode, while a person with bipolar 2 will experience a major depressive episode.
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What Is The Treatment For Mania Hypomania And Depression
You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:
The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.
What medications are recommended?
Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.
The mood stabilisers we talk about in this factsheet are:
- Certain benzodiazepine medication
Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.
If you are taking antidepressants your doctor may advise you to withdraw from taking them.
You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:
If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.
If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.
Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.
- Fluoxetine with Olanzapine
What Is Bipolar 2 Disorder
Bipolar 2 disorder involves a major depressive episode lasting at least two weeks and at least one hypomanic episode . People with bipolar 2 typically dont experience manic episodes intense enough to require hospitalization.
Bipolar 2 is sometimes misdiagnosed as depression, as depressive symptoms may be the major symptom at the time the person seeks medical attention. When there are no manic episodes to suggest bipolar disorder, the depressive symptoms become the focus.
As mentioned above, bipolar 1 disorder causes mania and may cause depression, while bipolar 2 disorder causes hypomania and depression. Lets learn more about what these symptoms mean.
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Treatment For Bipolar Disorder
Doctors use mood stabilizers to treat bipolar disorder. Antidepressants can make mania worse. They arent a first-line treatment for bipolar disorder. Your doctor may prescribe them to treat other disorders such as anxiety or PTSD. If you also have anxiety, benzodiazepines may be helpful, but you should use caution if you take them due to their risk for abuse. A variety of new antipsychotic drugs are approved and available for the treatment of bipolar disorder and can be effective. If one of these drugs doesnt work, another one might.
Bipolar Disorder In Children And Adolescents
Mania in children often appears as extreme irritability or rage. Children and teens are more likely to have destructive outbursts than to be excited or euphoric. Depression in early life may have symptoms such as headaches, muscle aches, stomachaches or tiredness, frequent absences from school or poor performance in school, talk of or efforts to run away from home, irritability, complaining, unexplained crying, isolation, poor communication and extreme sensitivity to rejection or failure. Other signs of a possible mood disorder are alcohol or substance use and difficulty making or keeping friends.
Young people may also have a continuous, rapid-cycling, irritable and mixed symptom state that may co-occur with disruptive behavior disorders, particularly attention deficit hyperactivity disorder or conduct disorder . Young people may have symptoms of ADHD and CD before having bipolar symptoms.
A child or adolescent who has symptoms of depression along with ADHD-like symptoms that are very severe, with excessive temper outbursts and mood changes, should be evaluated by a psychiatrist or psychologist with experience in bipolar disorder, particularly if there is a family history of the condition. This evaluation is especially important since medications prescribed for ADHD may worsen symptoms of mania.
Learn more about bipolar disorder in children Learn more about bipolar disorder in teens
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In This Video Learn How Doctors Distinguish Between Major Depressive Disorder And Bipolar Disorder
Bipolar disorder might be known for causing two extremes of the mood spectrummania and depressionyet recognizing symptoms of bipolar disorder can still be challenging. Manic episodes often occur infrequently, and some types of manic symptoms may fly under the radar to friends and family. In fact, to an outsider, someones bipolar disorder may seem indistinguishable from depression.
One possible reason for the confusion? Americans are more familiar with what depression looks like. Approximately 6.7 percent of adults in the United States have had at least one major depressive episode, while only 2.8 percent of U.S. adults have had bipolar disorder in the past year, according to the National Institute of Mental Health .
Bipolar disorder is a mental illness that involves both having had an experience of a manic episode, as well as experiencing depressive episodes, says Susan Samuels, MD, psychiatrist at New York-Presbyterian Hospital, Weill Cornell Medicine. Learn more about the types of bipolar disorder here.
How Bipolar Differs from Depression
Since bipolar disorder and depression both include depressive symptoms, the difference really boils down to mania. It only takes one manic episode to classify someone as having bipolar disorder instead of depression.
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Extreme distractibility
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Not needing sleep
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Feeling invincible and on top of the world
Why Knowing the Difference Really Matters
Manic Depression Vs Bipolar Disorder: Are They The Same
We hear the terms manic depression and bipolar disorder, and we picture two different things: one, a depressed individual who has trouble enjoying life, and two, an unpredictable person who experiences drastic mood swings and changes in behavior. We compartmentalize them as two different medical conditions.
This, however, is incorrectwhile manic depression and bipolar disorder may sound like two completely different disorders, these mental disorders actually refer to the same thing. Because depression and manic depression were often confused, manic depression adopted a new clinical name: bipolar disorder.
Lets take a look at both the manic and depressive symptoms of bipolar disorder, types, and treatment.
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Depression: The Lows Of Bipolar Disorder
Symptoms of depression include
- prolonged sadness or unexplained crying spells
- significant changes in appetite and sleep patterns
- irritability, anger, worry, agitation, anxiety
- pessimism, indifference
- loss of energy, persistent lethargy
- feelings of guilt, worthlessness
- inability to take pleasure in former interests, social withdrawal
- unexplained aches and pains and
- recurring thoughts of death or suicide.
Why Isnt It Bipolar Disorder
Bipolar disorder involves changes in mood and energy levels called mood episodes. These include mania, hypomania, and depression.
Symptoms of psychosis arent a diagnostic criterion for bipolar disorder, but people with bipolar disorder with psychotic features may experience hallucinations and delusions during episodes of depression or mania.
Mania is an elevated mood that may feature irritability, excessive energy, impulsive behavior, and in some cases, symptoms of psychosis.
Schizoaffective disorder bipolar type isnt the same as bipolar disorder because, in the latter, psychosis isnt a requirement for diagnosis. Because when and if psychosis happens, it always occurs at the same time as the mood symptoms.
Schizoaffective disorder falls under the schizophrenia spectrum and psychotic disorders category. Bipolar disorder is a mood disorder.
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Can Depression Turn Into Bipolar Disorder
While an episode of clinical depression can be a feature of bipolar disorder or unipolar depression , it is not always easy to predict if the episode indicates the presence of bipolar disorder. Ongoing treatment and re-assessment is necessary before a determination can be made.
It can be difficult to cope with a new or unexpected diagnosis, but having an accurate diagnosis is necessary to ensure the condition is treated properly.
Treatment Of Mixed Bipolar Disorder
Treating mixed bipolar disorder can be tricky, as the symptoms are constantly changing. The most important thing is to keep a close eye on your symptoms and seek help from a mental health professional if necessary. If you are in a mixed state, it is important to stay away from drugs and alcohol, as they can worsen your condition.
Some of these treatment methods are:
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Rates Of Occurrence: Bipolar Vs Depression
Bipolar disorder statistics indicate that approximately 2.8 percent of adults are diagnosed with this condition. Bipolar disorder appears to be equally common in males and females. One study estimated the level of impairment from bipolar disorder ranging from moderate to severe, with the majority of people experiencing serious impairment.
Depression statistics indicate that major depressive disorder is more common than bipolar disorder. It is estimated that approximately 7.1 percent of adults experience a major depressive episode. Unlike bipolar disorder, major depression is more common among females than males, with a prevalence of 8.7 percent and 5.3 percent respectively. The rate of severe impairment is far lower for depression, though a majority of people with this disorder do experience severe impairment.
Can You Have Both Bipolar Disorder And Schizoaffective Disorder
No, but you can have schizoaffective disorder bipolar type.
In schizoaffective disorder, you experience symptoms of psychosis at the same time as a mood episode like mania or depression. These symptoms are preceded or followed by at least 2 weeks of hallucinations and delusions without any mood episodes.
In schizoaffective disorder bipolar type, the mood episodes you experience are mainly mania, and you may or may not experience symptoms of depression.
Bipolar disorder involves intense mood episodes that include mania, hypomania, and depression. In some cases, some people experiencing mania can also show symptoms of psychosis. There are, however, no symptoms of psychosis when youre not experiencing a mood episode.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition has established the following criteria for diagnosing schizoaffective disorder bipolar type:
- hallucinations: perceiving something that others cant feel, hear, or see
- delusions: firm beliefs that dont change despite being shown evidence to the contrary
- disorganized and incoherent speech
- reduced emotional expression: or negative symptoms
At least one of the two symptoms required for diagnosis must be from the first three items on the list.
2. Experiencing positive symptoms like delusions and hallucinations for at least 2 weeks without symptoms of depression or mania.
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When Does Bipolar Show Up
Bipolar in children is often referred to as unipolar depression or major depressive disorder because the symptoms and medical issues are the same as in mature adults. However, the episodes of depression can be very severe and suicidal thoughts may be present. Young children may only have major mood swings when they are under extreme emotional stress. For example, a child with bipolar will swing into an emotional tailspin after an argument with a parent, an injury or a physical illness..
Comparison Of Neurotransmitter Activity In Bipolar Depression And Unipolar Depression
Several studies have identified distinct biological correlates of mania. These include increased dopamine activity , hyperpolarization in transmembrane potentials , and changes in dopamine sub-3 receptor mechanisms . However, here we focus on the correlates of bipolar depression, as compared to unipolar depression. Although there have been many recent gains in the procedures for studying neurotransmitter regulation, including studies of genetic transporter mechanisms, amphetamine-challenge studies, and for some neuro-transmitters, spectroscopy, these novel approaches have not been applied to direct comparisons of bipolar and unipolar depression.
5.2.1. Dopamine
A focal structure in theories of affective disorders is the DA-secreting neurons of the ventral tegmental area that project to the nucleus accumbens and the cerebral cortex . This system is the key because of its modulatory role in appetive motivation and goal-directed behaviors. Excessively low DA activity is posited to be the hallmark of depression, and considerable evidence supports this perspective in unipolar depression, including recent studies using a D-amphetamine challenge .
5.2.2. Norepinephrine
Importantly, when recurrence rates are similar, plasma NE and MHPG levels, urinary MHPG levels, and neuroendocrine abnormalities associated with the hypothalamic-pituitary-adrenocortical axis are remarkably similar in bipolar II and unipolar depression .
5.2.3. Serotonin
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