What Are The Types Of Bipolar Disorder
There are four types of bipolar disorder, including:
- Bipolar I disorder: People with bipolar I disorder have experienced one or more episodes of mania. Most people with bipolar I will have episodes of both mania and depression, but an episode of depression isnt necessary for a diagnosis. The depressive episodes usually last at least two weeks. To be diagnosed with bipolar I, your manic episodes must last at least seven days or be so severe that you need hospitalization. People with bipolar I can also experience mixed states .
- Bipolar II disorder: People with bipolar II experience depressive episodes and hypomanic episodes. But they never experience a full manic episode thats characteristic of bipolar I disorder. While hypomania is less impairing than mania, bipolar II disorder is often more debilitating than bipolar I disorder due to chronic depression being more common in bipolar II.
- Cyclothymic disorder : People with cyclothymic disorder have a chronically unstable mood state. They experience hypomania and mild depression for at least two years. People with cyclothymia may have brief periods of normal mood , but these periods last fewer than eight weeks.
- Other specified and unspecified bipolar and related disorders: If a person doesnt meet the diagnostic criteria for bipolar I, II or cyclothymia but has still experienced periods of clinically significant abnormal mood elevation, its considered other specified or unspecified bipolar disorder.
Mood Stabilizers In The Treatment Of Acute Manic Episodes
Mood stabilizers can be used in the treatment of acute mania as monotherapy or as part of a combination treatment. U.S. Food and Drug Administration has approved the use of lithium and valproate for acute mania indication. Lithium among the mood stabilizers and carbamazepine and valproate among the anticonvulsants are medications that can be used in the treatment of mania. However, lamotrigine, topiramate, gabapentin and oxcarbazepine, are known to be ineffective in prophylaxis and the treatment of manic episodes . Among these, only lamotrigine is known to have prophylactic effect on depressive episodes.
What Do Manic Episodes Feel Like
Because manic episodes can cause great elation or great irritability, manic episodes can be perceived as pleasant or unpleasant. For some with a grandiose, elated mood, a manic episode is a pleasurable experience. They feel very good about themselves and engage in pleasurable behavior, like spending money or having sex. They believe they are extremely creative and intelligent and can constantly create with no need for sleep. They feel above all others.
For some though, and sometimes within the same manic episode, a person feels extremely irritable with all those around them. They may feel special and brilliant but be extremely annoyed with others for not understanding their genius. Someone in a manic episode may be particularly angry if their goal-directed behavior is interrupted. The longer someone is in a manic episode, the more likely they are to become irritable. This irritability feels uncontrollable and can increase to rage.
In both cases, the person’s behavior feels “right,” obvious and makes very clear sense, even if it makes no sense to those around the patient or is extremely risky. Those in a bipolar manic episode often endanger themselves because of these behaviors and require emergency intervention. After a manic episode, it may be possible for the patient to see how unrealistic, unreal and out-of-touch with reality they were, but this isn’t possible during a manic episode.
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Can Bipolar I Disorder Be Prevented
The causes of bipolar disorder are not well understood. It’s not known if bipolar I disorder can be prevented entirely.
It is possible to lower the risk of episodes of mania or depression once bipolar disorder has developed. Regular therapy sessions with a psychologist or social worker can help people to identify factors that can destabilize mood , leading to fewer hospitalizations and feeling better overall. Taking medicine on a regular basis can help to prevent future manic or depressive episodes.
How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking here.
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Sudden Changes In Energy
It is one thing to have a sudden rush of energy it is an another when the energy is relentless, prolonged, and overwhelming. As with mood changes, the sudden upshot of energy would not be considered normal and can switch off as quickly as it was switched on.
Symptoms may include:
- A decreased need for sleep with little apparent fatigue
- A sudden increase in goal-oriented activities
- Persistent and often purposeless movement
- Restlessness and an inability to remain still
What Is Bipolar Disorder
Bipolar disorder is a mental health condition that causes unusual shifts in energy, mood, concentration, and the ability to perform activities of daily living. These shifts in mood, referred to as episodes, include emotional highs and lows . The National Institute of Mental Health reports that approximately 2.6 percent of the adult population in the United States is affected by bipolar disorder.
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A Common Misconception About Mania Is That Its Always A Strictly Euphoric Experience
The mood elevations of bipolar are not always the grandiose, feeling on top of the world experiences that people sort of classically think of, Wendy Marsh, M.D., director of the Bipolar Disorders Specialty Clinic and an associate professor in the department of psychiatry at the University of Massachusetts Medical School, tells SELF. That definitely does happen, but there are exceptions.
For example, a person may have a mood elevation with irritability or anger. So youve got this extra energy, your thoughts are moving fast, youre trying to do ten things at once, youre easily distracted, but youre agitated, Dr. Marsh says.
She adds that many of her patients express mania with irritability as feeling as if things are taking too long: You cant sit there at the red light its taking too long. You cant wait for someone to respond to what you just said because you have three other ideas you have to get express to them ASAP, she explains. Your brain is racing, and you dont need to sleep because youve got so many ideas and so much energy to do all these activities, and youre frustrated things arent happening even faster.
What Are The Symptoms Of Mania
Symptoms of a manic episode
- Having an abnormally high level of activity or energy.
- Feeling extremely happy or excited even euphoric.
- Not sleeping or only getting a few hours of sleep but still feeling rested.
- Having an inflated self-esteem, thinking youre invincible.
- Being more talkative than usual. Talking so much and so fast that others cant interrupt.
- Having racing thoughts having lots of thoughts on lots of topics at the same time .
- Being easily distracted by unimportant or unrelated things.
- Being obsessed with and completely absorbed in an activity.
- Displaying purposeless movements, such as pacing around your home or office or fidgeting when youre sitting.
- Showing impulsive behavior that can lead to poor choices, such as buying sprees, reckless sex or foolish business investments.
Psychotic symptoms of a manic episode
- Delusions. Delusions are false beliefs or ideas that are incorrect interpretations of information. An example is a person thinking that everyone they see is following them.
- Hallucinations. Having a hallucination means you see, hear, taste, smell or feel things that arent really there. An example is a person hearing the voice of someone and talking to them when theyre not really there.
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Bipolar Relationships: What To Expect
Ups and downs are natural in any romantic relationship, but when your partner has bipolar disorder it can feel like youre on an emotional rollercoaster. Not knowing what to expect each day is stressful and tiring. Over time, it wears on the relationship.
Understanding why your partner acts out sometimes or becomes withdrawn is the first supportive step you can take in strengthening your relationship. Learn exactly what a bipolar diagnosis means, how it could affect your partners behavior and what you can do to foster a healthy, stable relationship.
Bipolar Mania Is A Period Of Mood Elevation Thats Generally Characterized By High Energy And Activity Levelsalthough Its Much More Complicated Than That
When a person with bipolar disorder is experiencing a manic episode, they may feel up, or jumpy or wired, the National Institute of Mental Health says.
Mania is a state of high energy, high activity, and less of a need for sleep, Igor Galynker, M.D., associate chairman for research in the department of psychiatry at Mount Sinai Beth Israel, tells SELF. People engage in unusual behavior and may have an inflated opinion of oneself. In severe manic episodes, an individual might hallucinate and experience psychosis. Factors like experiencing a trauma or sleep deprivation can trigger a manic episode, Dr. Galynker adds.
As SELF reported previously, for a person to be diagnosed as manic, they need to have prolonged unusual behavior and high energy, in addition to at least three classic symptoms of mania . If someone has symptoms that result in psychosis or hospitalization, thats also considered a manic episode.
Its worth noting that only people diagnosed with bipolar I will experience full mania. A similar type of mood episode that can present in bipolar disorder is hypomania, which is essentially less severe mania, according to NIMH, and does not necessarily interfere with a persons ability to live their life and function day to day. If you have bipolar II, you have hypomanic episodes as opposed to full manic episodes .
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Use Or Abuse Of Substances Or Medication
Dr. Rx
During a manic episode, a person feels on top of the world, gifted, and incredibly creative. They may believe they have special abilities and ideas theyve never had before. Because they are so chatty, others feel they cant get a word in. They may dress in a strange or provocative manner, are running on minimal to no sleep, and are engaging in activities that have a high potential for dangerous consequences. In their eyes, nothing is wrong, and they are quick to deny the severity of their symptoms. Dr. Landau
Get Involved With Treatment
Ask if you can be involved with your partners treatment, which may include occasionally going to the psychiatrist together. Being a part of your partners treatment has multiple benefits, including:
- Gaining a better understanding of the illness.
- Providing additional insight for the psychiatrist.
- Learning to spot signs of impending episodes.
- Alerting the psychiatrist about mood changes.
Even if your partner hasnt signed off on you exchanging information with their psychiatrist, you can still report worrisome signs . This gives the doctor a chance to make quick medication changes that may help your partner avoid being hospitalized.
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Can My Diagnosis Change Between Bipolar I Disorder And Bipolar Ii Disorder
No. Once you have a diagnosis of bipolar I disorder even if you never have another manic episode or a psychotic event your diagnosis can never be changed to bipolar II disorder. Youll always have a bipolar I disorder diagnosis.
A note from Cleveland Clinic
Problems can develop in your social life, work/school functioning and home life when you have symptoms of mania, which include mood swings and an abnormal level of energy and activity. You may require hospitalization if you have severe hallucinations or delusions, or to prevent you from harming yourself or others. Its important to have a good understanding of mania, mania symptoms, your particular triggers and ways to better manage your manic episodes. Medications, talk therapy and support groups as well as support from your family and friends can help manage your mania. Stay in close contact with all your healthcare providers, especially during times of manic episodes. Your provider will want to see you and may need changes to your medications or dose.
Bipolar Disorder With Psychotic Features
This is another serious version of bipolar disorder. During a mood episode, a person can hallucinate or have delusional beliefs. These are features of psychosis. An example of a hallucination is hearing someone talk to you when there is no one there. An example of a delusional belief is thinking you have special powers.
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Bipolar Disorder Type I
There are various subtypes of bipolar disorder. Bipolar disorder I is defined by manic episodes and may or may not be followed by episodes of depression.
Other types of bipolar disorder include:
- Bipolar II: Involves hypomania that occurs with depressive episodes
- Cyclothymic: Involves less severe shifts between hypomanic and depressive symptoms for a period of two years, but does not meet the criteria of a full episode
- Rapid-cycling: Involves switching between mania or hypomania and depression at least four times within a 12-month period
A healthcare provider may suggest mood stabilizers to prevent mania from recurring. One study looked at the use of medications to treat mania and found that some mood stabilizers can improve symptoms. Examples of mood stabilizers include:
Depending on your symptoms, a healthcare provider may be less likely to prescribe antidepressants due to the risk of triggering mania. Working with your prescriber is the best way to determine what medication is going to best support your psychological well-being.
Talk to your healthcare provider about any concerns you have with your medication. Do not stop taking your medication or change dosages without seeking consultation. This can lead to intensifying symptoms.
Other Mental Health Conditions
Bipolar depression may be more likely if a person has another mental health condition, such as obsessive-compulsive disorder or traits of borderline personality disorder .
Bipolar disorder usually appears during adolescence or early adulthood, but it can occur at any age, including childhood.
Some statistics show that, on average, it starts between ages . Other research suggests its more likely to occur after the age of 25. One large study found evidence that higher numbers of first episodes appear in people ages 15 to 24 and in those ages 45 to 54.
Global statistics suggest bipolar I disorder affects around
Hypomania involves symptoms similar to mania but less severe. The biggest difference between the two is that symptoms of hypomania have a less significant effect on your life and your ability to work, study, and carry out daily tasks.
In addition, for a diagnosis of mania for bipolar I, the episode must last at least 7 days . For a diagnosis of bipolar II hypomania, an episode must last at least 4 days.
Manic episodes can involve psychosis and may lead to hospitalization, but this is unlikely to happen with hypomania.
Some people with bipolar disorder experience mixed mood states in which depressive and manic symptoms coexist. In a mixed state, a person will often have symptoms that include:
diagnoses of bipolar disorder, depending on how the features and symptoms appear.
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What Types Of Therapy Are Used To Treat Bipolar Disorder
Psychotherapy, also called talk therapy, can be an effective part of the treatment plan for people with bipolar disorder.
Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to you and your family.
Different types of therapy for bipolar disorder include:
What Is The Outlook Of Bipolar Disorder
The prognosis for bipolar disorder is often poor unless its properly treated. Many people with bipolar disorder who receive appropriate treatment can live fulfilling and productive lives.
Bipolar disorder results in approximately nine years reduction in expected life span, and as many as1 in 5 people with bipolar disorder commit suicide. An estimated 60% of all people with bipolar disorder have drug or alcohol dependence.
This is why its essential to seek medical care and stay committed to treatment for bipolar disorder.
Regular and continued use of medication can help reduce episodes of mania and depression. By knowing how to recognize the symptoms and triggers of these episodes, theres a better chance for effective treatment and finding coping methods that may prevent long periods of illness, extended hospital stays and suicide.
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