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Bipolar Disorder is one of the most misunderstood mental health conditions. Bipolar disorder is often written off as moodiness or confused with “having a split personality.” The truth is bipolar disorder is a serious, complex condition that can greatly affect a person’s energy, thinking, behavior and relationships. But with the right therapy and support, despite its challenges, stability is not only possible, it's expected.

What is Bipolar ?

Bipolar disorder is a mood disorder marked by extreme highs (mania or hypomania) and extreme lows (depressive episodes). The transition between these states can be dramatic and deeply disturbing, affecting sleep, judgment, relationships, and the capacity to perform at work or school.  Bipolar episodes are more intense than the normal mood swings that everyone experiences, and are usually severe enough to disrupt daily life and require medical treatment.

The disease occurs in several recognized forms. In Bipolar I Disorder, the person has had a full-blown manic episode lasting at least 7 days or is so severe that he or she needs hospital care. These episodes are generally followed by periods of depression. Bipolar II Disorder is characterized by episodes of hypomania ( a less severe form of mania ) and episodes of major depression. Hypomania isn’t as scary sounding, but the depressive episodes of Bipolar II are just as debilitating as those of Bipolar I. Cyclothymic Disorder is a chronic pattern of mood changes that are less severe than full mania or depression, but last for at least two years and interfere significantly with everyday functioning.

What Mania Really Looks Like

In popular culture, mania is often romanticized. It's the person who doesn’t need sleep, who produces brilliant ideas at lightning speed, who seems unstoppable in their energy and ambition. In reality manic episodes are impulsive, reckless behavior: irresponsible financial spending, sexual indiscretions, grandiosity, irritability, rapid speech, and grossly impaired judgement. The repercussions can be dire, including financial ruin, broken relationships, and lost employment.  "If someone is manic they feel invincible, so it's very hard to convince them they need help.

Hypomania is less extreme but has its own dangers. You can go through a phase of amazing productivity and charisma, hiding the red flags until the episode gets worse, or is followed by a crushing depressive crash.

The Burden of Depression

Bipolar disorder isn't just about the highs, the depressive episodes are just as defining, and often longer lasting. During these times they may feel very sad and hopeless. They may lose interest in things they used to enjoy. They may feel tired and have trouble focusing. They may eat or sleep more or less than usual. They may have thoughts of suicide. The emotional rollercoaster of elation and despair can be emotionally exhausting and take a toll on one’s ability to maintain relationships, hold down a job or trust one’s own perceptions.

It is important to know that many people with bipolar disorder are first diagnosed with depression only, as they usually seek help when they are feeling low and not when they are feeling high. The result is often treatment that is ineffective or even destabilizing . This is why accurate diagnosis is so critical .

Causes and Risk Factors of

Bipolar disorder has a big genetic component. Having a first-degree relative with the disorder greatly increases your risk. Changes in brain structure and neurochemistry are also involved, especially in brain areas that control mood, sleep and decision-making. Environmental factors also play a role in stressful life events, trauma, substance use, and disrupted sleeping patterns can all trigger or worsen episodes. The disorder typically begins in late adolescence or early adulthood, but can occur at any age.

Treatment & Management

Bipolar disorder is something that needs to be managed over time, not fixed at once. Mood stabilizers particularly lithium continue to be the mainstay of treatment, supported by decades of clinical evidence of their efficacy in reducing the frequency and severity of episodes. Anticonvulsants and atypical antipsychotics are also frequently prescribed, depending on the particular type and pattern of bipolar disorder.

But medication alone is rarely sufficient. Psychotherapy is important too, equally. Cognitive Behavioral Therapy (CBT) helps people identify negative thought patterns and develop healthier coping mechanisms. Interpersonal and social rhythm therapy (IPSRT) is particularly well suited to bipolar disorder because it helps people stick to their regular daily routines, which is a surprisingly powerful tool for regulating mood. Therapy also assists people to work through the interpersonal fall out of past episodes and to re-establish trust in relationships.

Another under-appreciated cornerstone of stability is lifestyle regularity. Regular sleep schedules, less alcohol and substance use, regular exercise, and predictable daily rhythms have all been found to reduce the frequency and severity of episodes. Stress management and a good support network complete a holistic approach to living well with bipolar disorder.

Holding Strong

A diagnosis of bipolar disorder isn’t a chaotic life sentence. With the right combination of medication, therapy and lifestyle support, many people with bipolar disorder go on to live full, meaningful and stable lives. The secret is correct diagnosis and tailored care.