Understanding Bipolar Disorder

We all experience changes in our mood based on what’s going on in our lives. But someone who has bipolar disorder experiences mood swings, often without a specific cause, that are much more severe than average mood changes. Their mood swings between two opposite poles or extremes: depression and mania. These shifts in mood can be so severe that they disrupt that person’s everyday life, affecting their relationships and their performance at work or school.

If you or someone you know is struggling with extreme mood swings or drastic changes in behavior, it’s important to understand the signs, symptoms, and treatments for bipolar disorder.

What is Bipolar Disorder?

Bipolar depression is a mood disorder that causes someone to experience sometimes extreme mood swings that can last up to several weeks. They will swing between depression—where they feel sad, disinterested, and withdrawn —and mania, which can look like:

  • Euphoria, or a “high” mood that is an extreme contrast to a depressed mood
  • Sleeping significantly less than usual, and feeling energetic despite getting less sleep
  • Increased irritability or agitation
  • Speaking faster than usual
  • Restlessness and difficulty focusing, or working on multiple projects at one time
  • Increasing risky behaviors. For example, increased drug use or drinking, reckless driving or driving under the influence, engaging in risky sexual activity, or getting into fights.

Sometimes, people experiencing mania may also experience symptoms of psychosis, including:

  • Disorganized thinking. When they speak, they switch between unrelated topics. If they are asked a question, they give tangentially related or completely unrelated answers.
  • Delusions, or beliefs in things that aren’t real.
  • Hallucinations, or sensory experiences that feel real but are not. For example, hearing voices that no one else can hear.

Though bipolar depression is more common in adults, studies show that close to three percent of teenagers have bipolar disorder. Of that group, more than 90 percent of those teenagers report having symptoms of bipolar disorder that are serious enough to disrupt their everyday lives.

What is Unipolar Depression?

Unipolar depression is what we typically think of as depression: a mood disorder that’s characterized by feeling sad or “down” for two weeks or more. Symptoms of unipolar depression can include:

  • Constantly feeling sad, empty, or hopeless
  • Changes in appetite and sleeping patterns
  • Feeling fatigue or a lack of energy
  • Feeling guilty, worthless, or like you are “not enough”
  • Frequently having thoughts of death or suicide
  • Losing interest or pleasure in your usual hobbies, or withdrawing from social activities

Unipolar depression does not include the manic behaviors that characterize bipolar depression, but like bipolar depression, its symptoms can be mild or severe, and can be disruptive to a person’s everyday life. Learn more about depression and depressive disorders here.

Bipolar 1 Disorder vs. Bipolar 2 Disorder

There are three types of bipolar depression. Bipolar 1 Disorder is characterized by manic episodes lasting seven days or more and depressive episodes lasting two weeks or more. Manic episodes may be severe enough to require hospitalization. For people who have Bipolar 1, it’s also possible for them to experience a mix of depressive and manic symptoms in rapid succession.

With Bipolar 2 Disorder, depressive episodes are broken up by episodes of hypomania. Hypomania is a less severe form of mania. Symptoms are milder and last for several days instead of a week or more.

Cyclothymic disorder is a rare mood disorder that causes emotional highs and lows that may go on for months at a time, but are not as severe as what happens with Bipolar 1 Disorder or Bipolar 2 Disorder.

How to Get Help for Bipolar Disorder

If you are struggling with bipolar disorder, your symptoms can be managed with the right treatment.

Get Professional Help

Think of bipolar disorder like any other medical condition that needs a doctor’s attention: the earlier you seek help, the more likely it is that you will improve or to find effective ways of managing it. Left untreated, manic or depressive episodes can worsen and can lead to acting out or in, meaning people who experience this are at heightened risk of hurting themselves or others. With the help of a mental health professional, bipolar disorder is manageable.

Learn About Bipolar Disorder

If you are struggling with bipolar disorder, you are not alone. It is also important to know that  there are resources available to help understand what you are experiencing and what to expect with treatment. If you struggle with bipolar disorder, you can ask your mental health professional questions, read books by and for people with bipolar disorder, and seek out articles about coping strategies for managing symptoms. Educating yourself is an important step in removing any potential shame or stigma around a bipolar diagnosis.

Lean on a Support Team

In addition to seeking professional help, it can help to put together a group of friends, family members, and other trusted adults who can support treatment. It’s not uncommon for someone with bipolar disorder to feel like a burden to others. When they do, it is common to self-isolate. It can help to remember that there are people who have a common goal: to help you cope with the ups and downs of bipolar disorder.

Understand What Medication Can Do For You

For many people, medication is an important part of bipolar disorder treatment. These medications help regulate the processes in the brain contributing to depression and mania. Many people with bipolar disorder struggle to stay on their medications. It is important that all members of your support system understand the role that medication plays in your treatment and encourage you to take it. If you are worried about misusing your medication, you may want to ask someone you trust to store medication for you and help you take it.

Learn Healthy Coping Strategies

There are plenty of coping strategies that can help you process your emotions in a healthy way. Try activities like:

  • Keeping a journal. Use a journal to write down your thoughts and feelings, both the negative and positive.
  • Exercising. Exercise releases chemicals that make you feel good. Find a way of moving your body that’s fun for you without judging your fitness level.
  • Trying a new hobby. Creative hobbies like painting, drawing, writing, or singing can help you express your feelings in a new way.

Put Together Your Emergency Plan

Sometimes, a manic or depressive episode can escalate, and it’s important to have an emergency plan in place before that happens. Together with a mental health professional, create a written plan with:

  • A list of your medications, including side effects
  • Patterns of what your usual symptoms are, and what worsening symptoms might look like
  • Phone numbers of people in your support network. Ask members of your support team if they are able to be part of your crisis plan before adding them to the list.
  • The contact information for a designated doctor’s office or hospital
  • Phone numbers of crisis hotlines, for example: 1-800-273-TALK (8255)

Create Your “New Normal”

Bipolar disorder is not your fault, and part of treatment is learning to accept yourself as you are. People with bipolar disorder can live full, happy lives. Setting realistic treatment goals and sticking to them, with help from your support system, can set you up to make positive strides.

How to Help a Friend with Bipolar Disorder

People with bipolar disorder tend to have a better prognosis when they have strong family and friend support systems. If you have a friend or loved one who is struggling with bipolar disorder, there are things you can do to support them.

Learn the Signs and Symptoms of Bipolar Disorder

The symptoms of bipolar disorder can show up in people differently. Learn the signs of depressive and manic episodes. It can help to directly ask your friend things like:

  • “What do your manic or depressive symptoms look like?”
  • “Is [specific symptom] getting worse or better?”
  • “Are there signs that I should look out for that things are getting worse or getting better?”
  • “What are the coping strategies that work for you?”

Be a Teammate

If your friend asks you to be part of their support network, ask what that entails. If you feel comfortable agreeing to being a part of their support team, know what your “job” is on their team and make sure they have your contact information. If you agree to be part of their emergency plan, it is important to know the plan and your role in it.

Many people with bipolar disorder struggle with feelings of embarrassment or shame—especially after manic episodes that may have led to negative consequences—and feeling like a burden to others. If your friend is expressing to you that they feel like a burden, reassure them that you want to support them.

Set Realistic Expectations

Once treatment begins, it will take some time before you really see a noticeable change in your friend’s behavior. Therapy and medication plans may need adjustment and revaluation over time, and there may be setbacks and growing pains before your friend finds the right combination that works to help them manage their symptoms. During this time, even if your friend experiences a setback, it’s important to remain supportive.

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If you or someone you know needs to talk to someone right now, text, call, or chat 988 for a free confidential conversation with a trained counselor 24/7. 

You can also contact the Crisis Text Line by texting HOME to 741-741.

If this is a medical emergency or if there is immediate danger of harm, call 911 and explain that you need support for a mental health crisis.