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Bipolar disorder: More than mood swings

Illustration of a cloud, half with a rainbow, half raining – Bipolar disorder
Bipolar mood changes may include severe depression and periods of extremely high energy.

People who have bipolar disorder experience shifts between depression and intense energy.

These shifts aren’t your typical mood swings, however. Bipolar mood changes are more extreme and cause significant problems in patients’ work, education, social and family lives.

Bipolar disorder often runs in families and is usually diagnosed when people are in their late teens to 20s. About 1-3 percent of people experience bipolar symptoms at some time in their lives, said Dr. Justin Schoen, a Marshfield Clinic psychiatrist.

Unpredictable mood swings

Unpredictable mood swings are the hallmark of bipolar disorder.

There are two forms of bipolar disorder, and both involve some degree of mania. Only a manic episode is needed to diagnose bipolar I disorder. Bipolar II disorder involves depression and hypomania.

Manic episodes range from highly energetic but still functional behavior, called hypomania, to severe episodes requiring the patient be hospitalized. Untreated manic episodes may last for months.

Depressive symptoms range from feelings of sadness to suicide attempts. About half of people diagnosed with bipolar disorder attempt suicide at some time in their lives, Schoen said.

Bipolar mania or hypomania symptoms include:

  • Feeling elated, irritable or agitated
  • Increased energy and activity
  • Racing thoughts
  • Increased goal-directed activity
  • Sleeplessness
  • High risk, impulsive behaviors, like reckless sex and spending sprees

Bipolar depression symptoms include:

  • Feelings of sadness, loneliness or hopelessness
  • Low self-esteem
  • Memory and concentration problems
  • Fatigue
  • Lack of interest in usual activities
  • Suicidal thoughts

Treatment and therapy for bipolar disorder

Medication and psychotherapy both are effective in treating bipolar disorder.

“One of the struggles of treatment is getting patients to take medication regularly,” Schoen said. “When patients are manic or hypomanic they feel like they don’t need medication or don’t want to lose the energetic feeling.”

Social rhythm therapy, which targets the patient’s schedule with a set bedtime, waking time and time for taking medications, can improve quality of life and reduce symptoms.

Support for families

Education about bipolar disorder helps family members and friends recognize when their loved one needs help.

If you live with someone who has bipolar disorder, you can be involved in their care by helping monitor medications and knowing how to respond to manic or hypomanic episodes as well as depressive episodes.

“The best thing family members can do is make sure someone who has bipolar disorder has an established provider to contact if there is an acute episode,” Schoen said. “Call 911 if you’re imminently concerned about your loved one’s safety.”

Related Shine365 stories:

Man up: Why men need to talk about depression

Depression: Different signs in teens, adults 

3 responses to “Bipolar disorder: More than mood swings”

  1. Gooden Center

    Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.

  2. Joe

    Bipolar disease has been linked with damage to the human microbiome.
    Have you examined research on the NCBI website connecting this ?
    Have you considered dietary interventions that support a healthy human microbiome as an intervention for bipolar disease ? { "The Micrbiome Solution" by Dr Robynne Chutkan is a reasonable guide }

    1. Kirsten Shakal, Shine365 Editor

      Hi, Joe. I spoke to Dr. Schoen about your comment and questions. "I am familiar with the microbiome and implications that it can have on mood, as well as the developing knowledge of dietary interventions as a treatment option. Our doctors work hard to keep current and, yes, the National Center for Biotechnology Information is one of those resources we use. I have not read the piece by Dr. Robynne Chutkan; thank you for the recommendation."

      Thanks for reading Shine365. -Kirstie

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