Bipolar disorder is a mood disorder. In addition to depression, there are often manias: periods of excessively cheerful or markedly irritable mood. Psychosis can occur both in the deepest valley of depression and during the highest peak of mania.
What Is Bipolar Disorder?
Bipolar affective disorder is colloquially called bipolar disorder. Previously, the disease was also called manic-depressive illness. When you have bipolar disorder, your mood and activity level fluctuate significantly. So, during some periods, the person is manic, and during others, they are depressed.
When you live with bipolar disorder, you have episodes of mania, hypomania, depression, or mixed mood, and mixed mood states mean that manic and depressive symptoms occur simultaneously or in rapid succession. There is a wide variation in symptoms and severity. Furthermore, the illness is often associated with serious social, financial and personal consequences.
Bipolar disorder begins in teenage. Depressive episodes are more frequent and longer than the opposite – mania. There are probably many people with milder manic symptoms who do not seek help and are therefore not diagnosed correctly. These people are treated exclusively for depression. This can have a major impact on their course of illness, because the treatment of bipolar disorder and depression differs in several areas.
While some people experience only a few episodes of illness, others fluctuate almost continuously between mania, depression and mixed states. Between the episodes of illness there are often neutral periods, which can last from weeks to years or decades.
Sometimes the person with bipolar disorder also needs hospitalization. Bipolar disorder carries an increased risk of suicide, which is also seen with a number of other mental illnesses.
Different Types Of Bipolar Disorder
Bipolar disorder is often divided into types and subtypes. Your doctor may diagnose you with a specific type of bipolar disorder. This will depend on how you experience different bipolar moods and symptoms, and how severely they affect you. Not all medical professionals agree on how to classify or diagnose bipolar disorder. Researchers need to conduct more studies in this area.
You may hear several different words or phrases used to describe types of bipolar, which can be confusing and frustrating. Especially if you feel like your experiences are not fully understood. Or if you get different messages from different people.
Bipolar Type 1
Bipolar disorder type 1 is a serious mental illness characterized by extreme mood swings, including manic episodes and often depressive episodes. To be diagnosed with bipolar disorder type 1, a person must have experienced at least one manic episode that has lasted at least one week.
Mania is a state in which a person feels extremely elated, energetic, or irritable. Symptoms of mania can include excessive joy, decreased need for sleep, rapid speech, grandiose ideas, and risky behavior. Manic episodes can be so severe that they require hospitalization to prevent harm to the person or others.
Although the diagnosis of bipolar disorder type 1 requires at least one manic episode, many people also experience depressive episodes. Depression associated with bipolar disorder type 1 can be very severe and affects the person’s ability to function in daily life. Symptoms of depression can include:
- Intense sadness;
- Loss of interest in activities;
- Sleep problems;
- Changes in appetite;
- Feelings of worthlessness;
- Suicidal thoughts.
Bipolar Type 2
Bipolar disorder type 2 is also characterized by mood swings, but they are typically less extreme than those in type 1. To be diagnosed with bipolar disorder type 2, a person must have experienced at least one hypomanic episode and one major depressive episode.
Hypomania is a milder form of mania and lasts for at least four days. During a hypomanic episode, a person may feel very energetic and productive, but these symptoms are not severe enough to lead to significant disability or require hospitalization. However, hypomania can still negatively impact a person’s life, especially when followed by a major depressive episode.
Depressive episodes in bipolar disorder type 2 are typically longer-lasting and more frequent than in type 1. These episodes can be as severe as in bipolar disorder type 1 and include the same symptoms:
- Intense sadness;
- Loss of interest
- Changes in sleep and appetite;
- Feelings of worthlessness, and
- Suicidal thoughts.
Difference Between Bipolar Type 1 And Type 2
The primary difference between bipolar disorder type 1 and type 2 is the nature and severity of the manic episodes. In bipolar disorder type 1, the person experiences full-blown manic episodes, which can be very severe and often require hospitalization. These episodes have a significant impact on the person’s life and can lead to risky behavior and serious consequences.
In bipolar disorder type 2, the person experiences hypomania, which is a milder form of mania. Hypomanic episodes are less severe and do not lead to the same degree of disability or risky behavior. However, people with type 2 typically experience more and longer-lasting depressive episodes than people with type 1, which can have a major impact on their quality of life.
Another major difference between them is the process of treatment. Treatment for bipolar disorder type 1 often focuses on stabilizing mood and preventing manic episodes through the use of medications such as mood stabilizers, antipsychotics, and sometimes antidepressants. Psychotherapy, such as cognitive behavioral therapy (CBT), also plays an important role in treatment.
Treatment for bipolar disorder type 2 also focuses on stabilizing mood, but there is often a greater emphasis on treating depressive symptoms. The combination of medication and therapy is still key, but a more intensive approach may be needed to manage depression.
Understanding the differences between bipolar disorder type 1 and type 2 is crucial to getting the right treatment and support. Both disorders require long-term management and can have a significant impact on a person’s life, but with the right help, many people with bipolar disorder can live full and productive lives.
Causes of bipolar disorder
We do not know how bipolar disorder develops, but we know that it is a combination of factors. However, traumatic childhood experiences (abuse, neglect) increase the chance of developing bipolar disorder. We also know that cannabis use is a risk factor. They have a greater chance of developing bipolar disorder.
In addition, a lot of stress plays a role. Think of illness, loss of a loved one, tension at work among negative stress factors. Positive factors can be the birth of a child, marriage or an upcoming move.
The third element in the mix of the development of this disorder are certain personal character traits or thought patterns, such as a lack of self-confidence or low self-esteem, a drive for perfectionism, or not being able to solve problems.
Bipolar disorder symptoms
The defining feature of bipolar I disorder is a manic episode that lasts at least one week, while people with bipolar II disorder experience hypomanic episodes. Many people with bipolar disorder experience both hypomanic/manic and depressive episodes. These changing mood states do not always follow a set pattern, and depression does not always follow manic phases. A person may also experience the same mood state several times – with periods of better mood in between – before experiencing the opposite mood.
Mood swings in bipolar disorder can occur over a period of weeks, months, and sometimes even years. An important aspect of mood swings is that they are a departure from your usual self, and that the mood swings last a long time. There may be many days or weeks of mania and many weeks or months of depression. The severity of the depressive and manic phases can vary from person to person and in the same person at different times.
Signs and symptoms of manic episodes
Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their lives; others may experience them only rarely. Signs and symptoms of a manic episode include:
- Excessive happiness, hopefulness and excitement;
- Sudden and severe changes in mood;
- Restlessness;
- Rapid speech and racing thoughts;
- Increased energy and less need for sleep;
- Increased impulsivity and poor judgment;
- Making big and unattainable plans;
- Reckless and risky behavior;
- Feeling as unusually important, talented, or powerful;
- Experiencing hallucinations and delusions.
Most of the time, people who experience manic episodes are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger – some people become suicidal during manic episodes, not just depressive episodes.
If a person has an intense manic episode, especially if they are experiencing hallucinations and delusions, they may need to be hospitalized to protect themselves and others from possible harm.
Signs and symptoms of hypomania
Some people with bipolar disorder have milder manic-like symptoms. This is called hypomania. With hypomania, you may feel very good and find that you can get a lot done. People with hypomania can often function well in social situations or at work.
You may not feel that anything is wrong during a hypomanic episode. But family and friends may notice mood swings, changes in activity level, and think they are unusual for you. After hypomania, you may experience severe depression. The symptoms of depressive episodes in bipolar disorder are the same as those of major depression. They include:
- Overwhelming sadness;
- Low energy and fatigue;
- Lack of motivation;
- Feelings of hopelessness;
- Loss of pleasure from things;
- Difficulty concentrating and making decisions;
- Uncontrollable crying;
- Irritability;
- Increased need for sleep;
- Insomnia or excessive sleepiness;
- A change in appetite, causing weight loss or gain;
- Thoughts of death or suicide.
If you are experiencing suicidal thoughts, it is important for you to seek immediate help from a mental health professional.
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Why do you need to treat bipolar disorder?
It is often painful to experience depression or mixed mood, and both increase the risk of suicide. Mania and hypomania can sometimes give a feeling of euphoria. Yet most people want to prevent and treat hypomania and mania. There are two reasons for this: First, mania is usually followed by depression, which lasts much longer than the mania itself.
Second, people often do things during mania that they deeply regret later. For example, you may end up arguing with your family, or you may do spontaneous, unconsidered things, such as incurring large debts.
Examination and diagnosis
To determine whether bipolar disorder is present, you may perform the following types of examination:
1. Physical examination
All patients who are referred should perform a physical examination. Often, psychiatric symptoms include physical symptoms. Among other things, you should look at the physical capacity and functioning of the body.
2. Psychiatric examination
During the conversations the patient has with the psychiatrist, he or she does psychiatric research. The psychiatrist looks at possible causes of the problems and assesses their severity.
3. Psychological examination
Psychological examination is done mainly with the younger patients. This examination is spread over two days. The psychologist measures IQ and charts personality.
4. Family diagnostics
Psychotic disorders make a deep impression on family and environment. If the relationship is disturbed, psychiatrists help the family cope with the problems.
Bipolar Disorder: Treatment plan
In a treatment plan, together with the patient, doctors record the goals they pursue and the means they use to achieve them. In any case, their outpatient treatment consists of a number of conversations. In these conversations they explain the disease. The types of treatments they use for depression are:
- ECT (electroconvulsive therapy): ECT is a treatment method for mood disorders. Doctors apply it mainly in depression;
- Drug treatment: Depending on what symptoms are in the foreground, you may be treated with medications such as antidepressants, a mood stabilizer, antipsychotics, or a combination of these;
- Psycho-education: During treatment, doctors pay attention to extensive psychoeducation. This is a good, structured explanation of the disorder and its treatment. There is also a psycho-education module for depression;
- Psychotherapy (talk therapy): With this therapy, doctors teach their patients to deal with the voices through psychotherapeutic treatment;
- Family and relationship talks: During the intake and in the follow-up program doctors also speak with the patient’s closest involved parties. Their social psychiatric nurse conducts the follow-up interviews;
- Life and body care program: This program is aimed at patients who have both psychiatric and physical disorders;
- Care program Stress & Trauma: This program focuses on patients with therapy-resistant bipolar depression due to underlying trauma.
Challenges in getting a diagnosis
The symptoms of bipolar disorder can overlap with other mental health problems. Different people may experience or express their symptoms in different ways. And professionals don’t always get it right. Because of this, you may experience:
- Not getting a diagnosis of bipolar disorder when you think you should have one;
- Getting a diagnosis of another mental health problem that you don’t agree with;
- Getting a diagnosis of bipolar disorder that you think is wrong;
Even if you believe your diagnosis is correct, you may still feel that it doesn’t completely fit your experiences. If you are unhappy or concerned about your diagnosis, it is important to discuss this with your doctor. You can make sure your voice is heard, seek a second opinion, and take action if you are not satisfied with your doctor.
