What Is Bipolar Disorder? Exploring the Peaks and Valleys

You might have heard of it or received a diagnosis. But what is bipolar disorder, exactly?

Bipolar disorder 101

Need the deets in a hurry? Here’s bipolar disorder in a nutshell.

Symptoms

Mania: feeling ridiculously happy and energetic (which could lead you to take risks)
Depression: feeling extremely low and possibly even suicidal
Cycling: alternating between periods of highs and lows

Types

Bipolar I: experiencing at least one episode of mania, with depression often hitting either before or afterward
Bipolar II: experiencing at least one episode of depression and a lesser version of mania
Cyclothymia: alternating between high and low, with less intense bouts of mania and depression

Causes

Genetics: your DNA
Brain chemistry: a hormonal imbalance you were born with
Trauma: extreme stress, serious illnesses, and loss

Treatments

Prescribed medications: such as lithium or Xanax
Natural remedies: like fish oil and plant extracts (but these shouldn’t replace conventional treatment)
Psychotherapy: to talk it out and help you cope

Well, it’s a mental illness that causes you to experience the highest highs (mania) alongside the lowest lows (depression). You might have also heard its old name, manic depression.

(These days, we know that there’s a whole spectrum of manic depressive disorders, and bipolar disorder is just one of them.)

Bipolar disorder is more than just experiencing both good and bad moods in a single day.

To meet the criteria for diagnosis, depressive episodes must last at least 2 weeks, while mania can last for several days or even weeks. And both of them can lead to behaviors that may have harmful effects.

You might experience these episodes rarely or multiple times a year. But you definitely won’t be alone: An estimated 2.8 percent of adults in the United States have bipolar disorder.

There are multiple treatments, and even home remedies and lifestyle changes, that can help you stay as stable as a horse’s house.

Man with bipolar looks to the left header — Michela Ravasio/Stocksy United

Symptoms of bipolar disorder

You’ll experience three main symptoms with bipolar disorder:

mania (extreme highs)
hypomania (a lesser version of mania)
depression (extreme lows)

Mania might sound like a lot of fun on the surface (euphoric moods? Heck yeah!). But the highs can actually be just as difficult as the lows (heck no!) and get you into some potentially harmful situations.

In women

The diagnosis numbers for bipolar disorder are about the same for males and females. But females do experience it in some slightly different ways, such as:

receiving a diagnosis later in life (often in their 20s or 30s)
being more prone to depression than to mania
having four or more episodes of mania and depression in a year (which is called cycling)
being more likely to relapse, especially during pregnancy
being more likely to misuse alcohol

In children

Diagnosing bipolar disorder in children can be tricky. That’s partly because children don’t always have the same symptoms as adults and partly because even a child who doesn’t have bipolar disorder can have rapid mood changes that put Gremlins to shame. #TerribleTwos

On the whole, you’ll want to keep an eye out for these symptoms:

experimentation with risks
rapid speech and changes of subject
a tendency toward anger and temper tantrums
a lack of interest in things they used to enjoy
frequent complaints of feeling unwell
thoughts or talk of death or suicide

You know your child better than anyone else. In the case of bipolar disorder, all the symptoms above would be much more pronounced than you’d usually expect from your child.

You can probably expect diagnosis to take longer, too, since you may need to seek care from a doctor specializing in children’s mental health.

Do you have bipolar disorder? A checklist

Although symptoms can vary from person to person, there’s a fairly steady set of things you can look out for in your behavior.

An episode of mania may lead to:

increased substance use
spending sprees
increased likelihood of sex without a barrier
unnecessary risk-taking and a general feeling of indestructibility
feelings of distraction or boredom
impaired judgment

Depression can cause you to experience:

extreme sadness and gloominess
sleep problems
reduced interest in activities you used to enjoy
weight changes
sensitivity to noise
suicidal thoughts

If that all sounds pretty familiar, especially if it seems to happen a few times a year, you might want to chat with a medical professional.

Comparing types: Bipolar I vs. bipolar II vs. cyclothymia

Yup, it’s not as simple as either having bipolar disorder or not — there are actually three different types. Because variety is the spice of life.

Bipolar I. This means you experience at least one manic episode lasting at least 7 days, or an episode so severe you end up in a hospital. You might have hypomania (the less intense version of mania) or a period of major depression before or after. This type affects men and women in equal numbers.
Bipolar II. This type affects more women than men. To fit the diagnosis, you must have at least one depressive episode that lasts for 2 weeks. You probably also experience hypomania, but it doesn’t progress to full mania.
Cyclothymia. You experience hypomania and depression. These episodes are less intense than you’d experience with bipolar I or II — they’re shorter and less overwhelming. But they can occur quite regularly.

There’s technically another type, “bipolar unspecified or other specified.” This includes types of bipolar disorder that don’t exactly fit the characteristics of the other three but still involve clinically significant periods of mania.

Bipolar disorder vs. depression: What’s the difference?

Although people often get the two confused (possibly because of the old name, manic depression — damn you, labels!), there are actually some distinct differences between bipolar disorder and depression.

This table can help you recognize either condition when you or someone you love experiences it.

Bipolar disorder	Depression
You experience mania or hypomania, periods of time when you feel as if you can do anything.	You experience a persistent low feeling and sensations of guilt or worthlessness.
Depressive episodes can be intense but are usually relatively short.	Depressive episodes can last for months or even years.
You may experience cycling, which is when moods go from high to low in a fairly regular pattern.	Moods stay pretty consistent throughout.
Ups and downs are extreme and not necessarily connected to life events.	Negative experiences in your life can often trigger depression.

Stats

Who doesn’t love some raw data? Rejoice, geeks of the world, ’cause here’s the statistical skinny on bipolar disorder:

Around 2.8 percent of adults in the U.S. currently live with bipolar disorder. But an estimated 4.4 percent of the population will experience it at some point in their lives.
An estimated 2.9 percent of men and 2.8 percent of women live with bipolar disorder.
Of those people, 82.9 percent say their condition causes serious disruption in their lives — that’s the highest percentage for any mood disorder.
The average age to receive a bipolar disorder diagnosis is 25 years, though many people get diagnosed in their teens.
Because bipolar disorder can lead to substance misuse, the life expectancy of someone with the condition can be reduced by up to 15 years.

Causes

Even though bipolar disorder is fairly common, no one’s entirely certain why some people develop it and others don’t. It’s one of the great medical mysteries.

But three factors seem most likely to play a part:

Genetics. Bipolar disorder can run in families. If one of your parents has it, you’re more likely to develop it (although it’s by no means a done deal).
Hormones. It’s possible there’s an imbalance in your brain’s hormones that makes you more prone to the condition.
Trauma. Extreme stress, serious illnesses, and even the loss of a loved one can trigger bipolar disorder.

Can you inherit bipolar disorder?

As mentioned above, researchers believe bipolar disorder runs in families. If you have a parent with bipolar disorder, you’re 4 to 6 times more likely to develop it.

But if you’re worrying, hold yer horses. You won’t definitely inherit it. There have even been cases with identical twins in which one twin developed bipolar disorder and the other didn’t.

Bipolar disorder in your family history doesn’t mean you’ll develop it yourself — but it does increase the risk.

Diagnosis

Bipolar disorder is complex and still fairly mysterious to the medical community. Getting a diagnosis isn’t quite as simple as a 10-minute appointment.

Don’t be put off, though — you may have to jump through a couple of hoops before you receive your diagnosis, but it’s very little effort compared with the reward.

Getting treatment as early as possible can help you hang on to a much better quality of life. If you think you may have bipolar disorder, make an appointment with a doc pronto!

Diagnostic criteria

If you do have family members with bipolar disorder, or if you’ve noticed some potential signs in yourself or a loved one, start the diagnostic process ASAP — it takes a while.

Take the time to check in with yourself:

Do you feel overwhelmed by uncontrollable sadness and despair at times?
Is that sometimes followed by periods of feeling on top of the world?

How long do these feelings last?

Does the feeling of happiness continue for around 1 week?
And do the lows last around 2 weeks?

If this all sounds familiar, get in touch with a doctor. They’ll use very similar criteria to assess whether you have bipolar disorder.

They’ll ask about your symptoms and rule out other conditions that can have similar effects on mood, such as schizoaffective disorder.

How doctors test for bipolar disorder

Doctors use a text called the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to diagnose bipolar disorder.

If you meet the diagnostic criteria, it’s likely you have bipolar disorder. But the doc needs to be extra careful — getting an accurate diagnosis is key to hook you up with the right treatment.

You’ll probably have to take some additional tests:

A mental health evaluation. If your doctor doesn’t specialize in mental health, they may refer you to a psychologist or psychiatrist, who can give you a more thorough evaluation.
Mood journaling. A bipolar disorder diagnosis depends on evaluating what’s going on with your moods. Recording how you’re feeling, as well as things like appetite and sleep patterns, is super informative for your mental health pro.
Physical examinations. You’ll likely get a full physical checkup, as well as blood and urine tests, so the doctors can identify what’s going on.

Treatments

Treatment, whether it’s for bipolar disorder or a broken finger, is a matter of personal choice.

There are quite a few routes you can take to manage bipolar disorder. With your doctor’s guidance, you can choose the option that works best for you.

Home remedies

While you should use home remedies alongside prescribed medications rather than as a replacement, several herbs and supplements might give you a helping hand:

Fish oil. Studies suggest that fish oil supplements could make you less likely to develop bipolar disorder. You can get fish oil either by taking an over-the-counter supplement or by eating more fish. Medical benefit and good food — what’s not to love?
Rhodiola rosea. This fairly boring-looking plant, which is available in capsules, may help with moderate depression and the lows that come with bipolar disorder.
S-adenosylmethionine (SAMe). This is an amino acid supplement, available in health food stores, which may help with the effects of depression.

Prescribed medications

Your doc will almost certainly prescribe medication that will help keep your moods stable. You might even find some additional meds useful, since they’ll target other symptoms of bipolar disorder that you may otherwise struggle with.

Common medications are:

mood stabilizers like lithium
antidepressant-antipsychotics like Symbyax
antipsychotics like Zyprexa
medication to help with sleep and anxiety problems, such as Xanax

It might take some trial and error to see which works best for you. Have a chat with your doctor if you’re experiencing severe side effects or don’t feel like your symptoms are responding to your meds.

Other treatments

Other treatments your doctor may recommend can include:

Psychotherapy. This can take different forms, such as talking things over with a therapist to come up with ways to manage your condition or planning arrangements for sleeping, eating, and exercising.
Electroconvulsive therapy. Not nearly as scary as it sounds, this can help with severe depression by administering small electric shocks to carefully targeted areas of your brain.
Acupuncture. A 2020 case report suggests that acupuncture can help manage both physical and mental symptoms of bipolar disorder. More research is needed, but it may be worth a try. Get those pins in ya (well, have a pro do it).

Coping tips

Rule number one for coping with bipolar disorder? Stick with the treatment.

It might be super tempting to give treatment the elbow, especially when you’re in one of those euphoric, I-can-do-anything moods, but you really need the ongoing support.

If the treatment is creating more problems than it solves or causing serious side effects, speak with your doc ASAP about switching meds or trying another approach. But definitely don’t quit treatment altogether.

It’s also important to read up and educate yourself as much as you can. This can help you notice how your moods are going and prepare accordingly.

You can also make lifestyle changes, such as keeping a strict routine for eating and sleeping. And you can try following these tips for kicking depression in the pants.

Feeling suicidal? Get help now

Recognizing when you or a loved one starts to feel suicidal can save a life. Call your therapist or allow a trusted friend or family member to do it for you.

You can also get help from a hotline. Call the National Suicide Prevention Lifeline at 800-273-8255 or text HOME to 741741.

If you’re outside the U.S., you can find your nearest emergency mental health resources using The International Association for Suicide Prevention.

What to do if a friend is talking about suicide

Take the following steps if you believe your loved one is at risk of suicide:

Ask them about it. Check in on them and gauge whether they face an immediate risk.
Keep them safe. Make sure they don’t have access to dangerous objects, firearms, or medications.
Listen. Getting them to talk about their suicidal ideation may reduce their risk.
Get help. Call your local emergency services, one of the resources above, or their therapist. It’s vital to connect your loved one with the best possible care.

Living with bipolar disorder

Living with bipolar disorder won’t be an easy ride, but there are definitely ways you can make the road ahead a little smoother. With the right treatment, you can live a healthy, happy life.

Home remedies and coping mechanisms

Assemble your squad. To give bipolar disorder the whooping it deserves, you’re going to need a team of superheroes. In addition to your doctor, find a psychiatrist and psychologist and talk through the aspects of the condition that medication just can’t help with.
Find a community. You can find awesome groups of people online who share and support each other through bipolar disorder. Check places like Facebook and Reddit — you’ll often find a community that can help keep you uplifted.
Stick with your treatment. It can’t be overstated. Just do it.
Eat healthy. Go for lots of fish, especially those with omega-3s, and cut down on saturated fats, which may have links to brain chemical imbalances.
Get plenty of sleep and exercise. Get into a routine with both of these, and keep things calm. Yoga and meditation can also be your new BFFs.