Get to Know Bipolar Disorder

Definitions you need to know

When most people think of bipolar disorder they think of rapid changes and mood swings. Hearing comments like “the weather is bipolar” or “she’s bipolar” when someone is having a bad day is hurtful and sadly common. Knowing what bipolar is and having an idea what that looks like in the real world can help you approach this mental illness in an educated way. If you’re wondering whether you have bipolar disorder, knowing the symptoms can also help you have a starting point before seeking treatment.

Types of Bipolar Disorder

Bipolar disorder consists most commonly of four different types with similar symptoms mainly differentiated by severity of symptoms. These four types are: Bipolar 1, Bipolar 2, cyclothymia, and Bipolar Not Otherwise Specified (NOS).

Bipolar 1

Bipolar 1 consists of full-blown mania and major depression. It may also involve mixed episodes which consist of symptoms of mania and depression at the same time.

Bipolar 2 —

Bipolar 2 consists of hypomania, a type of less severe mania, and major depression. It may also involve mixed episodes which consist of symptoms of mania and depression at the same time. Although people with bipolar 2 don’t experience mania, the disease can be just as severe when it comes to depression. Neither is worse than the other.

Cyclothymia —

Cyclothymia has long periods of alternating manic symptoms and depression that don’t rise to full-blown symptoms.

Bipolar NOS —

People with Bipolar Not Otherwise Specified don’t fall under the strict definitions of the other types of bipolar. They may have not have enough symptoms to meet the full criteria of either mania or depression or the symptoms may not last long enough.

Speed of cycling

Further defining bipolar disorder is how fast it cycles (moves between mood states). These include standard, rapid cycling, and ultra rapid cycling.

Standard —

People with standard cycling change episodes less than four times a year.

Rapid cycling —

With rapid cycling, a person changes episodes 4 or more times a year.

Rapid cycling —

When someone has rapid cycling, they change episodes much faster and can switch cycles every couple weeks or days.

The highs and lows

Depression —

Depression is the down state of bipolar disorder. It must last for two weeks or more to differentiate it from temporary bad days, is significant to cause impairment, and is not otherwise explained by situations like the recent death of a loved one. There much be 5 or more of the following symptoms as listed by the DSM-5:

1. Depressed mood — indicated by subjective report or observation by others (in children and adolescents, can be irritable mood).
2. 2.Loss of interest or pleasure in almost all activities — indicated by subjective report or observation by others.
3. Significant (more than 5 percent in a month) unintentional weight loss/gain or decrease/increase in appetite (in children, failure to make expected weight gains).
4. Sleep disturbance (insomnia or hypersomnia).
5. A5 Psychomotor changes (agitation or retardation) severe enough to be observable by others.
6. Tiredness, fatigue, or low energy, or decreased efficiency with which routine tasks are completed.
7. A sense of worthlessness or excessive, inappropriate, or delusional guilt (not merely self-reproach or guilt about being sick).
8. Impaired ability to think, concentrate, or make decisions — indicated by subjective report or observation by others.
9. A9 Recurrent thoughts of death (not just fear of dying), suicidal ideation, or suicide attempts.

Mania —

What Are the Signs of Mania in Bipolar Disorder?

Manic episodes are more severe than hypomanic episodes and sometimes has paranoia, delusions, or hallucinations. Mania is often thought of as the “up” side of bipolar disorder, but it is sometimes accompanied by agitation and anger. Mania must occur for at least a week or necessitate the person be hospitalized. Someone with mania must have at least 3 of the following symptoms:

• Inflated self-esteem or grandiosity
• Decreased need for sleep (e.g., one feels rested after only 3 hours of sleep)
• More talkative than usual or pressure to keep talking
• Flight of ideas or subjective experience that thoughts are racing
• Attention is easily drawn to unimportant or irrelevant items
• Increase in goal-directed activity (either socially, at work or school; or sexually) or psychomotor agitation
• Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

Hypomania —

Hypomania can have any of the above symptoms except paranoia, delusions, and hallucinations. It must last at least 4 days and represent a noticeable change from normal behavior. It’s generally less disruptive to the person’s life.

Mixed episodes —

Mixed episodes are a type of episode that involves both manic or hypomanic symptoms and depression co-occurring during most of an episode. This can be a very severe episode as it can result in combinations like a severely depressed and potentially suicidal person who also has rapid thoughts, agitation and energy.

Conclusion

Bipolar disorder is a complicated disease with many possible symptoms and multiple presentations. Having correct information can go a long way towards curtailing stigma and help someone who thinks they might have the illness.