You may have heard the phrase “stop acting so bipolar,” or you’ve seen how the condition is portrayed in movies or on television. While you might have an idea or what it refers to, it’s likely that its portrayal and what you believe about it is all wrong. Bipolar disorder isn’t a condition where you experience mood swings. Although mood swings are part of it, there’s much more than you’ve been led to believe.
Bipolar disorder is a severe condition that affects the quality of a person’s life. However, with early intervention, the diagnosed individual can lead a healthy life. Its prevalence in the population isn’t significant. According to the Depression and Bipolar Support Alliance (DBSA), the condition affects 5.7 million adults in the United States, translating to 2.6 percent of the American adult population over the age of 18.
The DBSA also states that 25 is the median age of onset for the disorder. However, unlike other conditions, the onset can occur in early childhood or as late as age 40 or age 50. Bipolar disorder doesn’t discriminate. It affects both men and women equally in all races, ages, ethnic groups, and social classes. More than two-thirds of those with the disease have a close relative with the illness, which indicates it has a heritable component.
The World Health Organization (WHO) considers bipolar disorder as the sixth leading cause of disability in the world. With that said, it’s vital to understand what bipolar disorder is and the two primary types, bipolar disorder 1 and bipolar disorder 2, and how to tell which one you or a loved one might have.
According to the National Institute of Mental Health (NIMH), bipolar disorder—once known as manic-depressive illness or manic depression—is a mental health disorder. It causes an unusual shift in activity levels, mood, energy, concentration, and the ability for a person to carry out routine day-to-day tasks.
Three different types of bipolar disorder exist today, and all three involve changes in activity levels, mood, and energy. The moods can range from periods of highly elated, energized, or irritable behavior. These are known as manic episodes. It also includes extreme sadness, indifference, or hopelessness, which are known as depressive episodes. Less severe periods of mania are characterized as hypomanic episodes.
This form of bipolar is defined by manic episodes that occur for seven days or more and manic symptoms severe enough to warrant immediate hospital care. In most cases, depressive episodes will appear alongside the mania, which lasts at least two weeks at a time. Bouts of depression with other mixed features like manic symptoms and depressive symptoms at the same time are also possible.
Bipolar 2 disorder is defined by the National Institute of Mental Health as a pattern of hypomanic episodes and depressive episodes, but these are not the full-blown manic episodes a person would experience with Bipolar 1 disorder. While these can be severe, they may not always lead to immediate emergency care. However, a person should be monitored if they’re going through a depressive bout.
NIMH defines cyclothymia as a period of hypomanic symptoms that include bouts of depressive symptoms that last for a minimum of two years. For children and adolescents, the symptoms must be prevalent for a minimum of one year. However, these symptoms don’t always meet the diagnostic requirements for a depressive episode or hypomanic episode.
A person may experience bipolar symptoms that don’t match the categories we’ve listed above. These are referred to as “other specified and unspecified bipolar or related disorders.” Bipolar disorder is most commonly diagnosed during the teen years or early adulthood, but on some occasions, these symptoms can show up in children. These symptoms will vary over time and will require lifelong treatment, but with the right help, symptoms can be managed and improve their overall quality of life.
The most common bipolar 1 and bipolar 2 disorder symptoms include depressive and manic episodes. However, the primary difference between the two is the length of symptoms and the severity. Below, we’ll delve into the differences between the two.
Those with bipolar 1 disorder will have manic episodes that last, at the very least, seven days and include three of the following symptoms. These include:
Those diagnosed with bipolar 1 disorder will experience depressive episodes that last two weeks. They will endure at least five of the following symptoms, which includes:
If you’re diagnosed with bipolar 2 disorder, you’ll experience symptoms of depressive episodes that we described above. However, instead of manic episodes, you’ll endure hypomanic episodes. These are similar to manic episodes, but they’re much less severe. They typically last at least four days but won’t cause the serious issues that you’d encounter with manic episodes.
Although scientists haven’t been able to pinpoint a specific cause of bipolar 1 or bipolar 2 disorder, they believe several factors contribute to both disorders occurring, which include the following:
If you have a parent or sibling who has been diagnosed with bipolar disorder, your chances of developing it are much greater. However, most people who have a family history of the condition won’t develop it themselves. There have even been cases of identical twins where one twin developed the disease while the other didn’t.
Unfortunately, an extremely stressful event may trigger a depressive or manic episode. If you’re going through an event like a divorce, recently lost a job that you needed, or you’re experiencing financial hardship, it can also play a role in developing bipolar disorder.
Researchers have found very subtle differences between the average size or activation of specific brain structures between those with and without bipolar disorder. However, you won’t be able to determine if someone has the condition with just a brain scan.
Only a medical professional can determine if you have bipolar 1 or bipolar 2 disorder. During an appointment, they’ll discuss your symptoms, family history, and medical history. You’ll also go through a physical exam and blood tests to rule out any other potential causes of your symptoms.
Your physician will also do a mental health evaluation and possibly refer you to a specialist with more experience treating bipolar disorder. Bipolar 1 disorder is diagnosed when you encounter at least one manic episode, whereas bipolar 2 is diagnosed when you’ve had at least one hypomanic episode.
If you’re diagnosed with bipolar 1 or bipolar 2 disorder, it’ll require lifelong treatment, consisting of medication to balance mood, psychotherapy treatment, potential substance abuse treatment if you have a co-occurring condition, or hospitalization if you’re feeling suicidal. Fortunately, help is available, and you can lead a normal life with the disorder. However, you must reach out for the treatment you need because bipolar disorder can be dangerous without adequate help.
World Health Organization (November 2019) Mental Disorders. from https://www.who.int/news-room/fact-sheets/detail/mental-disorders
National Institute of Mental Health (April 2021) Bipolar Disorder. from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
National Institute of Mental Health (April 2021) Substance Use and Co-Occurring Mental Disorders. from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health/index.shtml
Depression and Bipolar Support Alliance (April 2021) Bipolar Disorder Statistics. from https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/
National Institute of Mental Health (April 2021) Anxiety Disorders. from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml