Understanding Bipolar Disorder & Finding Treatment You Can Trust

What Is Bipolar Disorder?

Bipolar disorder is a chronic mental health condition that causes dramatic shifts in your mood, energy level, activities, and ability to function in daily life.[1] A person suffering from bipolar disorder goes through episodes of heightened moods (mania or hypomania) and low, depressed moods, sometimes with periods of feeling stable and “normal” in between until the next episode hits. 

However, these types of mood swings are not just the normal day-to-day ups and downs that everyone goes through — rather, they are long-lasting shifts that can last for days, weeks, or longer and affect almost everything about the way that person thinks, feels, and behaves.

Bipolar disorder typically emerges sometime during late adolescence or early adulthood; however, it can occur at any time in a person’s life.[2] While bipolar disorder is a lifelong condition, most people are able to live very fulfilling and productive lives if they receive adequate and appropriate treatment. 

Bipolar disorder is often misunderstood and incorrectly diagnosed. Many people with bipolar disorder look for help while they are in a depressive episode, and may not recognize their manic or hypomanic state as being part of the same illness. This makes identifying the correct treatment difficult.

In order to properly diagnose and treat someone with bipolar disorder, a complete assessment by a professional who understands mood disorders is necessary.

What Causes Bipolar Disorder?

There is no specific reason why someone develops bipolar disorder. However, researchers believe that certain factors contribute to its development. Some of those contributing factors include:

• Genetics — Bipolar disorder has one of the strongest hereditary components of any mental illness.[3] If someone has a first-degree family member who suffers from bipolar disorder, they are much more likely to develop it too.
• Brain chemistry and structure — Measurable differences in neurotransmitter regulation and brain function have been documented in people with bipolar disorder.[4]
• Stressful life events — Significant amounts of stress, traumatic events, or significant changes in a person’s life can initiate a first episode of bipolar disorder or result in a relapse in someone who already has a history of it.[5]
• Disruption of sleep — Disruptions in sleep are a symptom of manic episodes and a trigger for subsequent manic episodes.[6] This can create a cycle that destabilizes mood.
• Substance use — Alcohol, stimulants, and other substances can activate or worsen episodes of bipolar disorder.[7]
• Medical conditions — Certain thyroid disorders and neurologic conditions can contribute to or worsen symptoms associated with bipolar disorder. [8]

Bipolar disorder is responsive to established treatments, and outcome improves significantly when receiving ongoing and comprehensive care.

Types of Bipolar Disorder

Bipolar disorder presents in the distinct forms seen below:

• Bipolar I disorder — Characterized by at least one full manic episode lasting at least 7 days (or one severe enough to require hospitalization), usually followed by episodes of depression.
• Bipolar II disorder— Marked by hypomanic episodes less severe than full mania alternating with major depressive episodes, without full mania.
• Cyclothymic disorder  — Chronic pattern of fluctuation between hypomanic and depressive symptoms that does not meet the criteria for full mania or depression and lasts at least two years.
• Other specified and unspecified bipolar disorders — Forms of mood instability that fall outside of the above categories but involve significant emotional and mood instability.

A proper diagnosis is important because each form has its own unique requirements for treatment.

Symptoms of Bipolar Disorder

Symptoms of bipolar disorder depend on whether a person is experiencing a manic, hypomanic, depressive, or mixed episode.

The most common signs are listed below:

Manic episode symptoms: 

• Elevated or irritable mood
• Decreased need for rest
• Racing thoughts
• Rapid speech
• Grandiosity
• Impulsive or risky behavior (spending, substance use, sexual activity)
• Increased goal-directed activity
• Distractibility

Hypomanic episode symptoms are similar to manic episodes but less severe, often feel productive to the person experiencing them, and are less likely to be seriously inhibiting; still, they are indicative of bipolar disorder.

Depressive episode symptoms

• Persistent sadness
• Loss of interest in activities
• Fatigue
• Changes in sleep and appetite
• Feelings of worthlessness
• Difficulty concentrating
• Suicidal ideation.

Mixed features involve the simultaneous presence of both manic and depressive symptoms, frequently producing extreme agitation and significant risk for self-harm, hospitalization, and dangerous decision-making.[9]

Between episodes are periods of relative stability, although some people experience low-level ongoing symptoms throughout.

If you or a loved one are exhibiting these patterns, please seek professional evaluation. Bipolar disorder is highly treatable, but it does require accurate diagnosis and continuous care.

Bipolar Disorder and Addiction

Research indicates that there is an extremely high rate of co-occurrence between bipolar disorder and substance use disorders. More than 40% of people diagnosed with bipolar disorder will develop a substance use disorder during their lifetime — a statistically significantly higher percentage than the general population.[10] 

There are clinical and intuitive reasons why this relationship exists. During manic episodes, impulsivity, poor judgment, and a sense of invincibility can lead to substance use. During depressive episodes, substances may be used to self-medicate the pain. Sleep disruption caused by either pole can also lead to alcohol or sleep medications use that escalates into dependence and addiction.

This combination is particularly dangerous because using substances destabilizes bipolar symptoms — stimulants can trigger mania, alcohol worsens depression, and many substances interfere with mood-stabilizing medications.[11] Providing effective long-term stabilization for bipolar disorder requires that any co-occurring substance use disorders be treated along with it. Dual diagnosis treatment for both disorders is now the standard of care, and this is central to our treatment approach at Forward Motion Health.

When to Get Help With Bipolar Disorder

Bipolar disorder is a serious mental illness, and early intervention matters. Please consider seeking professional help from a bipolar disorder treatment center if you or a loved one is experiencing:

• Mood swings that are beyond what would be considered normal ups and downs, lasting days or longer
• Elevated moods without needing sleep, racing thoughts, or engaging in impulsive behavior
• Depression that interferes with your job, relationships, or daily life
• Substance use that has become associated with mood instability
• Thoughts of self-harm or suicide — these require immediate attention
• A family history of bipolar disorder and emerging patterns of mood instability

Please contact emergency services or the 988 Suicide and Crisis Lifeline immediately if you are currently experiencing acute safety concerns or active suicidal thinking.