The focus on bipolar disorder is often on the highs and lows, but there are definable stages of a typical bipolar cycle. Knowing what these stages are can help individuals understand what they’re going through, avoid triggers and manage their symptoms accordingly. Keep reading for a comprehensive overview of the four stages of bipolar disorder.
What Is Bipolar Disorder?
Bipolar disorder is a mental illness characterized by extreme mood swings, from depressive to manic states. People with bipolar disorder often have drastic shifts in energy, mood and behavior to the point that it becomes challenging to carry on with everyday life. The condition isn’t curable, but its symptoms are treatable with therapy and medication.
It’s estimated that 4.4% of American adults will experience bipolar disorder at some point in their life. The condition impacts men and women equally.
There are still a lot of stigma and misunderstandings around bipolar disorder, which can be very isolating for people with the illness. Many individuals think people with bipolar disorder are in two constant states: extreme depression and extreme mania. In reality, the condition tends to present itself in a cycle that includes four distinct bipolar stages.
What Is Manic Depression?
Manic depression, now more commonly referred to as bipolar disorder, is a common mental health condition marked by extreme shifts in mood, energy and activity levels.
While the term “manic depression” is sometimes used casually to describe mood swings, it’s a medical diagnosis with specific criteria. These intense mood episodes, ranging from the highs of mania to the lows of depression, can significantly impact daily functioning. Understanding the symptoms, triggers and treatment options for this condition helps start the healing process for those affected.
The Four Stages of Bipolar Disorder
The four bipolar disorder phases are:
1. Mania
When someone is in the “mania” stage, it’s typically referred to as a manic episode. During these times, the person feels incredibly elevated and energized. They may seem incredibly happy or irritated and have a “buzzing” style of energy to them. Manic episodes often lead them to reckless behavior without considering long-term consequences. For example, someone going through mania may take out a new car loan even though they already have a car, engage in sexual activity outside their relationship or take a dangerous new drug for the first time.
Some symptoms of mania are:
- Increased self-esteem
- Lowered sleep needs
- High energy levels
- Intense sessions of creativity, often with ideas not making sense or linking together
- Intense happiness or extreme irritability
- Poor judgment and risky behavior
- Increased aggressiveness toward others
Mania lasts at least seven days in a row and often disrupts regular life, so the person in this stage can’t go to work, attend their usual events and responsibly take care of themselves or others.
In extreme situations, mania can trigger psychosis so that the person can’t tell the difference between reality and their perceived reality. In these situations, hospitalization may be required.
2. Hypomania
Hypomania is the second of the manic stages in the bipolar disorder cycle. While both manic phases are similar, hypomania is the less extreme version of mania. Hypomania lasts at least four days in a row but still allows the individual to go about their everyday routine. The individual may have heightened energy levels and mood swings but can still function and go to work. To the outside world, someone going through hypomania may seem more cheerful, talkative, creative and willing to “have a good time.”
Individuals going through the mania and hypomania bipolar disorder stages often feel shame and regret for their actions or behavior, which brings them to the depressive phase of the bipolar cycle.
3. Depression
When someone experiences the phase of depression in the bipolar disorder cycle, it’s often an intense depressive state.
Someone is in the depressive stage when they experience at least five of the following symptoms, lasting for at least two weeks:
- Feelings of sadness and hopelessness
- Decreased self-worth
- Feeling extraordinary amounts of guilt
- Lack of energy
- Sleep issues
- Increased irritability
- Suicidal thoughts
- Having zero interest in any activities or passions
- Restlessness
- Noticeable weight loss or weight gain
During the depressed phase, people with bipolar disorder may isolate and keep to themselves until they get out of this stage.
4. Mixed Episodes
As it sounds, the mixed episodes phase is when an individual experiences symptoms of mania and depression simultaneously or back-to-back. This stage can feel confusing and tempestuous for both the person with bipolar disorder and the people in their life.
Some possible symptoms of the mixed episode stage are:
- Feeling sad when engaging in favorite, pleasant activities
- Irritation
- Feelings of regret
- Low energy
The rough up-and-down combination of the mixed episodes phase can lead to an increased risk of self-harm and violence.
How Long Does Each Stage of the Bipolar Disorder Cycle Last?
The length of each phase is unique to each person. A study that followed patients with bipolar disorder for up to 25 years found that the median mood episode lasts 13 weeks.
Additionally, the cycle frequency can change over time. So, a person completing an entire cycle once a year might find themselves experiencing two full cycles the following year. Most people with bipolar disorder experience one to two complete cycles per year.
If a person goes through four or more full cycles in a 12-month period, they’re going through something called rapid cycling. One study found that 12–24% of individuals with bipolar disorder experience rapid cycling. This unique presentation of rapid cycling in bipolar disorder is most common in:
- Women
- Individuals who had an earlier onset of their bipolar disorder
- Those with a higher-than-average treatment resistance
How Manic Depression Differs From Other Mood Disorders
Manic depression is often confused with other mood disorders, but it has distinct features that set it apart. Understanding these differences helps with accurate diagnosis and effective treatment.
One key difference is the presence of mania. Unlike major depressive disorder, which involves only depressive episodes, bipolar disorder includes periods of mania or hypomania (a less severe form of mania). These high-energy states are a hallmark of manic depression and are absent in other mood disorders like persistent depressive disorder or generalized anxiety disorder.
Another distinguishing factor is the episodic nature of manic depression. While conditions like dysthymia involve chronic, low-grade depressive symptoms, bipolar disorder characteristically alternates between high and low extremes. This cycling pattern can occur over weeks, months or even years, depending on the individual and the type of bipolar disorder they have.
It’s also important to note that bipolar disorder shares some overlapping symptoms with borderline personality disorder (BPD), such as mood instability. Where they differ is that BPD is primarily a personality disorder involving issues with interpersonal relationships and self-image, whereas bipolar disorder is a mood disorder with defined episodes of mania and depression. Proper diagnosis often involves a thorough psychological evaluation and a review of personal and family medical history. Misdiagnosis can lead to inappropriate treatment.
Common Triggers and Risk Factors
Manic depression is influenced by a combination of genetic, biological and environmental factors. Understanding common triggers and risk factors can help individuals manage their condition and reduce the likelihood of severe episodes.
- Genetics play a significant role in bipolar disorder. Research shows that individuals with a family history of manic-depressive disorder are at higher risk of developing the condition. However, not everyone with a genetic predisposition will experience symptoms, suggesting that environmental factors also contribute.
- Stressful life events, such as job loss, divorce or the death of a loved one, are common triggers for mood episodes. These stressors can disrupt sleep patterns and overall mental stability, increasing the likelihood of both manic and depressive episodes.
- Substance use is another major risk factor. Drugs and alcohol can exacerbate symptoms or interfere with the effectiveness of treatment. Stimulants, for example, may trigger manic episodes, while depressants can deepen depressive states.
- Sleep disturbances also play a crucial role in mood regulation. Irregular sleep patterns or chronic insomnia can provoke episodes of mania or depression, further complicating the condition.
- Hormonal changes, particularly in women, can act as triggers. Pregnancy, menopause or fluctuations in hormonal levels during the menstrual cycle may influence the severity and frequency of mood episodes.
Treatment Options for Managing Bipolar Disorder
Effective management of manic depression symptoms calls for a comprehensive treatment approach that addresses both the symptoms and the underlying causes of the condition. Treatment plans often involve a combination of medication, therapy and lifestyle modifications.
Medication is a cornerstone of bipolar disorder treatment. Mood stabilizers, such as lithium or anticonvulsants, help regulate the extreme highs and lows associated with the condition. Antipsychotic medications may also be prescribed for severe manic episodes, while antidepressants are sometimes used cautiously to treat depressive symptoms.
- Therapy plays an important role in managing manic depression, especially talk therapy and peer support.
- Cognitive behavioral therapy (CBT) helps individuals identify and modify thought patterns that contribute to mood episodes.
- Interpersonal and social rhythm therapy focus on establishing consistent daily routines, including regular sleep patterns, to stabilize mood.
Psychoeducation is another valuable tool for individuals and their families. Learning about the symptoms, triggers and treatment options for bipolar disorder empowers individuals to take an active role in their recovery. Family therapy can improve communication and support within the household, fostering a more stable environment.
Lifestyle changes can also be helpful. Regular exercise, a balanced diet and adequate sleep can improve overall well-being and reduce the severity of mood episodes. Stress management techniques, such as mindfulness or meditation, can further enhance emotional resilience. In severe cases, hospitalization may be necessary to ensure safety and stabilization during acute manic or depressive episodes. Intensive outpatient programs or partial hospitalization can provide structured support during the recovery process.
Bipolar Disorder Treatment at Restore Mental Health
Restore Mental Health in Deerfield Beach helps individuals get the treatment they need for various mental health conditions, including bipolar disorder. Your illness doesn’t have to define or control you. Treatment can help you live a fulfilled, happy life with minimal impact from your bipolar symptoms. Call (877) 810-2074 or contact Restore Mental Health today to find out how we can help.
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