Signs of bipolar disorder (BPD) may be difficult to recognize at their onset because symptoms often emerge during adolescence or early adulthood. Parents of teens know that moodiness, impulsive decision-making, and sleeping too little or too much are characteristics of teenage behavior. These “teen growing pains” could also be initial symptoms of bipolar disorder.
It is critical that treatment for BPD begins as soon as symptoms become consistent and problematic. The mood cycling indicative of BPD ranges from extreme lows (severe depression) to extreme highs (mania). When a person with BPD is in the depressive phase, they are at risk for suicide ideation and attempted suicide. Alternately, the same person experiencing the manic phase of BPD may become sexually promiscuous, gamble away large sums of money, or engage in criminal behavior. In some cases, the person in a manic episode is delusional and does not remember much of what they did after cycling out of the episode.
If you suspect you may have bipolar disorder, schedule an appointment with your primary care physician. They may recommend several blood tests that rule out diseases that cause symptoms similar to BPD. A physician can also refer you to a psychologist or psychiatrist with experience diagnosing and treating BPD.
Recognizing the Signs and Symptoms of Bipolar Disorder
Bipolar disorder is subdivided into three types of BPD: bipolar I disorder, bipolar 2 disorder, and cyclothymic disorder.
Signs of Bipolar I Disorder
Individuals with bipolar I disorder experience manic or manic/depressive episodes that continue for at least seven days each time they appear. Depressive episodes can persist for two weeks or more.
Symptoms of bipolar mania include:
- Racing thoughts/delusions
- Grandiosity (believing you are invincible, omnipotent, and even telepathic)
- Rapid speech that may be irrational or unintelligible
- Engaging in high-risk behaviors/impaired judgment
- Spending excessive amounts of money/maxing out charge cards
- Insomnia/staying awake for several days
- Ignoring personal hygiene
- Forgetting to eat/lack of appetite
- Suffering a psychotic break severe enough to require hospitalization
Symptoms of bipolar depression include:
- Sleeping 12 or more hours each day
- Lack of appetite or binge eating
- Constantly feeling sad, anxious, and hopeless
- Inability to think clearly, concentrate, or remember (short-term memory)
- Having no interest in anything/staying in bed most of the day
- Feeling worthless, guilty, and suicidal
Signs of Bipolar 2 Disorder
The difference between bipolar I vs 2 is that bipolar 2 disorder involves depression as the primary mood. Although a person with bipolar 2 disorder will cycle through mania and depression, their depressive episodes will last much longer and be more severe than manic episodes. Studies have shown that individuals with bipolar 2 disorder experience depression over 50 percent of the time compared to individuals with bipolar 1 disorder, who experience 30 percent of the time.
The Importance of Professional Evaluation and Diagnosis
Signs of bipolar disorder mimic symptoms of several medical conditions. For example, when the thyroid produces excessive T1 and T2 hormones, the resulting hyperthyroidism can cause anxiety, agitation, increased appetite, and insomnia. Untreated hyperthyroidism may begin to resemble symptoms of the manic phase of bipolar disorder. Signs of the autoimmune disease lupus include extreme fatigue, memory loss, confusion, and lack of appetite, which are symptoms of the depressive phase of bipolar disorder.
Dementia, brain tumors, drug addictions, and temporal lobe contusion will also be ruled out before a psychiatrist or psychologist diagnoses someone with bipolar I or bipolar 2. Substance abuse is frequently seen in individuals with bipolar disorder as they attempt to self-medicate their symptoms.
Getting a professional diagnosis is vital for avoiding mistreatment of bipolar disorder or other physical or mental disease.
Treatment Options and Strategies for Managing Bipolar Disorder
Mood stabilizers, such as lithium and lamotrigine, are commonly prescribed to control bipolar mood swings. Lithium decreases norepinephrine levels in the brain while increasing the production of serotonin. Norepinephrine is a neurotransmitter and hormone that stimulates alertness and attention. Serotonin is a neurotransmitter that regulates mood, appetite, and sleep.
Lamotrigine is an anticonvulsant that reduces the release of glutamate while increasing the release of GABA. Glutamate is an excitatory neurotransmitter that stimulates signaling among brain cells. GABA is also a neurotransmitter involved with cell signaling. When these two chemicals are combined, they can help lessen the severity of manic and depressive episodes.
Atypical antipsychotics help control delusions, auditory hallucinations, and other psychotic symptoms of bipolar disorder. Commonly prescribed atypical antipsychotics include Abilify, Seroquel, and Zyprexa. In addition to relieving psychotic symptoms, atypical antipsychotics treat impulsivity, irrational thoughts, delusions, and insomnia. Atypical antipsychotics do not cause the tremors or muscle rigidity that older psychotic medications cause in long-term users.
Antidepressants treat the depressive phases of bipolar episodes by regulating serotonin levels in the brain. Antidepressants such as Zoloft, Celexa, Effexor, and Wellbutrin are taken as soon as a person with bipolar disorder realizes they are slipping into the “down” phase of a cycle. In addition to relieving depression, antidepressants may reduce the frequency of rapid cycling and mania.
Tricyclic antidepressants (monoamine oxidase inhibitors) for bipolar depression may work better for those who do not respond very well to traditional antidepressants. Tricyclics such as Elavil (amitriptyline), Tofranil (imipramine), and Pamelor (nortriptyline) are typically prescribed to patients who have not found relief with other medications.
Cognitive Behavioral Therapy (CBT)
CBT offers a therapeutic method of examining how thoughts, emotions, and behaviors influence each other. CBT therapists guide patients through a thought-restructuring technique that improves self-examination and coping skills by phasing out negative thinking patterns. CBT is a person-oriented, problem-focused therapy that works well to treat people with bipolar disorder.
Electroconvulsive therapy (ECT) is used to help patients who suffer from severe depressive episodes that are long-lasting and debilitating. Research shows that ECT is helpful for people who require immediate stabilization and cannot wait for medications to take effect. ECT may be recommended for people with persistent suicidal ideation during depressive episodes. When individuals with bipolar disorder cannot find a medication that works or cannot tolerate the side effects of medication, they may try ECT to treat their bipolar disorder symptoms.
Bipolar Treatment Centers
Treatment centers specializing in diagnosing bipolar disorder perform intake assessments that examine and evaluate the severity and frequency of the patient’s mood swings, life skill deficits, cognition, and general intelligence. In addition to psychotherapeutic and pharmacological interventions, bipolar treatment centers may provide one or more of the following:
- Supplementary activities to increase self-esteem and develop coping skills
- Meetings with counselors who specialize in spiritual awareness and relaxation/meditation techniques
- Dual diagnosis/bipolar treatment programs for patients with bipolar disorder and other mental health issues
- Drug detoxification, nursing supervision, and addiction help for patients with a substance abuse problem
- Residential or outpatient treatment programs that address the needs of the patient
Professional bipolar treatment centers also offer post-treatment assistance such as crisis counseling, medication management, and outreach services.