Mental Health Awareness: Bipolar Disorder

“They are just so bipolar.”

This phrase is one that is commonly used in casual conversation, and typically, what the individual saying it means is that the person the phrase is referring to has frequent and intense mood swings between various emotions such as angry, sad, and happy. However, because the word bipolar has been used in this manner, it has led to a fundamental misunderstanding of what bipolar disorder is.

So what is bipolar disorder? That depends on which type you are referring to. Per the DSM-5, there are two types of bipolar disorder: Bipolar I Disorder and Bipolar II Disorder. With Bipolar I Disorder, one must have experienced a manic episode. While depressive episodes are common with Bipolar I Disorder, it is not required for the diagnosis. With Bipolar II Disorder, one must have experienced a hypomanic episode and a depressive episode.

The key word there is “episode.” Unlike the conceptualization of intense mood swings, an episode means there are days of the mood. For example, a manic episode requires at least one week of a persistently elevated, expansive, or irritable mood. This means that this person is feeling this way for at least one straight week. A hypomanic episode requires at least four consecutive days of a persistently elevated, expansive, or irritable mood. Other symptoms of manic or hypomanic episodes include: inflated self-esteem or grandiosity, a decreased need for sleep, being more talkative than usual or pressured speech, a flight of ideas or racing thoughts, distractibility, increased goal-directed activity, and/or excessive involvement in activities that have a high potential for painful consequences (e.g., binge shopping, risky sex behavior, substance use).

It is important to understand the difference between bipolar disorder and having intense mood swings, in part because what treatment looks like may vary depending on the reasoning for the mood swings. For those with bipolar disorder, standard treatment includes some form of medication and therapy (e.g., cognitive behavioral therapy, family-focused therapy, interpersonal and social-rhythm therapy). Another reason it is important to know what bipolar disorder looks like is because it can look like other disorders when, in fact, it is not. For example, there are overlapping symptoms between bipolar disorder and ADHD or anxiety-related disorders but the way the disorders are managed is completely different. If you have concerns that you or a loved one are experiencing bipolar disorder, it is key to seek appropriate mental health care, including evaluation services.

Photo by Taylor Deas-Melesh on Unsplash

Written by Justina Yohannan, PhD