Bipolar Disorder Treatment Methods and Common Signs

Picture sitting in a sailboat in the middle of the water, envisioning your destination. After setting the rudder and lifting the anchor, you put the sails up and start out. If it’s windy, you’ll get there quickly. Maybe the wind grows stronger, and suddenly you feel less like a sailor and more like a pilot.

The faster the wind blows, the faster you go, until you feel like you’re on a thrill ride. Looking down at the water, you watch the waves speed by as if you’re flying, with nothing to stop you or slow you down.

After a while, the wind starts to die down and then to disappear altogether, until you’re a sitting duck, all alone on the ocean waves with no wind in your sails. A sense of isolation overtakes you, and you realize that the high-speed thrill ride left your hull damaged, pieces of wood missing, and basic maintenance neglected. There’s no way to get your boat going again.

That is until the wind picks up again and you find yourself speeding over the waves like you were before. Yet it eventually dies down and you find yourself stuck again. This cycle continues for a long time, and you begin to feel worn out, sure you’ll never reach your destination. You’re at the mercy of the wind’s whims.

This is a fitting analogy of the life of someone suffering from bipolar disorder.

Among the many possible mental illness diagnoses, bipolar disorder can be one of the most difficult to diagnose, treat, and manage on a daily basis. Many of the symptoms of this disorder can be hidden and confusing, even for the person who is suffering from them, or for those close to them.

A person living with bipolar disorder might feel as though they’re on a roller coaster ride. Dramatically high emotions feel exhilarating for a time, but they are followed by a crash and a period of depression.

If you have a loved one experiencing this disorder, you might feel like they’ve become a stranger to you. The changes may sometimes seem positive, at least on the surface. When a person is experiencing the highs of the bipolar cycle, they may become very productive, but can also partake in risky behavior. It’s critical to identify the early signs of bipolar disorder so it can be treated and allow the person to live a successful and healthy life.

What is Bipolar Disorder?

Learning about bipolar disorder can be complicated. It’s common in our culture to casually say that someone is bipolar, even if this is wildly incorrect. If you change your mind a lot, make decisions based on your current mood, or experience shifting emotions, that doesn’t make you bipolar. (Usually, episodes of highs and lows last for weeks with true bipolar disorder.)

Many people have enough knowledge of bipolar disorder to understand that people suffering from it experience cyclical ups and downs, but this limited awareness does not grasp the full scope of the disorder. Even in clinical use, the term can have varying meanings.

Experts agree on three different types of bipolar: Bipolar I, Bipolar II, and cyclothymia.

• In Bipolar I, the extreme highs and lows (for which bipolar is famous) are experienced.
• Bipolar II is characterized by hypomania. Hypo means “less,” so this diagnosis refers to a condition where a person experiences elevated mood without having full-blown manic episodes, and this mood alternates with deep depression.
• Cyclothymia is a cycle that occurs over a much longer period of time (typically years) with periods of high and low that fall short of full mania or depression.

To complicate things further, individuals with any of these diagnoses can have radically different experiences. A person who is predominantly depressed but has had one manic episode at some point in time will fit the definition of bipolar, where another person might be diagnosed as bipolar who tends to be manic as a baseline but has had a depressive episode at some point.

Clinicians are able to distinguish between these varied experiences, but diagnosed individuals tend to simply label themselves as bipolar without articulating the nuances. This can lead to complicated discussions when people may not truly understand what this individual’s bipolar experience is like.

Understanding that this can be complicated and the way it presents will vary even among people with the same diagnosis. It’s critical to consult a professional in order to be diagnosed properly and find the most helpful treatment options for yourself or someone you love.

Signs of Bipolar Disorder

Consider some of the most common symptoms of bipolar disorder. Understanding these signs can help you to decide whether any of these sound familiar in your life or in a loved one. Please do not diagnose yourself or anyone else; instead, consult a professional.

Depression

For someone with bipolar disorder, depressive episodes will look the same as they do in someone with major depressive disorder. Episodes will always vary depending on the individual. In traditional terms, depression is typically associated with being sad. This is often part of a depressive episode but isn’t the only determining factor in identifying depression.

In order for a diagnosis of depression to be made, there must be either sadness or a marked lack of interest in pleasure. Many people may not feel noticeably down, but they might still be experiencing depression.

What does it mean to have a lack of interest in pleasure? This often manifests as a lack of motivation in general. Clients have described this experience as being in a “funk” or a “fog.” It’s also been described as “a case of the screw-it’s” (typically with more colorful language). In other words, depression is correlated with having an indifferent or apathetic outlook on life.

Specific factors are also present along with these hallmark symptoms, such as weight changes or varied eating habits, disrupted sleep patterns, constant fatigue, misplaced guilt, difficulty focusing, and a preoccupation with death.

Mania

If a person has had a manic episode at any point in their life, then that becomes the differentiating factor between bipolar disorder and major depressive disorder.

Clinicians’ go-to diagnostic manual, the DSM-5, describes a manic episode as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least one week and present most of the day, nearly every day (or any duration if hospitalization is necessary).”

A manic episode is the “high” of bipolar disorder. These episodes often lead to serious trouble. An individual in the throes of mania will often behave impulsively—for example, going on a shopping spree or making an expensive purchase that doesn’t fit the budget.

It can feel exhausting to spend time with a person going through a manic episode. You might feel like you can’t keep pace with the rapid stream of their thoughts. Often they talk quickly and are intensely driven to finish tasks or seek fun experiences. They can frequently function on a decreased amount of sleep. Unfortunately, this manic energy sets them up for a lot of difficulties when they inevitably crash.

These symptoms of mania usually feel good at the time, which is why they’re called a high. People enjoy these episodes and anticipate their recurrence. However, the symptoms are so overwhelming that they often have negative consequences.

Even if you experience manic episodes without depressive episodes, you may still be suffering from bipolar disorder.

Other Subtypes

While mania and depression are the main features of bipolar, other subtypes exist as well. A Bipolar I sufferer will experience full-blown highs, while individuals with Bipolar II experience only hypomania. Their moods are less elevated, and their episodes don’t last as long – the baseline is four days rather than a week.

The most noticeable difference between the two subtypes is that hypomania generally allows for the individual to function in their normal routines, albeit with a more directed energy. Additionally, Bipolar II assumes that a major depressive episode has occurred at some point in time. In Bipolar I, this may or may not be true.

The third subtype – Cyclothymia – describes a combination of hypomania with mild depression. What this looks like practically is an elevated mood that isn’t out of control or accompanied by risky behavior, followed by a depression that’s usually high-functioning (normal routines can be carried out). Although cyclothymia isn’t as severe, it can cause emotional whiplash as this cycle continues over the course of several years.

It’s also important to note that psychotic features can accompany bipolar disorder. Individuals may hear or see things that other people do not, such as voices saying negative or hurtful things. For people who have this symptom, it’s often one of the most distressing elements of their disorder.

Bipolar Disorder Treatment

If any of these signs seem to describe your experience, you might wonder what options you have for bipolar disorder treatment. Start with going to see a therapist who is qualified to make a diagnosis of your condition. The gold standard for mental health issues is a combination of targeted therapy and medication.

A mood stabilizer can be a helpful option available to you when you go to see a psychiatrist or other qualified prescriber. If you’re experiencing depression but have had manic episodes in the past, be sure to share this with your therapist. Many medications prescribed for major depressive disorder can cause a recurrence and even a worsening of mania. Specifically, antidepressants often trigger mania, while mood stabilizers create a steady and reliable baseline.

Therapy should be present in bipolar disorder treatment to complement medication. It can help you take ownership of the situation, talking through your disorder with your therapist so you can develop specific skills to use when your mood is starting to fluctuate up or down.

Family therapy can be a useful way to receive support from those who care about you the most. Bipolar disorder, especially the manic component, is often noticed by those around the individual before they even notice it themselves. Family therapy can give your family the tools to support you, to recognize the signs of your episodes, and to help you cope with them.

If you’ve related these signs to yourself or a loved one, please ask for help. Counseling can help you get back to a stable place and move towards your goals in life. It can be frightening to live with bipolar disorder, but rest assured that this condition is manageable. A combination of therapy and medication can have you feeling like the best version of yourself.