What is Bipolar Disorder?

Learn about the two different phases of bipolar disorder – depression and mania – and how the disorder is treated.

Sanaz Majd, MD
3-minute read
Episode #109

Contrary to popular myth, suffering from bipolar disorder doesn’t simply mean that you are “nice” one minute and “mean” the next. It is far more complicated than that. Bipolar disorder can be very distressing to live with, but believe it or not, it is quite common. More likely than not, you know someone with bipolar disorder (however, you may not necessarily know that they have it). So let’s learn a little more about this condition this week.

What is Bipolar Disorder?

Bipolar disorder, like personality disorders, often begins in adolescence or even late childhood. But patients may go undiagnosed for many years. There seems to be a substantial genetic component, but a stressful environment can also predispose patients to developing it. 

Just to make one thing clear: moodiness or mood swings are not the same thing as bipolar disorder.  Patients do often cycle between two different states, hence the term “bi-polar,” but referring to the phases of mania and depression (not meanness or niceness). Here’s what the phases mean:

Mania - When in the manic phase, patients may exhibit:

  • Sense of elation or great happiness, or on the other hand, increased irritability. Either way, they seem filled with emotion.

  • Increased energy (for instance, they may paint the house in one day, or become very goal-oriented at work)

  • Decreased need for sleep (patients find that they just don’t require as much sleep, or even none at all, and don’t feel sleepy)

  • More talkative than usual (their sentences may appear “pressured” or super fast)

  • Racing thoughts (they may jump from one idea to another, without fully completing the first one)

  • Involvement in pleasurable but high risk activities like promiscuity, impulsive spending, etc.

  • Inflated self-esteem or delusions of grandeur

Sometimes patients present in what doctors call a “hypomanic” phase, in which they exhibit the same symptoms but on a smaller scale.

Depression - Unfortunately, what goes up must come down. And eventually those with bipolar disorder experience depression. And sometimes the depression is just as low as the mania is high. Patients can become suicidal (suicide rates are 20 times higher than in the general population, and one third of those with bipolar disorder attempt suicide). Patients with bipolar disorder tend to spend a lot time in this phase. Symptoms of depression include: depressed mood, lack of interest/pleasure, difficulty with sleep or appetite, fatigue, feelings of hopelessness, diminished concentration, physically slowing down.

How is Bipolar Disorder Diagnosed?

Your doctor can administer a questionnaire to screen for bipolar disorder, or they can refer you to a psychiatrist. You can also complete this questionnaire from Depression and Bipolar Support Alliance to find out if you may suffer from bipolar disorder.

It’s also really important make sure you don’t suffer from a medical condition that can mimic bipolar disorder, such as:

  • Drug or alcohol abuse

  • Medications that can cause manic-like episodes: corticosteroids, medications used to treat ADHD, certain antidepressants, trazadone, etc.

  • Thyroid disorder

Treatment of Bipolar Disorder

Bipolar disorder is really important to treat once it’s diagnosed. And treatment is often recommended for life, because there is a high relapse rate once in remission – about 70% relapse within 5 years. It is often treated in the following way:

  • Good sleep (sleep deprivation can induce manic episodes)

  • Mood stabilizers such as Lithium or Valproic Acid

  • Antipsychotics

  • Anticonvulsants

  • Therapy

If you or someone you know suffers from bipolar disorder, make sure to get a referral to a good psychiatrist from your primary care doctor. There are good treatment options available, you just have to seek them.

Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.

About the Author

Sanaz Majd, MD

Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women's health and patient education.