Bipolar Disorder: Understanding Symptoms and Treatment

Bipolar disorder manifests through cyclical episodes of depression and mania that significantly impact mood, behavior, and daily functioning, with evidence-based therapeutic interventions like cognitive behavioral therapy providing essential support for symptom management and emotional stability alongside medical treatment.

Does it feel like you're riding an emotional roller coaster that you can't control? Living with bipolar disorder can make even simple days feel overwhelming, but understanding your experiences and working with a skilled therapist can help you find stability and hope. Let's explore how therapy can help you manage these challenging mood shifts and reclaim your sense of control.

Understanding Bipolar Disorder: Signs, Symptoms, and Support

Bipolar disorder, formerly known as manic depression, is a common and serious mental health condition characterized by significant emotional fluctuations. During depressive episodes, individuals typically experience depressed mood and low energy, while during manic or hypomanic episodes, they experience elevated moods and high energy levels. Distinguishing bipolar disorder from other conditions—such as borderline personality disorder, severe depression, or attention-deficit/hyperactivity disorder (ADHD)—requires a comprehensive mental health evaluation. Bipolar disorder is treatable, and many people find their mood symptoms stabilize through a combination of treatment approaches, including therapy with licensed clinical social workers.

People diagnosed with bipolar disorder may experience intense emotional shifts that dramatically alter how they feel, think, and act. When these shifts occur four or more times per year, they’re classified as rapid cycling, though some individuals experience daily mood oscillations. Importantly, rapid cycling patterns aren’t necessarily permanent. Adjustments in care, such as modifying treatment plans, may effectively reduce rapid cycling occurrences and help maintain more stable moods.

Depressive Episodes

While sadness is a normal human emotion, those experiencing depressive episodes describe periods of negative thoughts extending beyond typical sadness. Research indicates that individuals in a depressive cycle take approximately 11 weeks, on average, from initial symptoms to return to a state without diagnosable mental health conditions. Many people experiencing depressive episodes may exhibit several of these symptoms:

• Difficulty focusing
• Low energy and/or motivation
• Trouble sleeping, oversleeping, or general changes in sleep patterns
• Little interest in activities that were once enjoyable
• Feeling lonely, worthless or both
• Change in eating habits
• Feeling extended periods of sadness or unhappiness
• Isolating from friends, family members, and loved ones
• Thoughts of suicide

Manic Episodes

While depressive episodes share similarities with major depressive disorder, manic episodes present distinctly different symptoms:

• Impulsive decision-making
• Racing thoughts or speaking quickly
• Experiencing high levels of energy
• Delusions of grandeur
• Engaging in risky behaviors
• Feeling extremely confident, excited, or irritable
• Needing less sleep
• Experiencing paranoia and/or hallucinations

Though the heightened energy of mania might sound positive, many people with bipolar disorder face serious challenges during these episodes. Symptoms like irritability, anger, and lack of control can be extremely difficult to manage. Bipolar I disorder is diagnosed when full manic episodes occur.

Diagnosis

Psychosis—a term describing hallucinations and grandiose delusions—affects approximately half of individuals with bipolar disorder at some point in their lives. People experiencing psychosis may be misdiagnosed with schizophrenia or related disorders, with studies showing this misdiagnosis is particularly common among Black and Hispanic individuals. An accurate diagnosis requires in-person evaluation by a qualified healthcare provider who takes a thorough history. Family history is also significant, as 80-90% of people with bipolar disorder have a family member with depression or bipolar disorder.

Diagnostic standards for bipolar disorder have improved significantly in recent years. During assessment, a healthcare provider will evaluate mood fluctuations and determine if criteria are met for Bipolar I (manic depressive), Bipolar II (major depression with less severe hypomanic cycles), or unspecified bipolar disorder. Diagnosis in children can be more challenging as they commonly experience mixed episodes with simultaneous symptoms of both mania and depression. People with Bipolar II may have additional mental health conditions that intensify their symptoms.

Bipolar disorder can sometimes be confused with other conditions. For example, ADHD symptoms may resemble those of manic or hypomanic episodes. A mental health professional may need to differentiate between these conditions or recognize when they coexist. Research suggests that 10-20% of adults with bipolar disorder also have comorbid ADHD.

Understanding Mood Swings

Though many people with bipolar disorder learn to recognize early warning signs of episodes, mood swings can be unpredictable. They may develop gradually or occur abruptly, lasting for hours, weeks, or months. As mental health experts note, the recurrence of mood swings is “the expectation, not the exception” because the disorder is characterized by these emotional oscillations. A licensed clinical social worker can help you identify overstimulation and factors that may increase episode likelihood. Keeping a mood journal to document emotional changes over time can also be beneficial. With proper treatment and support from organizations like the Depression and Bipolar Support Alliance, individuals can better manage their condition and potentially prevent episodes.

Triggers

While episodes don’t always have identifiable triggers, common precipitating factors include:

• Job changes
• Moving or changes in living situations
• Certain medications (some can trigger mania)
• Substance use
• Traumatic experiences
• Relationship changes
• Sleep disruption
• High stress or excitement

Familiarizing yourself with warning signs of potential manic or hypomanic episodes can help with early intervention and management.

Treatment Approaches

Because bipolar disorder is a long-term, cyclical condition, ongoing treatment is recommended for most people. Treatment typically combines psychotherapy with appropriate medications.

Medication management requires expertise from healthcare providers experienced in treating bipolar disorder. For example, some individuals struggle with medication adherence during mood swings, requiring specialized approaches to reduce “breakthrough symptoms.” It’s important to note that antidepressants alone are generally not recommended for bipolar disorder; if you’ve previously been diagnosed with depression and prescribed antidepressants, your provider may recommend adjusting your medication regimen. A healthcare professional can explain efficacy, side effects, and treatment duration for specific medications.

Therapy provides valuable support for people with bipolar disorder, improving wellbeing and life satisfaction while addressing comorbid conditions like ADHD. Effective therapeutic approaches include interpersonal therapy and family therapy. For treatment-resistant symptoms, healthcare providers might recommend brain stimulation therapies such as electroconvulsive therapy (ECT).

Working with a ReachLink therapist can help you understand your condition and develop tools to recognize and navigate symptoms. Cognitive behavioral therapy (CBT) effectively reduces mania severity and relapse rates for people with bipolar disorder. Research shows that online CBT, like that offered through ReachLink, effectively manages bipolar disorder symptoms. Telehealth therapy can be more convenient and accessible, potentially improving treatment consistency.

Takeaway

Bipolar disorder is a common condition characterized by significant mood swings between manic and depressive states. When experiencing emotional instability and mood fluctuations, it’s crucial to consult with qualified mental health professionals for proper evaluation and treatment. While ReachLink’s licensed clinical social workers provide valuable therapeutic support for managing symptoms and recognizing early warning signs of episodes, comprehensive care often requires collaboration with medical providers who can provide diagnosis and medication management when appropriate. With proper treatment and support, many people with bipolar disorder successfully manage their symptoms and lead fulfilling lives.