Life involves plenty of ups and downs, and it’s normal to have days when you feel really good and others when you feel, well, not so much. But frequent and extreme mood changes—especially those that involve significant highs followed by profound lows—aren’t normal and might be a symptom of bipolar disorder. If you or someone you love is experiencing severe mood swings, and you find yourself wondering, “What is bipolar disorder, anyway?” we invite you to read on to discover the answer to this question as well as what causes bipolar disorder and how you can find the treatment needed to address this chronic mental health condition.
What Is Bipolar Disorder?
Bipolar disorder, which was once known as manic depression, is a mental illness that causes unusual and sometimes severe shifts in mood, energy, and ability to function. The alternating highs and lows that characterize mood swing episodes may occur either frequently (rapid cycling) or rarely.
According to the National Institute of Mental Health (NIMH), approximately 4.4% of adults in the United States experience bipolar disorder at some point in their lives.
What Causes Bipolar Disorder?
While no one knows exactly what causes bipolar disorder, most experts agree that several factors are likely to blame. These include:
- Brain differences: Studies have shown that people with bipolar disorder exhibit structural differences in certain areas of the brain. Although the significance of these differences is not fully understood, research is ongoing.
- Genetics: It’s generally recognized that people with close family members who have been diagnosed with bipolar disorder have a greater chance of developing the illness themselves. However, studies investigating bipolar disorder in identical twins have demonstrated that one twin may have the condition while the other does not. This seemingly contradictory finding highlights the complex nature of bipolar disorder, but research into the potential genetic basis of the condition continues.
In addition, certain risk factors may put a person at an increased likelihood of developing the illness. These include:
- Substance abuse
- Traumatic events
It’s also important to note that bipolar disorder can coexist with other physical and psychological illnesses, many of which can exacerbate symptoms or affect treatment. These conditions include:
- Anxiety and eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Substance abuse
- Medical conditions like obesity, thyroid problems, and heart disease
Symptoms of Bipolar Disorder
Individuals with bipolar disorder experience symptoms of both mania and depression, though hypomanic episodes can be present as well. While hypomania is similar to mania, the symptoms seen during these episodes are less severe. Symptoms of mania (and hypomania) can include:
- Feelings of euphoria
- High energy levels or increased activity
- Agitation, jumpiness, or irritability
- Decreased need for sleep
- Racing thoughts
- Excessive talkativeness or inability to stick to one topic
- Lavish spending, substance abuse, or risky sexual behavior
Likewise, depressive symptoms may include:
- Feelings of sadness, emptiness, or hopelessness
- Fatigue or loss of energy
- Weight loss or gain
- Loss of interest
- Feelings of worry or guilt
- Concentration or memory problems
- Suicidal thoughts or attempts
Although estimates differ, many studies indicate that between 25% and 50% of people with bipolar disorder attempt suicide at least once, and the number of individuals who are successful is thought to be 10 to 15 times greater than that seen in the general population.
Types of Bipolar Disorder
Bipolar disorder isn’t just one diagnosis. In fact, there are actually four distinct types of the illness. These are:
- Bipolar I disorder: This type of bipolar disorder is characterized by manic episodes that last at least 7 days or become so severe that hospitalization is required. Although the existence of depressive episodes isn’t necessary for a diagnosis of bipolar I disorder, symptoms of depression are usually present. Mixed episodes—symptoms of both depression and mania—may be present as well.
- Bipolar II disorder: This form of bipolar disorder isn’t as severe as bipolar I disorder and involves episodes of depression followed by episodes of hypomania. While episodes of mania aren’t present, depressive episodes may last for a longer period of time.
- Cyclothymic disorder (cyclothymia): To be diagnosed with this type of bipolar disorder, multiple milder episodes of both hypomania and depression must be present for at least 2 years in adults and 1 year in children and teenagers. Periods of normal mood may be present as well, but these episodes should be brief, lasting fewer than 8 weeks at a time.
- Other specified (and unspecified) bipolar and related disorder: This miscellaneous diagnosis addresses bipolar-like symptoms that don’t fall under any of the above categories.
Seeking Treatment for Bipolar Disorder
If you or a loved one is suffering from bipolar disorder, you should know that help exists. While it may take time to find the right treatment plan, a combination of medication, psychotherapy, lifestyle changes, and nutrition and supplements can reduce the frequency and severity of bipolar symptoms.
The standard treatment for people suffering from bipolar disorder includes medication to address the highs and lows that characterize the condition. Some of the more commonly prescribed medications for bipolar disorder include mood stabilizers, antipsychotics, antidepressants, and anti-anxiety drugs. Finding the right mix of medications can take time, so be sure to let your health care provider or mental health professional know what’s working and what’s not as well as any side effects you may be experiencing.
When used alongside medication, psychotherapy can be extremely beneficial for people with bipolar disorder. Some of the more effective forms of therapy include:
- Cognitive behavioral therapy: CBT is useful for addressing ongoing issues, identifying symptom triggers, finding more effective ways of coping, and developing new, more positive ways of processing feelings, thoughts, and behaviors.
- Interpersonal and social rhythm therapy: IPSRT helps people with bipolar disorder better manage mood symptoms by working to establish routines for everyday activities like eating and sleeping.
- Family-focused therapy: Involving family members in the therapeutic process helps create a social support system that can aid in identifying and managing mood swings and assisting patients with treatment adherence.
- Psychoeducation: Intervention designed to educate patients and their families about bipolar disorder can make coping with the illness and sticking with treatment much easier.
Certain lifestyle changes can also be helpful for creating new, more positive patterns of behavior to replace negative patterns that worsen symptoms. For example, avoiding drugs and alcohol, tracking how moods are affected by various treatments, establishing a support system, and striving for plenty of sleep and exercise can help individuals with bipolar disorder get control over their symptoms.
Nutrition and Supplements
Although relatively few studies have looked at complementary approaches to the treatment of bipolar disorder, more and more research is beginning to demonstrate a link between food and this condition. In fact, studies have shown that deficiencies in omega-3 fatty acids, B vitamins, minerals, and amino acids are commonly seen in people suffering from mood disorders, including bipolar disorder.
A 2008 study found that people with bipolar disorder are subject to a number of specific biochemical imbalances, including “oversensitivity to acetylcholine, excess vanadium, vitamin B deficiencies, a taurine deficiency, anemia, omega-3 fatty acid deficiencies, and vitamin C deficiency.”
This study also found that amino acids that function as neurotransmitters are helpful in reducing the symptoms associated with bipolar disorder. Amino acids that have been identified as useful in the treatment of the illness include taurine, phenylalanine, tryptophan, and S-adenosyl-L-methionine (SAM).
In addition, research presented at the 2018 conference of the European College of Neuropsychopharmacology (ECNP) found that bipolar disorder patients who had lower body mass indexes (BMIs) and ate anti-inflammatory diets that contained plenty of fruits and vegetables had greater reductions in their symptoms, especially when augmented by supplements known for their anti-inflammatory properties—including the amino acid N-acetylcysteine (NAC).
If you or someone you love is suffering from symptoms of bipolar disorder, be sure to discuss your treatment options with your health care provider or mental health professional. And be open with them about your symptoms and any supplements you’re taking. Bipolar disorder is a serious medical condition, but with proper care and support, you can maintain normal moods and lead a productive and fulfilling life.