People with bipolar disorder experience dramatic shifts in mood, energy and activity levels, affecting their ability to function in their daily lives. Bipolar disorder was previously known as manic-depressive disorder due to its characteristic changes in mood from the high end of the mood spectrum (mania) to the low end (depression). The National Institute of Health estimates that 4.4% of adults in the United States experience bipolar disorder at some point in their lives.

Manic Phase

The manic phase of bipolar disorder is characterized by restlessness, high energy and racing thoughts. Mania can spiral into agitation, aggression or even violent behavior. Individuals experiencing a manic phase of bipolar disorder may:

• Experience hallucinations and euphoria
• Experience sudden and severe mood changes
• Lose touch with reality/have false beliefs or perceptions
• Feel invincible
• Show risky or impulsive behavior such as reckless activities or substance misuse
• Avoid sleep
• Become obsessed with a particular activity
• Make grand and unattainable plans

A manic phase may last from a week to months and may be triggered by highly stimulating environment (lots of noise, sound or crowds), major life changes, family history, other mental health disorders, substance use, lack of sleep or others. As manic triggers are unique to each person, it may be helpful to keep a journal to track events and moods in order to distinguish a pattern and become aware of triggers.

Depressive Phase

Following a manic episode, it’s common for people with bipolar disorder to then fall into a depressive period.

Some symptoms of bipolar depression are:

• Lack of motivation or desire to take part in daily life
• Overwhelming sadness
• Uncontrollable crying
• Little interest in activities that used to bring joy
• Feelings of sadness, hopelessness, worthlessness and/or even guilt
• Suicidal thoughts or ideations
• Changes in appetite
• Insomnia or excessive sleep

Bipolar disorder is classified into three types: bipolar I, bipolar II and cyclothymic disorder. Individuals with bipolar I experience both true mania and depression. People with bipolar II experience hypomania, which is less impairing than true mania, and may experience longer episodes of depression with the potential for them to become chronic.  Those with cyclothymic disorder experience hypomania and mild non-clinical depression.

Treatment for bipolar disorder may include:

• Psychotherapy: Talk therapy involves several sessions over a period of time with a mental health professional. This process helps identify and change emotions, thoughts and behaviors that may contribute to triggering bipolar mania episodes or that are impeding on effective management strategies for the disorder. There are many psychotherapy modalities, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and more. Therapy can include individual, group and/or family therapy.
• Psychoeducation: Psychoeducation is an educational and therapeutic process health professionals teach people about their mental health conditions. As bipolar disorder is a complex condition, learning about the condition can help clients and their loved ones manage and cope with it better.
• Medication: Medications can help bipolar symptoms. These include mood stabilizers, second-generation neuroleptics (antipsychotics) and antidepressants.
• Holistic therapies: Holistic therapies can be used in tandem with any other treatment methods. These may include yoga, mindfulness and meditation practices, equine therapy, massage and more.

Although the phases of bipolar disorder can be minimized and the symptoms managed, bipolar disorder is considered a life-long disorder and will require continuous care. This means that it’s important to find supportive healthcare professionals who can help their clients find an appropriate and accessible treatment plan.

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