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What is Bipolar Disorder?

Everyone has mood swings. Feeling elated one day and then down-in-the-dumps just a couple of days later is perfectly normal.

But when mood swings are severe and the shifts between extreme happiness and sadness occur daily or weekly, it may actually be a sign of bipolar disorder.

Being diagnosed with any mental health condition can be scary, and bipolar disorder is no exception. You may feel anxious, nervous, confused, or even embarrassed. On the other hand, you may feel relieved to have a diagnosis that finally explains the roller coaster.

    5 Fast Facts About Bipolar Disorder

  1. About 4.4% of US adults will be diagnosed with bipolar disorder.
  2. The average age of onset for bipolar disorder is about 25 — however, it can be diagnosed at any age.
  3. Bipolar disorder doesn’t discriminate — it affects all genders, ethnicities, and economic backgrounds. However, African Americans are less likely to receive a diagnosis, so they go untreated more often than Caucasians.
  4. There is no known cause of bipolar disorder.
  5. Nearly 83% of cases of bipolar disorder are classified as severe.

What is Bipolar Disorder?

Bipolar disorder — formerly called manic-depressive illness — is a mental health disorder that causes dramatic shifts in your mood, energy, and ability to think clearly. Everyday tasks become difficult, such as getting out of bed or going to work.

The hallmark of bipolar disorder is the pattern of high (manic) moods and low (depressive) moods. Each of these has their own symptoms.

Manic episodes often consist of feelings of extreme happiness, high energy, racing thoughts, or reckless behavior, such as drug use or spending sprees, without worrying about consequences.

Depressive episodes are drastically different. They involve extreme sadness; fatigue; low energy; and difficulty making decisions, concentrating, or remembering.

There are four types of bipolar disorder, and a person’s diagnosis will be based on the length, frequency, and severity of the manic and depressive episodes:

  1. Bipolar I Disorder is when someone has had one or more episodes of mania, which lasted for at least 7 days or was severe enough to be hospitalized. They will most likely have episodes of depression as well, but they do not need to have them in order to be diagnosed with bipolar I disorder.
  2. Bipolar II Disorder is when someone has had at least one depressive episode and one hypomanic episode — a less severe and shorter type of manic episode. They’re more likely to have longer periods of depression than people with bipolar I disorder.
  3. Cyclothymic Disorder (cyclothymia) includes both hypomanic and depressive episodes on a fairly regular basis. The mood swings and symptoms aren’t as extreme as they would be in someone with bipolar I or bipolar II. But they can lead to full episodes of mania or depression down the road.
  4. Other Specified and Unspecified Bipolar and Related Disorders have the symptoms of bipolar disorders but don’t meet the criteria for a diagnosis of any of the other three types. These disorders could be induced by alcohol or drugs, or be caused by a medical condition, such as multiple sclerosis or stroke.

Why Doesn’t Everyone With Bipolar Disorder Get Treated?

While there’s no cure for bipolar disorder, you can control symptoms, making it much easier to live with. Unfortunately, not everyone gets the help they need.

There are a few reasons why not everyone gets help who needs it:

Stigma

It’s not just bipolar disorder — there is a stigma around mental illness in general. In the US, up to 75% of people with mental health disorders do not get treatment, and stigma is one of the top reasons.

People with bipolar disorder may be ashamed, and feel as if they’re admitting something is “wrong” with them. What if others find out?

But the truth is you have nothing to be embarrassed about. Almost 44 million US adults experience mental health conditions each year, and more than 6 million adults are living with bipolar disorder. You are not alone.

Access to Care

There’s no denying that medical care can be expensive, especially if you don’t have insurance. And unfortunately, people with mental health conditions are more likely to be uninsured. This leads to skipping out on care.

Here’s the good news: If you can’t afford treatment, don’t give up. Talk to your healthcare provider about financial assistance programs or non-profit organizations that help with payments. Ask your pharmacist about manufacturers’ coupons, prescription discount cards, or smartphone apps that provide ways to save on prescriptions. With a little bit of research, the high costs of care don’t need to stand in your way.

Misunderstanding Treatment

Bipolar disorder is very biologically driven, meaning it has much to do with what’s happening inside your brain and body. This is one reason why symptoms can often be controlled so well with medication — which is also why some people might not get treatment.

If you’re weary about relying solely on medication, don’t let that stop you from getting help. Many treatment plans include medication, but also include other types of therapy, such as cognitive behavioral therapy (a form of psychotherapy, where you talk with a mental health professional to change your negative thoughts and behaviors).

Also, medication isn’t your only option. Many people are able to control symptoms with lifestyle changes, such as regular exercise — so you may not even need medication at all.

Going Undiagnosed

Sometimes, the biggest barrier to getting treatment is not knowing you need treatment in the first place.

Bipolar disorder often goes undiagnosed. Some people don’t bring up symptoms with their provider because of stigma or because they don’t recognize a problem.

Also, bipolar disorder can be tricky to spot and easy to misdiagnose — about 40% of patients with bipolar disorder were actually diagnosed with major depression at first. And without the right diagnosis, it’s hard to get the right treatment.

How Is It Treated?

Once you do decide to get treatment, you have many options on the table. You might try just one or a combination of a few. Since everyone is different, your provider will work with you to find a plan that’s best suited to your individual needs.

  • Psychotherapy

    Psychotherapy involves talking with a psychiatrist, psychologist, social worker, or therapist.

    You can do psychotherapy one-on-one, with your family and friends, or in a group.

    There are a few common types of psychotherapy used for treating bipolar disorder:

    • Cognitive behavioral therapy (CBT) helps you change your negative thoughts and behaviors into positive, healthy ones. This type of therapy can help you identify what triggers bipolar episodes. You will also learn strategies for coping with emotional or stressful situations.
    • Family-focused therapy gets the whole family involved. It provides your loved ones with support, educates them about the disorder, and encourages them to help you through your treatment.
    • Interpersonal and social rhythm therapy (IPSRT) helps you stabilize your daily rhythms — such as mealtimes, sleeping, and waking — and understand the link between routines and moods. It rests on the idea that a consistent routine makes it easier to manage moods, so people with bipolar disorder may benefit from having established daily routines.
  • Medication-Based

    If you and your provider decide to go the medication route, some common medications include:

    • Mood stabilizers that control manic and hypomanic episodes. Lithium is one of the most well-known mood stabilizers, but there are many types available.
    • Antidepressants, such as fluoxetine, help manage depressive periods. It’s possible for them to trigger manic episodes, but that doesn’t mean you can’t take them — they’re usually prescribed alongside a mood stabilizer or antipsychotic to lower that risk.
    • Antipsychotics, such as lurasidone, are often used when symptoms don’t go away with other medications. They’re also often used during a manic episode, since they act quickly.
    • Anticonvulsants are usually used to treat seizures, but they can also act as mood stabilizers and are commonly prescribed for bipolar disorder treatment. Lamotrigine is an anticonvulsant that can help treat depression and reduce mood swings.

    It might take a few tries to find the medication and the specific dosage that is best for you. This can be frustrating, but try to stay patient during this process — just because something doesn’t work right away doesn’t mean it (or a different medication) will never work at all.

    Some medications can cause side effects, such as dizziness, nausea, rash, confusion, tremors, or weight changes. Tell your provider right away if you experience any of these, as they may need to switch your medications or alter your dose.

    If you’re not happy with the side effects, don’t stop the medication on your own. Stopping suddenly can cause withdrawal effects — such as anxiety or flu-like symptoms — and make symptoms of bipolar disorder worse.

  • Electroconvulsive Therapy (ECT)

    In rare cases, you may be referred to a provider who practices electroconvulsive therapy (ECT), or “shock” therapy. ECT sends electrical currents to your brain, triggering a brief seizure — usually less than a minute — and relieving depression.

    It’s not quite as scary as it sounds. You will be given anesthesia — a medication to make you sleep so you don’t feel anything or remember the treatment. And, physicians and nurses will be monitoring you while you’re having the seizure.

    Also, ECT is typically a very safe procedure. There is a risk of side effects, such as confusion or muscle aches, but they usually are not severe or permanent. It has not been shown to increase your risk for more seizures in the future.

    When used for bipolar disorder, ECT is usually given after other medications haven’t worked or if you can’t take antidepressants for health reasons, such as being pregnant.

  • Inpatient Treatment

    In severe cases, bipolar disorder can cause someone to attempt or commit suicide. If you find yourself thinking about ending your life, you may need to be hospitalized and receive 24/7 medical care.

    If you are feeling suicidal, call (800) 273-TALK (800-273-8255) to reach the toll-free, 24/7 National Suicide Prevention Lifeline where you can talk to a trained counselor.

    For more information on Stormont Vail Health’s Adult Inpatient Program, call (785) 270-4646.

  • Non-Medical Approaches

    There are other methods for managing symptoms of bipolar disorder. They are not cures, and they may not replace medication or psychotherapy. However, they can make living with bipolar disorder easier:

    • Exercise: Physical activity is known to combat depression, and it may improve long-term management of bipolar disorder. It can also improve symptoms of insomnia, anxiety, and pain, which are disorders that often occur alongside bipolar disorder, and can potentially make bipolar disorder symptoms worse.
    • Eat well: Like exercise, a nutritious diet is a well-known way to fight depression. Also, it can protect you against diabetes, obesity, heart disease, and stroke — all of which are common in people with bipolar disorder.
    • Create a daily routine and stick to it: Consistency can be key in managing moods.
    • Get a good night’s sleep. In general, adults need about 7 to 9 hours per night. Sleep deprivation can cause bad moods and feelings of depression, and insomnia can trigger manic episodes.
    • Develop relaxation techniques: Controlling your breathing can help you healthily cope with stressful situations that affect your mood. There are many ways to go about this, such as yoga, meditation, or deep breathing. Talk to your primary care or mental health provider about the ways that are best for you.
    • Try acupuncture: Acupuncture uses very thin needles inserted into certain parts of your body to balance the flow of energy. It’s usually used for pain management, but it’s also becoming increasingly common for stress relief.

Starting treatment as soon as you can is important, since going untreated can make symptoms worse.

For some people, it’s easy to get started — the hard part is sticking with it. Unfortunately, many people with bipolar disorder stop their treatment when they feel the depression lift. However, treatment shouldn’t be skipped just because you’re feeling better.

Bipolar disorder is a lifelong condition. Even if you’re feeling great with treatment, that doesn’t mean you’ve been cured. Once you stop treatment, the symptoms will come back, and they could be worse than before.

Suffering on the Side: Are You Married to Someone with Bipolar Disorder?

When your spouse has bipolar disorder, it doesn’t just affect them — eventually, it can take a toll on your marriage. In fact, 90% of marriages end in divorce when one partner has bipolar disorder — more than twice the average divorce rate in the US.

But you don’t need to lose hope.

Don’t be afraid to get help from a family therapist or marriage counselor. A mental health professional can work with you on finding ways to cope with the physical and emotional effects of bipolar disorder, as well as ways to keep your marriage strong.

In severe cases, bipolar disorder can lead to domestic violence or child abuse. Make sure that you and your children have a safe place to go if this ever occurs. Call 911 right away if your spouse is putting you or your child in danger.

Caring for Yourself

Watching someone you love struggle with bipolar disorder isn’t easy on your own mental or physical health. Your stress levels can increase, which can put you at risk for developing conditions such as anxiety, depression, or heart disease. You might become overwhelmed as you think about how to balance the responsibilities of caring for them with the responsibilities you already have.

You can’t fully take care of your loved one until you’ve taken care of yourself, too. When their bipolar disorder is affecting your mental and physical health, try these tips:

  • Commit to me-time: Block off some chunk of time where you can be uninterrupted doing something that you enjoy, whether it’s 10 minutes of prayer or meditation, an hour at the gym every other day, or staycation at a local hotel.
  • Don’t give in to stress eating: Plan meals ahead of time, keep a food diary, work with a dietitian — whatever it takes to make sure you’re eating well.
  • Get enough sleep: Most adults need about 7 to 9 hours of sleep per night. Being overtired can increase your risk of depression, heart disease, diabetes, or drowsy driving, which can lead to car accidents.
  • Talk to a therapist or social worker: Getting professional help is one of the best things you can do to keep your mental health in check and cope with your emotions.

Why Choose Stormont Vail

Located in Topeka, Kansas, Stormont Vail Health is a community-driven organization. It offers close to home care and with limited travel requirements, it will be easier for you to get the bipolar disorder care you need in a community you trust.

In 2018, Stormont Vail achieved Magnet designation for a third time. Magnet designation is one of the highest awards in nursing excellence and high-quality patient care. Only 9% of US hospitals have earned this recognition. The Joint Commission — with more than 50 years of accrediting hospitals in high quality standards — has also accredited Stormont Vail Hospital.

With a team of behavioral health providers that’s been recognized for excellence with the prestigious Magnet designation, Stormont Vail Health has an experienced and skilled medical team to help you manage your bipolar disorder care.


Next Steps

Make an Appointment

See a Primary Care Provider

  • Call (785) 270-4440 to schedule an appointment with your Stormont Vail primary care provider.
  • Not a Stormont Vail patient? Call (785) 270-4440 to set up your first appointment with one of our primary care providers.