Bipolar disorder is a disruptive lifelong condition. It affects you, your family, and other loved ones. It’s characterized by periods of “highs” and “lows.” These recurring episodes can make life unproductive and unstable. During each cycle, you may experience hyperactivity and irresponsibility or severe depression. Getting diagnosed and seeking treatment immediately can help you function and avoid issues it may cause.
How Is Bipolar Disorder Diagnosed?
Getting a proper diagnosis is the first step toward treating bipolar disorder. Unfortunately, though, it can be difficult. Many other disorders share similar symptoms with bipolar disorder, making it hard to distinguish between them. Major depression, ADHD, and borderline personality disorder share the main symptom of bipolar disorder: mood swings. Those who have bipolar disorder often see a doctor many times before they are properly diagnosed.
Since it can be difficult to diagnose bipolar disorder, it’s best to see a psychiatrist instead of your family doctor or another professional. Psychiatrists are specialized in treating mental health issues. Psychiatrists are also often more familiar with recent research and treatment options.
What to Expect During the Diagnostic Tests
When you visit a psychiatrist, they will do a complete diagnostic exam. It will consist of the following:
• Psychological evaluation – Your doctor will perform a psychiatric history. You will be asked about your symptoms, how long you’ve had them, any treatments you have tried, and your family history.
• Medical history – There aren’t any lab tests to determine if you have bipolar disorder. Your doctor should receive your medical history to rule out any possible illnesses or medications.
• Physical exam – A physical exam can rule out any health issues you may have that are mimicking the disorder. For example, thyroid disorders can cause mood swings that mirror bipolar disorder. Some other conditions that cause bipolar disorder symptoms are neurological disorders, adrenal disorders, and vitamin B12 deficiency. Medications that mimic bipolar disorder symptoms are corticosteroids, antidepressants, anti-anxiety drugs, and drugs for Parkinson’s disease.
Your doctor may go a step further and speak with family and friends to gain a more objective view of your symptoms and behavior. From there, a diagnosis can be made.
Types of Bipolar Disorder
There are three types of bipolar disorder. Each one is determined by their manic episodes and depression. Your bipolar disorder treatment plan will vary depending on the type you’re diagnosed with. Your doctor will evaluate your symptoms and identify which type they belong to.
• Bipolar I Disorder (mania and depression) – Bipolar I Disorder is the most severe type of the illness. It’s characterized by at least one manic episode or a mixed episode. The majority of people diagnosed with Bipolar I Disorder have also experienced at least one depressive episode. Depressive episodes aren’t required for a Bipolar I diagnosis.
• Bipolar II Disorder (hypomania and depression) – In Bipolar II Disorder, mania isn’t experienced. This type cycles between depression and hypomania. Hypomania is a milder form of mania. Those diagnosed with Bipolar II Disorder must have had at least one hypomanic episode and one major depressive episode. If you ever experience a manic episode, your diagnosis will be re-identified as Bipolar I Disorder.
• Cyclothymia (hypomania and mild depression) – Cyclothymia is a mild form of bipolar disorder. Cyclothymia has cyclical mood swings. The difference between cyclothymia and bipolar relates to the fact that the highs and lows aren’t as severe to qualify as either major depression or mania. The diagnosis for cyclothymia requires that you experience several hypomanias and mild depressive episodes over two years. People diagnosed with cyclothymia must be monitored and treated closely as there’s an increased risk for developing a full bipolar disorder.
Differences Between Depression and Bipolar Disorder
Bipolar disorder is often misdiagnosed. Most people who have bipolar disorder tend to seek help during their depressive episodes, leading to a misdiagnosis of depression. When in the manic stage, a problem isn’t recognized.
People with bipolar disorder are often more depressed than they are manic or hypomanic. A misdiagnosis is potentially dangerous. This is due to the different ways depression and bipolar disorder are treated. For depression, you’d normally receive therapy and an antidepressant. Antidepressants can make bipolar disorder worse. If you are having any symptoms of bipolar disorder, it’s important to be evaluated by a mood disorder specialist so that you can find out what’s wrong and avoid misdiagnosis.
How to Tell If You Have Depression or Bipolar Disorder
There are some indicators that your depression may be bipolar disorder:
1. You have a first-degree relative with bipolar disorder.
2. You had a major depressive episode before the age of 25.
3. Your depressive episodes last less than three months.
4. You experience/experienced repeated episodes of major depression
5. You’ve had post-partum depression.
6. When you aren’t depressed, your energy and mood levels are higher than other people’s.
7. When you are depressed, you tend to overeat and oversleep.
8. While depressed, you lose contact with reality.
9. You’ve developed mania or hypomania while taking antidepressants.
10. The antidepressant you were taking stopped working after a few months.
Bipolar Disorder Treatment Options
Once your doctor completes an evaluation and determines that you have bipolar disorder, he or she will go over a treatment plan with you. The treatment plan may include medication and various types of therapy options.
Depending on your doctor’s services, he or she may refer you to another mental health professional. This can be a counselor, psychologist, or bipolar disorder specialist. It’s important to remember that as the patient, you will work with your providers on a personalized treatment plan. Treatment options aim to not only treat your symptoms but also enable you to function, fix any problems your illness causes you at home or work, and reduce the illness’s recurrence. Treatment may include:
• Medications – Medications are essential to treating bipolar disorder. Mood stabilizers help manage your highs and lows while also keeping other symptoms at bay. Some medications may make you feel unemotional or tired. While it takes some time for medications to work, be sure to share any unpleasant side effects you are experiencing with your doctor.
• Psychotherapy – Bipolar disorder can disrupt your work and home life. You may be feeling overwhelmed or unsure of how to fix the issues it has caused. Speak with a therapist and learn how to cope with your feelings, repair your relationships with others, manage stress, and regulate your mood.
• Education – While therapy and medication help with your bipolar disorder symptoms and the life problems they have caused, knowing how to manage your disorder can help a great deal. It can be frustrating to experience a setback. Knowledge of your disorder for both you and your loved ones can help with avoiding problems and managing symptoms.
• Lifestyle changes – Your symptoms and mood episodes can be kept to a minimum by making lifestyle changes. Avoid alcohol and drugs, maintain a proper sleep schedule, follow an exercise program, keep stress to a minimum, eat a mood-boosting diet, and get adequate sunlight year-round.
• Support network – A support network for those with bipolar disorder is crucial. Support networks help you in times of stress and setbacks. This can mean connecting with your friends and family or a bipolar disorder support group. Bipolar disorder support groups can be very beneficial. You not only share your struggles but also listen to and learn from those who are experiencing similar things you are.
Types of Therapy for Bipolar Disorder
There are many ways to treat bipolar disorder. One of the first steps is getting on medication. While not all of those who are diagnosed with bipolar disorder need medication, most do. Medication helps keep the symptoms under control. Long-term use of medication reduces episodes and their severity and sometimes prevents them altogether.
Medications can have negative side effects, and you may feel opposed to taking them. Your doctor will find the right combination of drugs to help you, and it may take a few tries to get the right ones. If a medication is giving you unpleasant side effects or isn’t working, speak with your doctor.
While taking bipolar medication, you’ll need blood tests to make sure that they’re not causing your body any harm. The right dose will differ from person to person and is based on various things. Your doctor will closely monitor you while on a medication to make sure that you are safe and it’s working.
Once you find the right combination that works, you must keep taking it. Many people stop medication therapy once they start to feel better. Stopping your medications, however, can result in symptoms returning. Medication can make you feel better, and you might want to stop therapy or live life as if nothing is wrong.
It’s important to remember that living life with your support system, therapy, and proper diet and sleep only benefits you. If you are diagnosed with bipolar disorder, you won’t be put on an antidepressant, but be sure to tell your doctor if you’re on one. It’s best to avoid them altogether because antidepressants trigger episodes and cause rapid cycling between them.
In terms of therapy, there are generally three types used for the treatment of bipolar disorder. They are:
1. Cognitive behavioral therapy (CBT)
CBT teaches you to evaluate how your thoughts affect your emotions. It deals with changing negative thinking patterns and behaviors to more positive outlooks. Problem-solving, symptom management, and avoiding triggers are the main focuses of treating bipolar disorder.
2. Interpersonal and social rhythm therapy
Interpersonal therapy focuses on your relationships with others. By being able to solve your relationship problems and how you relate to others, you can reduce stress. Stress triggers bipolar disorder, and this approach helps with reducing mood cycling.
Social rhythm therapy is typically combined with interpersonal therapy. It’s thought that those who suffer from bipolar disorder have sensitive circadian rhythms. Your “clock” is easily disrupted when you change your daily social rhythms. Social rhythm therapy focuses on a proper diet, sleep schedule, and exercise routine. Keeping these stable regulates your moods.
3. Family-focused therapy
Bipolar disorder not only affects you but your loved ones as well. It can be difficult living with someone who has this disorder. This doesn’t mean that you are a burden if you have bipolar disorder, but therapy can help better manage your relationships with others. Family-focused therapy is different from interpersonal therapy because it deals with making your home life supportive, addressing issues and fixing them, and educating family members on the disorder.
Standard therapies combined with alternative therapies have been shown to be successful in treating bipolar disorder. Some complementary treatments include:
1. Light and dark therapy
Similar to social rhythm therapy, light and dark therapy focuses on your sensitive internal “clock.” Sleep-wake cycle disturbances can be a trigger for mania and depression. Light and dark therapy regulates biological rhythms and reduces mood cycling by managing your exposure to light. Artificial light is restricted for 10 hours each night.
2. Mindfulness meditation
Mindfulness uses meditation, breathing exercises, and yoga to bring your awareness to the present moment, breaking any negative thought patterns. Research is promising. It shows that when combined with cognitive therapy, it helps manage anxiety, depression, anger, and irritability.
Acupuncture has been shown to help with several ailments. For bipolar disorder, it may help modulate your stress response. Studies on acupuncture for depression and mania show a relief of symptoms.
If you think you’re living with bipolar disorder, there is no need to suffer in silence when you can access the available resources and get the help you need.