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Help With Bipolar Disorder

Curated and updated for the community by APA

Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.

People without bipolar disorder experience mood fluctuations as well. However, these mood changes typically last hours rather than days. Also, these changes are not usually accompanied by the extreme degree of behavior change or difficulty with daily routines and social interactions that people with bipolar disorder demonstrate during mood episodes. Bipolar disorder can disrupt a person’s relationships with loved ones and cause difficulty in working or going to school.

Bipolar disorder is a category that includes three different diagnoses: bipolar I, bipolar II, and cyclothymic disorder.

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  • Oct 30, 2020
Putting a Care Plan in Place Before a Mental Health Crisis

A Psychiatric Advance Directive (PAD) can be useful tool to help people with serious mental illness plan ahead and have more control over their treatment during a time of crisis. However, they can only be effective when they are prepared in advance and implemented when needed. A PAD (sometimes called a mental health advanced directive) is a legal document that includes a list of instructions and preferences that the individual wishes to be followed in case of a mental health crisis.

  • Nov 06, 2019
Treatments are Available for the So-called Winter Blues

As we move toward winter with shorter daylight hours and falling temperatures, many people begin to feel the cloud of seasonal depression. Seasonal affective disorder (SAD) is a form of depression that occurs seasonally, typically in the winter months. SAD is not just the winter blues – SAD is a subtype of major depressive disorder. It can also occur during summer, but it is much less common that time of year.

  • Nov 19, 2018
Managing Holiday Anxiety and Depression

You may be feeling a build-up of anxiety this holiday season. Thoughts of all the events and gatherings with family, coworkers and friends may fill you with anticipation along with a little angst.

How quickly does a person with bipolar disorder shift between highs and lows?

It depends. Mood shift frequency varies from person to person. A small number of patients may have many episodes within one day, shifting from mania (an episode where a person is very high-spirited or irritable) to depression. This has been described as “ultra-rapid cycling.” More

Does having one manic episode necessarily mean you will have more and will have depressive episodes?

Not necessarily. Studies have shown that approximately 10 percent of patients have a single episode only. However, the majority of patients have more than one. The number of episodes within a patient’s lifetime varies. Some individuals may have only two or three within their lifetime while others may have the same number within a single year. Frequency of episodes depends on many factors including the natural course of the condition as well as on appropriate treatment. Not taking medication or taking it incorrectly are frequent causes of episode recurrence. More

Can someone with bipolar disorder be treated without medication?

Although it is possible that during the natural course of the illness individual patients may get well without any medication, the challenge is that it is impossible to identify or determine beforehand who those fortunate patients are. Although some patients don’t get well or just have partial response to the best available treatments, on average — and for the vast majority of patients — the benefits of medications outweigh the risks. More

What is a “mixed episode?”

The term “mixed episode” was changed to “mixed features” in the last edition of the Diagnostic and Statistical Manual (DSM-5) published by the American Psychiatric Association in 2013. The new term may apply to either episodes of mania with additional symptoms of depression or the opposite, episodes of depression with additional symptoms of mania. The overall idea is that the presence of both symptoms of mania and depression can exist at the same time. Symptoms of mania include elated or irritable mood, decreased need to sleep or racing thoughts. Symptoms of depression can include depressed mood, impaired sleep and feelings of hopelessness or worthlessness. More

Could my child have bipolar disorder?

It is possible for children to have bipolar disorder. This mental illness occurs in approximately 1 to 3 percent of the general population, and studies have shown that bipolar disorder has a genetic component. However it is also possible for bipolar disorder to appear in someone who has no family history of the disease. More

What can family members do to support a person with bipolar disorder?

Outcomes are always better when there is a strong family support network. Think of bipolar disorder as any other severe medical condition. However, also note that in many severe psychiatric conditions, patients may not be aware that they are ill. They may minimize the severity of their condition. The result of these factors may be that patients will not follow through on their treatment. In very severe cases, there may be instances of a lack of behavioral control where family members may not be able to look after their loved ones. In those cases, assistance from providers or even law enforcement agents may be necessary. More

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About the Expert:

Mauricio Tohen, M.D., Dr.PH, M.B.A.
University Distinguished Professor and Chairman, Department of Psychiatry and Behavioral Sciences
University of New Mexico Health Sciences Center

Chelsea's Story

Chelsea was a 43-year-old married librarian who came to an outpatient mental health clinic with a long history of depression. She described being depressed for a month since she began a new job. She had concerns that her new boss and colleagues thought her work was poor and slow, and that she was not friendly. She had no energy or enthusiasm at home. Instead of playing with her children or talking to her husband, she watched TV for hours, overate and slept long hours.

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Editor's Choice

MAY 20 2021

 Reasons for endorsing or rejecting self-binding directives in bipolar disorder: a qualitative study of survey responses from UK service users
The Lancet

This study is, to our knowledge, the first large study assessing the reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health services as well as advance decision-making practice and policy, and might help address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity.

MAY 19, 2021

6 Reasons Bipolar Patients Don't Take Their Meds     
Health Day

Not taking prescribed medications can lead to relapse, hospitalization and increased risk of suicide for people with bipolar disorder, yet many who have this condition do not take their medicines as prescribed. A new study examines why this happens, finding six key factors that stop people who have bipolar disorder from taking their medications. The reasons include unpleasant side effects, difficulty in remembering to take the medications, fear of addiction, and preference for an alternative treatment. 

MAY 18, 2021

Types of bipolar disorder
Psych Central

There are three main types of bipolar disorder, along with additional specifiers. Even within these, each person’s condition will be unique to them. The three main types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Your doctor or mental health professional may also talk about additional specifiers — extra features that can occur with bipolar disorder. These include anxiety, psychosis, and seasonal changes. 

Resources

Additional Resources and Organizations

Depression and Bipolar Support Alliance

International Bipolar Foundation

International Society for Bipolar Disorders

Mental Health America

National Alliance on Mental Illness

Physician Reviewed
Molly Howland, M.D.
Alex El Sehamy, M.D., APA/APAF Fellow
January 2021