Bipolar Disorder: The Ultimate Guide | 3 Types, Causes, Symptoms, and Diagnoses

Bipolar Disorder

The Manic Depression or Bipolar Disorder

Bipolar Disorder is a serious mental illness that’s thought to be caused by an imbalance in the way brain cells communicate with each other. 

‘Bipolar disorder is a relatively new term and has gradually replaced ‘manic depression’ as the official name for this condition. 

The term ‘manic depression‘ was first coined in 1896 by Emil Kraepelin, a German doctor. It was widely used in the psychiatric world throughout the twentieth century, until the American Psychiatric Association renamed it in 1980 as ‘bipolar disorder’ – to reflect the ‘bi-polarity, or dual nature, of the illness (the highs and lows). 

The brain imbalance causes extreme mood swings that go way beyond the normal ‘ups and downs of everyday life, wildly exaggerating the mood changes that everyone has. 

Bipolar patients can have long or short periods of stability but then go ‘low’ (into deep depression) or ‘high’ (experiencing mania or psychosis). They can go into a ‘mixed state’ too, where symptoms of depression and mania occur simultaneously.

Bipolar Disorder Types

There are three major types of bipolarities, known as Bipolar I, Bipolar II, and Bipolar III. 

To be diagnosed with Bipolar I, a person will have experienced at least one fully manic episode in their lifetime, along with one major episode of manic depression. Around 1% of the general population is thought to develop Bipolar I during their lives. 

Bipolar II is diagnosed when someone’s mood swings between major episodes of depression and periods of hypomania rather than manic episodes. The incidence of Bipolar II is estimated to be about 4–5% of the general population. 

Cyclothymia or Bipolar III – Suppose a person’s depressive and manic symptoms last for two years but are not severe enough to qualify as bipolar disorder. They may instead be diagnosed with ‘cyclothymia’ which is a milder form of bipolar. A

Bipolar is not in the official rulebook. Confusingly, cyclothymia is also sometimes referred to as Bipolar III. 

In terms of diagnosis, this is a tricky area. Even the world’s leading experts on mental health can’t agree and probably never will. After all, what’s normality, and what’s cyclothymia.

In the US, Bipolar II and III are sometimes referred to as ‘soft’ bipolar.

Bipolar Disorder Causes

People often ask if mental illnesses are caused by genes (‘nature’) or environment (‘nurture’). Many research studies show a tendency for bipolar disorder (along with other mental illnesses) to run in families. 

So is it all down to someone’s genetic ‘blueprint’? 

No. All human characteristics are a combination of genes and experiences. 

And, it’s now widely recognized that environmental factors can affect both the structure of our brain and our mood – both on a day-to-day basis and in the long term. 

Of course, all individuals differ in their life experiences and the genes they inherit from their parents, so the relative importance of genes and environment will vary from person to person. Having a genetic predisposition to bipolar disorder in the family doesn’t mean somebody’s destined to develop it. 

The best way of illustrating this is to look at studies of identical twins. If one twin has bipolar disorder, their genetically identical sibling has a 60% chance of developing the illness and a 40% chance of staying bipolar-free. If a bipolar disorder were purely genetic, both twins would be diagnosed 100% of the time. 

So if the cause of bipolar disorder can’t be purely genetic, what other environmental, mental factors can cause bipolarity?

  • Upbringing may play a part for some people, such as the traumatic childhood shared by Amanda’s mum and Sarah’s dad. 

  • Stress and depression due to positive and negative events are highly involved in triggering bipolar and other mental illnesses.

  • The use of street drugs such as cannabis can also trigger bipolar and other mental disorders.

  • Hormonal changes, particularly for women going through menopause.

  • Persistent lack of sleep can be a trigger.

What are Bipolar Disorder Symptoms?

People with bipolar often swing between depression and mania. But there’s no ‘typical’ pattern of symptoms. 

Every bipolar person is different, and the length of time they spend in extreme mood (high or low) is very variable – it can be days, weeks, or even months. 

A person with bipolar disorder can have any number of episodes of highs and lows throughout their life. There can be periods of normal mood in between the two extremes. 

Still, some people can swing between depression and mania quite quickly without a period of stability in the middle. 

More than four mood swings in one year are known as ‘rapid cycling bipolar disorder,’ and some people who rapid cycle can have monthly, weekly, or even daily mood swings (sometimes called ‘ultra-rapid cycling’). 

According to the latest Diagnostic and Statistical Manual of Mental Disorders or DSM IV, the typical symptoms of bipolar disorder are the following:

– Stress

– Mania

– Anxiety

– Psychosis

– Depression

– Hypomania

– Suicidal Thoughts

– No Attitude of Gratitude

– Alcohol and Drug Abuse

Whereas other ‘unofficial’ symptoms include anxiety, low self-esteem, libido problems, and self-harm.

Bipolar Disorder is often Misdiagnosed

In one national survey, 70% of people with bipolar disorder were initially misdiagnosed. Why so?

Well, the first clue that someone has bipolar disorder is often a depressive episode. If someone seeks help from their family doctor at this point, and if the patient mentions no mention of previous mania or a family history of bipolar disorder, the doctor is likely to make a diagnosis and suggest treatment for depression. 

On the other hand, first experiences of mania are not always reported. 

A manic episode, especially in the early stages, often feels so enjoyable that the person experiencing it can’t see the problem. 

Their family and friends may be alarmed and try to intervene, but for the manic person, feeling euphoric and invincible, it seems as if everyone else is trying to spoil their fun: ‘Why should I go to the doctor? There’s nothing wrong with me!’

On average, someone with bipolarity has to consult four different doctors before making the correct diagnosis. 

Andrea Sutcliffe, deputy chief executive of NICE, says: ‘ bipolar disorder often goes unrecognized or misdiagnosed. And concluded with, “more right ways still needs to be introduced to raise awareness of the condition and effective treatments.”

The Final Takeaway: Treatment of Bipolar Disorder

So, most of you must be thinking, what is the most effective way to treat bipolar disorder? 

It can’t be said enough times that bipolar disorder is a lifelong condition like diabetes or asthma. The treatment for bipolar is the management of a chronic illness, not a permanent cure.

Hey! Don’t lose hope. This isn’t necessarily bad news. 

So much more can be done nowadays to treat bipolar disorder successfully, reduce or remove symptoms, and help someone with a diagnosis live a happy and stable life. 

Promoting a healthy lifestyle, taking the right medication, and taking good care of the patient will surely help prevent future relapse. 

Read more related resources – ‘8 Tips If You Feel Like You are getting Manic,’ by BIPOLAR BANDIT (MICHELLE CLARK).

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Nidhi Thakur

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