What Is Bipolar Disorder? What Psychiatrists Want You to Know

Treatment can be lifesaving for this complicated mental illness.

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Bipolar disorder is more than just, say, intense mood swings; this mental health disorder can take a dramatic toll on patients’ lives, affecting their ability to succeed at work, maintain healthy relationships, and take care of responsibilities like managing finances. It may also be more common than you think: Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population, according to the National Institute of Mental Health.

Unfortunately, bipolar disorder is often poorly understood and surrounded by misconceptions about what symptoms actually look like or why it’s critical to receive a proper diagnosis and treatment. Here, mental health experts shed light on key facts about bipolar disorder that all patients (and those who love or help care for them) should know.

Bipolar disorder has two main types.

  • Bipolar I consists of depression alternating with true manic episodes, which include psychotic symptoms. Psychosis is a break from reality when you see, hear, or believe things that aren’t really there.

  • Bipolar II involves depression alternating with hypomania, which is a milder form of mania that does not include psychosis. Hypomania consists of an elevated mood, which can present as either euphoric or irritable.

Occasionally, patients with bipolar disorder may experience a mixed state, which is depression and hypomania at the same time. Another lesser-known state is cyclothymia, according to Gail Saltz, MD, a psychiatrist at New York-Presbyterian Hospital, Weill Cornell Medicine. This is an up-and-down fluctuation between mild depression and mild hypomania, without ever becoming severely manic or depressed.

Recognizing Mania

Most people are familiar with depression symptoms, but mania might be a little harder to recognize. Mania isn’t just a prolonged good mood or burst of energy. When someone with bipolar disorder is experiencing mania, the following symptoms may occur, according to Ben Michaelis, PhD, a psychologist in New York City.

  • Heightened confidence

  • Decreased need for sleep

  • Experiencing racing thoughts

  • Being more talkative than usual

  • Engaging in risky activities, which can range from substance abuse to excess spending

Many people with bipolar disorder experience mania seldomly. Many patients may look and feel depressed most of the time and may not seem bipolar. In fact, you only need to have experienced one manic episode in your life to be diagnosed with bipolar disorder, says Susan Samuels, MD, a psychiatrist at New York-Presbyterian Hospital, Weill Cornell Medicine.

Depression symptoms include:

  • Feeling sad most of the day, every day

  • Feeling hopeless or worthless

  • Inability to concentrate

  • Loss of enjoyment in things you used to like

Treatment for Bipolar Disorder

Typically, doctors treat bipolar disorder using mood stabilizers, according to Dr. Samuels. These neutralize and stabilize the high and low moods. Additional medication may also help treat specific symptoms of bipolar disorder.

In addition to taking medication, patients with bipolar disorder also benefit from psychotherapy. “Bipolar disorder—untreated—is dangerous,” says Dr. Saltz. “It really can wreak havoc with your life, marriages split up, jobs are lost.” Together, medication and psychotherapy can help patients avoid the consequences of risky behaviors and poor decision making.

Seeking and following treatment for bipolar disorder is crucial. Ignoring a mental health issue can make symptoms more severe or harder to manage. Getting the right diagnosis is also key, as bipolar disorder can be mistaken (and mistreated) for other mental health issues like depression. Suicide rates are high among patients with bipolar disorder (as many as one in five patients with bipolar disorder completes suicide), so getting treatment could even save your life.

“This is a deadly illness if left untreated,” says Dr. Saltz. “This is an illness that must be treated.”