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Introduction & Overview of Bipolar Disorder​

A 2013 study from The University of Queensland School of Public Health in Australia found that approximately 48.8 million individuals worldwide live with Bipolar Disorder. We know that there has been a lot of misunderstanding regarding Bipolar disorder in the past. This misunderstanding leads to over-diagnosing and over-medicating individuals who do not have Bipolar Disorder. Bipolar disorder is not as common as we thought. Those living with Bipolar Disorder can speak to the significant impact it that can have on their lives.

Before we can talk about the different Bipolar Disorders, we need to discuss the symptoms that you can experience. This would include a Manic Episode, a Hypomanic Episode, and a Depressive Episode.

Manic Episodes are often depicted in movies and television shows as someone who is not sleeping, talking fast, whose thinking is all over the place, who is erratic. This is not an entirely false description, but keep in mind that the symptoms shown are supposed to make good television, not necessarily educate us. Signs you may experience during a manic episode can include:

• Mood disturbance (this can be irritability or feeling euphoric) for a minimum of one week
• Increased energy and activity along with at least three of the following symptoms, four if irritability is the only mood disturbance:
  • Increased self-esteem or grandiosity
  • Not needing to sleep as much, feeling rested after small periods of sleep
  • Being more talkative than usual
  • Having racing thoughts
  • Easily distracted 
  • An increase in goal-driven behaviors or restlessness 
  • Engaging in more dangerous or risk-taking behaviors than usual
• Your symptoms have a significant impact on your functioning at work and home, or symptoms pose a danger to your health 

Hypomanic Episodes are similar to manic episodes, with noticeable differences. Below are symptoms associated with hypomanic episodes:

• Mood disturbance for a minimum of 4 days
• Increased energy and activity with at least two of the following symptoms
  • Increased self-esteem or grandiosity
  • Not needing to sleep as much, feeling rested after small periods of sleep
  • Being more talkative than usual
  • Having racing thoughts
  • Easily distracted 
  • An increase in goal-driven behaviors or restlessness 
• Your symptoms have an impact on your level of functioning, and this impact does not occur when symptoms are not present
• Others can notice the change in your mood and functioning
• Your symptoms do not have a significant impact on your work and social life

The third characteristic associated with Bipolar disorders is Major Depressive Episodes. These depressive episodes can be present with other mental health concerns and do not always indicate bipolar disorder. The following symptoms are associated with a Major Depressive Episode:

• Having five or more of the following symptoms within a 2 week period, one of which is either depressed mood or loss of interest and pleasure
  • Depressed mood most of the day almost daily
  • Loss of interest in pleasure and enjoyable activities
  • Unintentional weight loss or gain
  • Insomnia or hypersomnia almost daily
  • Psychomotor agitation almost daily
  • Fatigue or loss of energy almost daily
  • Feeling worthless or very guilty almost daily
  • Difficulty concentrating or being indecisive almost daily
  • Reoccurring thoughts of death, suicidal ideation, making a plan for suicide, and suicide attempts
• Your symptoms have a significant impact on your work or school, and your social relationships

In order to receive the proper care for Bipolar Disorder, it is important to receive an accurate diagnosis. There are three forms of Bipolar Disorder, each having unique features. 

The first would be Bipolar I. For Bipolar I, you need to have a history of one manic and one major depressive episode. For Bipolar II, a person needs to have the symptoms associated with a hypomanic episode, a major depressive episode, and have no history of a manic episode. 

The main difference between manic and hypomanic episodes is the severity of the symptoms. For both disorders, there is an impact on functioning. However, with manic episodes in Bipolar I, the individual may need to be hospitalized to be helped. Whereas, in a hypomanic episode, hospitalization is rarely needed. 

The third disorder in the Bipolar section would be Cyclothymic Disorder. With Cyclothymic Disorder, the individual has been struggling with hypomanic symptoms for at least two years without meeting the full criteria for a hypomanic episode. The individual’s hypomanic and depressive symptoms have not been absent for more than two months in the same two-year period. The key difference between Cyclothymic Disorder and the other two Bipolar disorders is whether or not the person has met the full criteria for manic, hypomanic, and depressive episodes.

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