Unfortunately, most people don’t understand bipolar disorder. Pop culture paints a picture of frequent and rapid mood changes. However, this is anything but true. To clear some misconceptions, we’ve developed a list of ten bipolar disorder facts everyone should know about.

1.) Bipolar Disorder is Characterized by Shifts that Look Like Depression

Often referred to as “mood episodes,” the number one characteristic of bipolar disorder involves dramatic shifts in one’s behavior and temper. Two distinct types of shifts occur: ¹

1. Manic – When you’re filled with energy and a heightened sense of creativity and euphoria.
2. Depression – When you experience low feelings, such as sadness, worriedness, emptiness, and a lack of energy.

While it may be assumed you’re always in one of these episodes, it’s common to have periods when you don’t experience symptoms. In fact, signs of bipolar are similar to a major depressive disorder (depression). Unfortunately, this tends to lead to misdiagnosis.

2.) Manic Episodes are Complex

Symptoms of mania are more difficult to identify than those of depression. Sometimes, mania symptoms can seem beneficial. For example, if you’re getting a lot done at work due to your manic episode, your boss may congratulate you on the good effort.

However, since mania is usually followed by a depressive episode, it’s not a positive trait. Symptoms of a manic episode include:

• Abnormal amount of increased energy
• Abundance of happiness and exhilaration
• Agitation or irritability
• Difficulty sleeping (insomnia)
• Developing a sense of overconfidence
• Engaging in risky behavior (i.e. sexual or financial risks)
• Feeling jumpy or wired
• Taking on too many tasks at once
• Talking quickly

3.) Some People Struggle with Hypomania Rather Than Mania

One of the reasons manic episodes can be difficult to identify is they aren’t as apparent as depressive episodes. This can result in hypomanic episodes, a lower severity of mania. ²

While hypomania doesn’t present the same dangers as mania, it can still be dangerous for your mental and physical health. Hypomanic episodes still shift to depressive episodes and can result in the same loop as their manic counterparts.

Not to mention, people may experience what’s known as a “mixed episode,” when manic and depressive symptoms occur at the same time. According to professionals, these cases are the most at risk as coping mechanisms can be dangerous to mental and physical health. ³

4.) There Are Different Types of Bipolar Disorder

Bipolar disorder symptoms will showcase different levels of severity depending on the person. But did you know there are four unique types of bipolar disorder? These include: ⁴

• Bipolar I – When manic episodes last for 7 or more days followed by a depressive episode that lasts at least 14 days. Symptoms will present themselves in various severities, but you’re always at risk of “mixed episodes.”

• Bipolar II – This is similar to bipolar I. The key difference is people with bipolar II will experience hypomania rather than full-blown manic episodes.

• Cyclothymia – A mild form of bipolar disorder where you’ll experience hypomania and less severe depression for about 2 years. More often than not, you’ll have symptom-free periods. Cyclothymia is often misdiagnosed and it poses the risk of developing bipolar I or bipolar II. ⁵

• Unspecified Bipolar and Related Disorder (Other Specified) – When one experiences symptoms similar to bipolar disorder that don’t fit into the above types.

5.) We Still Don’t Know What Causes Bipolar Disorder

As with most mental illnesses, scientists still aren’t entirely sure what causes bipolar disorder. However, there are a few key factors that may play a role:

• Brain Structure – Bipolar changes certain regions of the brain change. While researchers still don’t completely understand how this works, the prefrontal cortex does show abnormal signs in patients. ⁶

• Environment – Stressful life events may lead to a “trigger” or relapse in bipolar disorder. Not to mention, your living arrangements may be fueling bipolar symptoms. ⁷

• Genetics – If someone within your family (especially, your immediate family) has bipolar disorder, you’re more at risk of developing it. ⁸

The biggest issue with these causes is researchers aren’t 100% sure how much each plays a role in the development of bipolar disorder.

6.) Bipolar Disorder Often Goes Misdiagnosed

Bipolar disorder is often misdiagnosed as depression. Being that there is an overlap in symptoms and not everyone presents obvious signs of mania, it can be difficult for a mental health professional to come to a certain diagnosis. Especially if there is no history of bipolar disorder in your family.

Not to mention, if you struggle with bipolar disorder and haven’t been diagnosed, you’re more likely to seek help for a depressive episode rather than mania. To come to a proper diagnosis, a doctor must identify both mania and depression. This will require you to undergo an evaluation and some medical tests.

7.) Adolescents and Children are Vulnerable to Bipolar Disorder

While bipolar disorder is commonly diagnosed in late teenagers and young adults, children and young teens can also develop it. It’s difficult to diagnose people of this age group as their symptoms may not match the diagnostic criteria. ⁹

More often than not, children and young teenagers who struggle with bipolar disorder also have a co-occurring mental health condition, such as attention-deficit/hyperactivity disorder (ADHD). Doctors may be prone to treating that condition instead of looking for co-morbidities.

Not to mention, people of this age group naturally experience heavy emotions. Growing up and undergoing puberty can be difficult and leave adolescents with mixed emotions. To identify whether or not you or your child has bipolar disorder, it can help to see a specialized child psychiatrist.

8.) Proper Treatment Requires Medication

Medications are often prescribed to stabilize your mood throughout the day. Certain medications are for manic episodes while others are for depressive ones. The bipolar medication your doctor may recommend include: ¹⁰

• Antidepressants – To lower your mood and prevent depressive episodes. Some doctors have found that antidepressants may trigger manic episodes and suggest other medications to be taken alongside them. ¹¹

• Antipsychotics – While these are more commonly prescribed for schizophrenia, antipsychotics can work wonders at treating mania (especially, in extreme cases).

• Mood Stabilizers – The most common medication for bipolar disorder. These reduce the amount of unusual activity in your brain and are also used as anticonvulsants or antiseizures. ¹²

It’s likely a mental health professional will prescribe you more than one type of medication to manage both manic and depressive episodes. Finding the best combination and dosage can be tricky as the characteristics of bipolar disorder vary from person to person.

It’s important to note that women who are pregnant, plan to become pregnant, or lactating shouldn’t take bipolar medication. These medications can go through the placenta and into breast milk, increasing the risk of birth defects. ¹³ Not to mention, when anti-epilepsy drugs are mixed with birth control pills, they increase the risk of pregnancy. ¹⁴

9.) Therapy is Almost Essential for Treatment

While medications are effective at reducing symptoms, they don’t do anything to address the underlying issues associated with bipolar disorder. For this reason, treatment is a must to overcome symptoms and, eventually, wean yourself off of medication.

Through various forms of psychotherapy, you will be allowed to better understand what triggers your bipolar disorder symptoms. This comprehension helps you work towards healthy coping mechanisms that allow you to go on with daily tasks. ¹⁵

10.) People with Bipolar Disorder Can Go on to Lead Fulfilling Lives

Before you receive treatment, it’s natural to doubt that things will get better. Everyone who experiences bipolar disorder feels as though they’re stuck in a constant loop that’s impossible to mentally break. However, with the proper treatment, you can get better and lead a fulfilling life. With the right care and time, anyone can overcome this illness.

References

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² Camacho M, Almeida S, Moura AR, Fernandes AB, Ribeiro G, da Silva JA, Barahona-Corrêa JB, Oliveira-Maia AJ. Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic. Front Psychiatry. 2018 Nov 7;9:527. doi: 10.3389/fpsyt.2018.00527. PMID: 30464747; PMCID: PMC6234765.

³ Muneer A. Mixed States in Bipolar Disorder: Etiology, Pathogenesis and Treatment. Chonnam Med J. 2017 Jan;53(1):1-13. doi: 10.4068/cmj.2017.53.1.1. Epub 2017 Jan 25. PMID: 28184334; PMCID: PMC5299125.

⁴ Brancati GE, Nunes A, Scott K, O’Donovan C, Cervantes P, Grof P, Alda M. Differential characteristics of bipolar I and II disorders: a retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment. Int J Bipolar Disord. 2023 Jul 14;11(1):25. doi: 10.1186/s40345-023-00304-9. PMID: 37452256; PMCID: PMC10349025.

⁵ Perugi G, Hantouche E, Vannucchi G. Diagnosis and Treatment of Cyclothymia: The “Primacy” of Temperament. Curr Neuropharmacol. 2017 Apr;15(3):372-379. doi: 10.2174/1570159X14666160616120157. PMID: 28503108; PMCID: PMC5405616.

⁶ Clark L, Sahakian BJ. Cognitive neuroscience and brain imaging in bipolar disorder. Dialogues Clin Neurosci. 2008;10(2):153-63. doi: 10.31887/DCNS.2008.10.2/lclark. PMID: 18689286; PMCID: PMC3181872.

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⁸ Kerner B. Genetics of bipolar disorder. Appl Clin Genet. 2014 Feb 12;7:33-42. doi: 10.2147/TACG.S39297. PMID: 24683306; PMCID: PMC3966627.

⁹ Birmaher B. Bipolar disorder in children and adolescents. Child Adolesc Ment Health. 2013 Sep 1;18(3):140-148. doi: 10.1111/camh.12021. PMID: 24273457; PMCID: PMC3835470.

¹⁰ Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013 May 11;381(9878):1672-82. doi: 10.1016/S0140-6736(13)60857-0. PMID: 23663953; PMCID: PMC3876031.

¹¹ Patel R, Reiss P, Shetty H, Broadbent M, Stewart R, McGuire P, Taylor M. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ Open. 2015 Dec 14;5(12):e008341. doi: 10.1136/bmjopen-2015-008341. PMID: 26667012; PMCID: PMC4679886.

¹² Altamura AC, Lietti L, Dobrea C, Benatti B, Arici C, Dell’Osso B. Mood stabilizers for patients with bipolar disorder: the state of the art. Expert Rev Neurother. 2011 Jan;11(1):85-99. doi: 10.1586/ern.10.181. PMID: 21158558.

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¹⁴ Kennedy MLH. Medication management of bipolar disorder during the reproductive years. Ment Health Clin. 2018 Mar 23;7(6):255-261. doi: 10.9740/mhc.2017.11.255. PMID: 29955531; PMCID: PMC6007728.

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