There are many types of bipolar disorder, with different people experiencing different symptoms. But most people with bipolar disorder experience episodes of high energy, or mania, and low mood, or depression. These episodes can be very intense, and sometimes people who have a manic episode experience psychosis. Psychosis is characterized by delusions or hallucinations, and it’s important that anyone with those symptoms gets professional help.
Several factors contribute to the development of bipolar disorder, including genetics and life events. People who have a parent or sibling with the illness may have a greater chance of developing it themselves, although genes are not the only factor—identical twins that share the same parents can sometimes develop completely opposite conditions (like schizophrenia). Stressful life events, like death of a loved one, financial problems, a divorce or a job loss, can trigger an episode in some people. Often, a person will develop a mood change after a severe stressor, but for some people, the change is more gradual and comes in response to ongoing or increased levels of stress.
The symptoms of a manic episode vary from person to person, but they can include feeling euphoric or extremely high or inflated self-esteem, excessive spending sprees, racing thoughts, rapid speech and agitated behavior. During these episodes, people with bipolar disorder can be impulsive and take on risky or dangerous situations that they would otherwise avoid. People with a depressive phase of bipolar disorder often feel sad, hopeless, apathetic or worthless. They may withdraw from their friends and family, experience suicidal thoughts or act on those feelings.
There are several treatment options for people with bipolar disorder, and the best approach is a combination of medication and psychological therapy. Medications can stabilize moods and manage other symptoms, and psychotherapy can help people learn how to recognize early signs of a manic or depressive episode so they can get professional help before the episode takes hold.
Cognitive-behavioral therapy, or CBT, is a common type of psychotherapy used to treat bipolar disorder. It helps people with BD understand how their mood changes affect them and their behavior, so they can identify their triggers and make healthy choices. It can also be used to address comorbid conditions like anxiety and attention-deficit/hyperactivity disorder, or ADHD.
People with BD often have a hard time understanding and accepting the speed at which their moods change. This can lead to them being more prone to panic attacks, which are often characterized by rising heart rate, sweating and fast breathing. CBT can help people with BD learn to recognize and handle anxiety and panic attacks.
Behavioral therapy can be used to teach people with BD how to recognize and respond to their mood changes, develop healthy sleep and activity routines, improve medication adherence, resolve underlying issues and improve relationships. It can also be used to manage comorbid conditions like ADHD and substance abuse. Psychoeducation, or psychoeducational interventions, are also a component of many evidence-based therapies. These involve providing support, education and guidance to family members.