What is Bipolar Disorder anyway?

What is bipolar disorder?

Bipolar disorder is a brain condition that causes extreme shifts in mood, energy, and the ability to function day to day. It used to be called manic-depressive illness. The shifts aren’t the normal ups and downs everyone goes through — they’re severe, they last for weeks or longer, and they wreck relationships, jobs, and school.

I have bipolar disorder. I’ve had it for most of my adult life. Let me walk you through what it is.

Mood episodes

People with bipolar disorder experience distinct periods called mood episodes. Each one is a drastic change from your usual state.

A manic episode is an overly elevated, excited, or irritable state.
A depressive episode is a period of deep sadness or hopelessness.
A mixed episode has symptoms of both at the same time — depression with the extra energy and agitation of mania. It’s as awful as it sounds.

Some people cycle between these states a few times a year. Some cycle within a single day. See ultra-rapid cycling if you want the details on the fast version.

Symptoms of mania

During a manic episode, you might experience:

An extended period of feeling “high,” overly happy, or outgoing
Extreme irritability
Talking fast, jumping between ideas, racing thoughts
Getting easily distracted
Taking on new projects at once
Restlessness
Sleeping little or not feeling tired
Unrealistic confidence in your abilities
Impulsive, high-risk behavior — spending sprees, risky sex, bad financial decisions

Not everyone gets every symptom. Severity varies too.

Symptoms of depression

During a depressive episode:

A long stretch of feeling sad or hopeless
Loss of interest in things you used to enjoy, including sex
Feeling tired, slowed down, physically heavy
Trouble concentrating, remembering, making decisions
Restlessness or irritability
Changes in eating and sleeping habits
Thoughts of death or suicide

If you’re having suicidal thoughts right now, please go to say no to suicide or call/text 988 (988 Suicide & Crisis Lifeline) if you’re in the US.

Other symptoms that come with it

Bipolar hits more than mood. You might also experience:

Cognitive: delusions, poor concentration, unwanted thoughts, false beliefs of superiority
Behavioral: aggression, agitation, impulsivity, risky behavior, self-harm
Psychological: anxiety, paranoia, agitated depression
Sleep: trouble falling asleep, or way too much sleep
Weight: gain or loss from appetite changes
Other: fatigue, rapid speech, general restlessness

For me, the delusions, hallucinations, and paranoia part has been a big one. It’s also why I ended up with a possible schizoaffective disorder diagnosis.

What causes bipolar disorder?

The honest answer: nobody fully knows yet. What researchers have found, per the Mayo Clinic:

Biology. People with bipolar disorder appear to have physical differences in their brains. Researchers are still figuring out what those differences mean.
Neurochemistry. An imbalance in brain chemicals called neurotransmitters seems to play a role.
Genetics. Bipolar is more common if a first-degree relative (parent or sibling) has it. Researchers are working on identifying which genes are involved.

None of this means it’s your fault. It’s a medical condition, not a character flaw.

Treatment

Bipolar disorder is disruptive and long-term, but it’s manageable with a treatment plan. For most people that means medication plus therapy. Mood stabilizers, antipsychotics, sometimes antidepressants (carefully — they can trigger mania). Cognitive behavioral therapy is useful for a lot of people, myself included.

Treatment takes time to dial in. Meds that work for one person don’t work for another. You might go through several combinations before finding what helps. It’s frustrating, but it’s worth sticking with.

Want my personal experience?

This was the broad overview. If you want to know what living with it actually feels like, read bipolar disorder: my personal experience.

Sources: National Institute of Mental Health — Bipolar Disorder and Mayo Clinic — Bipolar Disorder.