One key difference: “The normal ups and downs and moods that all people tend to experience are often associated with something going on in their life — they’re often a reaction,” explains Jeffrey Borenstein, MD, the president and CEO of the Brain & Behavior Research Foundation in New York City. Plus, he adds, “They aren’t often as severe as they might be in bipolar disorder.” Holly A. Swartz, MD, a professor of psychiatry at the University of Pittsburgh and editor-in-chief of the American Journal of Psychotherapy, likens it to the difference between the weather and climate. Shifting emotional states that vary over the course of a day are more like the atmospheric changes associated with the weather and do not typically characterize bipolar mood episodes. Bipolar episodes, by definition, persist for longer periods, usually weeks to months, acting more like a shift in the climate. With bipolar disorder, the changes in mood states, thoughts, energy, and behaviors can last for days, weeks, or even months. During a depressive stage, you may feel so low that you can’t muster the will to get yourself out of bed. With mania, you could feel so wired that you don’t sleep for days or end up making impulsive decisions that you regret later. There are several types of bipolar disorder, but the two main ones are:
Bipolar I: Defined by the presence of either mania (experiencing one or more manic episodes) or mixed episodes, which involve symptoms of both mania and depression. (Experiencing an episode of depression isn’t necessary for this diagnosis.)Bipolar II: Characterized by depression with hypomania — a less extreme form of mania that, for some people, may not always be problematic, says Swartz. Still, it’s “often a harbinger of a bad depression that’s about to follow,” she says, noting that bipolar II can be mistaken for major depression if signs of hypomania are not recognized.
“It [can] take a decade for people to get correctly diagnosed,” she says, which can lead to people getting inappropriate treatments that won’t effectively control the full range of their symptoms. The symptoms of bipolar disorder and the signs of an upcoming bipolar episode vary considerably from one person to another. However, if you’ve been living with the condition for a while, you may have noticed that certain symptoms (like hypomania) appear like clockwork before a relapse. Some are more common bellwethers than others. “People [can] start to have a pattern, and I think it’s quite helpful for individuals to learn to recognize their early warning signs of both depression and hypomania or mania relapses,” says Swartz. Treatment for bipolar disorder is designed to manage symptoms, prevent recurring mood episodes, and help you stay healthy. If you’ve noticed a change in the severity of your symptoms, it may mean that your medication — or another aspect of your treatment regimen — needs to be adjusted. Answer these nine questions to get a better understanding of your symptoms and find out whether your bipolar disorder is truly under control.
