You might have faithfully waited for your loved to be diagnosed bipolar free. According to WHO, in 2019, 40 million people experienced bipolar disorder (1). Bipolar disorder or manic depression is a mental condition that brings about unforeseen fluctuations in a person’s mood, energy, engagement, and attention. The day-to-day tasks can become difficult to manage during these disruptions.
In this article we’ll explore what causes bipolar, the origin of bipolar, types, signs, treatments and all you need to know about bipolar disorders.
History of Bipolar Disorder?
The roots of “mania” and “melancholy,” referring to the bipolar extremes, can be found in the Greek language. The terms “melancholy” and “chole,” meaning “black and bile” respectively, stem from Hippocrates’ belief that depression resulted from an excess of black bile. “Mania” is derived from the Indo-European root “men-” meaning “mind,” to which, interestingly, “man” is sometimes related. “Mania” relates to “menos” meaning “spirit, force, passion”; “mainesthai” meaning “to rage, go mad”; and “mantis” meaning “seer.” (The scientific term for depression, “depression,” comes from the Latin “primer,” meaning “press down” or “sink.” It is of much more recent origin.)
The concept of a link between mania and depression dates back to the Ancient Greeks, particularly to Aretaeus of Cappadocia, a physician and philosopher during the reign of Nero or Vespasian (1st century AD). According to Aretaeus, a group of patients alternated between being “torpid, dull, and sorrowful” at times and “laughing, playing, dancing night and day, and sometimes going openly to the market crowned, as if victors in some contest of skill.” While he posited that both behavioral patterns were due to the same disorder, this theory did not gain popularity until modern times.
It wasn’t until the nineteenth century that the contemporary psychiatric concept of bipolar disorder first emerged. The condition was independently described to the Académie de Médicine in Paris in 1854 by Jules Baillarger (1809–1890) and Jean-Pierre Falret (1794–1870). Falret termed it “folie circulaire,” or “circular insanity,” while Baillarger referred to it as “folie à double forme,” or “dual-form insanity.” Falret correctly theorized that the condition had a strong genetic basis after observing its clustering in families.
Renowned German psychiatrist Emil Kraepelin (1856–1926) observed that the natural course of the untreated disorder was interrupted by periods of relatively few symptoms at the beginning of the 20th century. Based on this distinction, he named the condition “manic-depressive psychosis” to distinguish it from “démence précoce,” or schizophrenia. Kraepelin emphasized that manic-depressive psychosis had an episodic nature and a more benign course than “démence précoce.”
Notably, Kraepelin did not differentiate between individuals with psychotic symptoms only during depressive episodes and those who experienced manic and depressive episodes alone. This differentiation, made only in the 1960s, is largely responsible for the current focus on bipolarity and, as a result, mood elevation as the hallmark of the condition.
Bipolar Disorder Definition
Psychiatry.org defined bipolar disorders as brain disorders that causes changes in a person’s mood, energy, and ability to functions. People with bipolar disorder experience intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes. Another definition states that the terms “bipolar disorder” and “manic-depressive illness” are relatively recent, originating in the 1980s and the 1950s, respectively. Due to being less stigmatizing than the previous term, “manic-depressive illness,” the term “bipolar disorder” (also known as “bipolar affective disorder”) has largely replaced it. Nonetheless, some individuals with bipolar disorder and psychiatrists still argue that “manic–depressive illness” captures the essence of the disorder better.
What Are the 3 Types of Bipolar Disorder
There are three different types of bipolar disorder, all of which present noticeable variations in mood, energy, and activity levels. These moods range from extremely low, downhearted, disinterested, or hopeless periods to exceedingly high, thrilled, restless, or lively periods (known as manic episodes) (known as depressive episodes). Hypomanic episodes are less intense forms of manic episodes.
Bipolar I
Bipolar I disorder is characterized by manic episodes that persist for at least seven days (or almost every day for most of the day), or manic symptoms that are severe enough to necessitate urgent medical attention. Depressive episodes usually accompany these and usually last for at least two weeks. It is also possible to experience mixed-feature episodes involving both manic and depressive symptoms at the same time. “Rapid cycling” refers to experiencing four or more manic or depressive episodes in a single year.
Bipolar II
Bipolar II disorder is defined by a pattern of hypomanic and depressive episodes. The hypomanic episodes are milder than the manic episodes in bipolar I disorder.
Cyclothymia
Cyclothymia, or cyclothymic disorder, is characterized by recurring hypomanic and depressive symptoms that do not meet the criteria for hypomanic or depressive episodes due to their lesser intensity or duration.
Types of Bipolar Disorder Test?
While screening tools like the Mood Disorder Questionnaire (MDQ) exist, consulting with a psychiatrist or other mental health specialist is the most reliable method for obtaining an accurate diagnosis.
What Causes Bipolar Disorder?
Exactly what triggers bipolar disorder? The specific cause of bipolar disorder remains unknown. According to experts, a complex interplay of social, environmental, and physical factors contributes to increasing the risk of developing it.
These factors are believed to involve a complex combination of social, environmental, and physical elements.
Genetics
Experts presume that bipolar disorder has a genetic component because it tends to run in families.
Family members of the affected individual have a higher likelihood of developing bipolar disorder. However, it is not caused by a single gene. Instead, it is thought that a variety of environmental and genetic factors act as triggers.
Triggers
The symptoms of bipolar disorder are often triggered by stressful events or situations.
Stressful triggers include, for example:
- The end of a relationship due to physical, sexual, or emotional abuse
- The death of a loved one or close relative
- These kinds of significant experiences can lead to depressive episodes at any point in a person’s life.
Additionally, bipolar disorder may be triggered by:
- Physical illness
- Disruptions in sleep
- Significant challenges in daily life, such as financial, professional, or interpersonal issues
Chemical Imbalance in the Brain
There are indications that bipolar disorder may be associated with imbalances in brain chemistry.
Neurotransmitters—chemicals that regulate brain function—such as noradrenaline, serotonin, and dopamine are examples.
Evidence suggests that an individual may experience certain symptoms of bipolar disorder when there is an imbalance in the levels of one or more neurotransmitters.
For instance, excessively high levels of noradrenaline may trigger manic episodes, while too low levels of noradrenaline can lead to depressive episodes.
What Causes Bipolar Disorder to Get Worse
Stress
Stress is one of the most common triggers for bipolar disorder. A study published in the Journal of Affective Disorders revealed that stressful or adverse life events were associated with subsequent mood episodes. Stressful life events seem to be the primary cause of manic or depressive episodes in the early stages of the disorder.
Changes in Sleep Patterns or Lack of Sleep
Although the specific causes of stress vary widely from person to person, certain events and lifestyle choices, such as poor sleep or relationship problems, can act as triggers.
Changes in sleep patterns or lack of sleep also appear to exacerbate bipolar disorder.Slumber
An alteration in sleep patterns is a key indicator of bipolar disorder and can also serve as a triggering factor.
Students who are not getting sufficient rest, individuals who work extended and irregular hours, and those who work shifts are all vulnerable to recurring mood episodes due to lack of sleep. “Moreover, traveling across different time zones can also act as a trigger for a mood episode,” as per Bennett.
According to Bennett, interpersonal and social rhythm treatment (IPSRT) is one of the most effective preventive strategies. This form of therapy, available in both group and individual sessions, helps in establishing a routine for your meals, physical activity, and sleep patterns to better manage bipolar disorder.
The condition may also benefit from other forms of therapy such as cognitive behavioral therapy (CBT) and psychoeducation.
Blowout Arguments with Partners, Coworkers, or Friends
Untreated bipolar disorder is often the underlying cause of strained relationships.
However, engaging in arguments with a loved one can also act as an early indication: The disagreement may stem from the irritability that commonly occurs during a manic or depressive episode, or it might generate stress contributing to a recurrent episode.
Conflicts in relationships, whether involving a spouse, coworker, family member, or friend, can be extremely stressful and debilitating. Individuals with bipolar disorder reported that negative social interactions triggered suicidal thoughts in a separate study published in the Journal of Affective Disorders.
Bad Breakups or Marriage Breakdown
Many individuals with bipolar disorder go through marital separations, particularly those who have a history of intense manic episodes. Seeking support from a therapist during this typically prolonged and highly stressful process can be beneficial.
When experiencing a depressive or manic episode during or after a breakup, considering appointing a durable power of attorney, granting someone else the authority to make important decisions on your behalf, including financial ones, may be advisable.
It is advisable for anyone going through a bipolar episode to consider designating a durable power of attorney.
Abuse of Alcohol, Overdose of Drugs, and Their Consequences
While drug and alcohol abuse cannot directly cause bipolar disorder, it can exacerbate the underlying condition or trigger an episode. Furthermore, around one in five individuals with bipolar disorder also have a substance abuse disorder, according to a review of data on young adults with mental illness published in the journal Social Psychiatry and Psychiatric Epidemiology.
While the aftermath of cocaine or alcohol use is linked to aggravating depressive symptoms, being intoxicated with drugs such as amphetamines and cocaine can induce or intensify manic symptoms.
Problems with Finances and Emotions Resulting from Job Loss
One of the most erratic stressors in life is losing one’s job. Moreover, feelings associated with losing one’s job can also be equally erratic. While it could be liberating for those dissatisfied with their job, others may experience significant stress due to the financial and emotional burdens. Regardless, a bipolar episode could be triggered by sudden mood swings.
A prudent strategy to assist with the transition could include endeavoring to save three to six months’ worth of expenses in case of job loss.
Grieving the Loss of a Loved One
The loss of a loved one is perhaps the most challenging experience in life. While many individuals can effectively manage their bipolar disorder during their grieving process, some may face severe repercussions, such as the onset of “funeral mania,” as suggested by Bennett.
This occurs when a person with stable symptoms of bipolar disorder attends a funeral and experiences a manic episode in the following week. Bennett suggests the need for increased oversight and support during the grieving period.
Changes in Hormones and Sleep Patterns Linked to Pregnancy
Research published in the Lancet indicates that individuals with bipolar disorder are more prone to experience a mood episode in the postpartum period, following childbirth.
Researchers noted that hormone fluctuations, altered medication regimens, and changes in sleep patterns can all act as risk factors for a psychotic episode or postpartum mood after giving birth.
According to the Cleveland Clinic, there is a significant association between bipolar disorder and postpartum psychosis, a severe mental illness characterized by thoughts of harming one’s baby or an inability to emotionally respond to one’s newborn.
During pregnancy, collaborating with your OB-GYN, specialists in bipolar disorder, and the rest of your medical team to establish treatment options to avert postpartum psychosis, mania, or depression after childbirth is advised.
A Brand-New Season and Unusual “Clock Genes”
About 20% of individuals with bipolar disorder experience seasonal mood changes. A review of research published in the Journal of Affective Disorders found that they are more likely to experience seasonal depression in early winter and mania or hypomania in the spring or summer.
These shifts are attributed to sunshine. The body’s innate response to variations in a twenty-four-hour day, known as the circadian rhythm, is influenced by the amount of sunlight received each day. These responses are regulated by a complex set of genes called “clock genes.” Individuals with faulty versions of these genes may have seasonal bipolar disorder.
Corticosteroids, Antidepressants, and Other Medications
Can antidepressants trigger mania? Treatment for bipolar disorder may precipitate manic episodes, exacerbating unpredictable moods and behaviors. Several psychiatrists report witnessing patients enter a manic phase after starting antidepressant medication, and some are cautious about prescribing it to individuals with bipolar disorder.
According to Gao, MD, Ph.D., a professor of psychiatry at Case Western Reserve School of Medicine in Cleveland and head of the mood disorders program at University Hospitals Cleveland Medical Center, recommends various measures until long-term safety data is available: Antidepressants for bipolar I depression should only be used in conjunction with a mood stabilizer or stabilizers if FDA-approved therapy options (such as mood stabilizers) have not alleviated symptoms.
While some recent research suggests that antidepressants alone can be as effective as lithium for some individuals with bipolar II (those who have not experienced a manic episode), according to Dr. Gao, antidepressants should never be used alone for bipolar I depression. Instead, it is advisable to consider discontinuing antidepressant use once symptoms have improved. He added that antidepressants, medications such as appetite suppressants, thyroid medications, and corticosteroids have been linked to manic episodes, according to Gao.
What are Signs of Bipolar in a Women?
Signs of Bipolar Disorder in Women:
Euphoria
In bipolar disorder, manic episodes typically precede depressive episodes. A prominent characteristic of a manic episode is a feeling of extreme exhilaration. Euphoria is marked by intense and overwhelming joy, along with a sense of invincibility. Individuals experiencing euphoria may seek out pleasurable activities or actions they believe will elevate their mood. This is distinct from simply having a positive mindset. Euphoria is a powerful emotion that usually makes a person extremely agitated rather than calm.
Reduced Need for Sleep
During a manic episode, many individuals may not feel the urge to sleep. Instead, they may feel they have boundless energy and can continue without rest.It’s important to encourage those not experiencing manic episodes to participate in activities with individuals going through them, as they may lack the energy to keep up or work continuously without taking breaks. People with this condition often have a strong desire to continue tasks even when they should be sleeping.
Lack of judgment
During manic episodes, individuals often display poor decision-making skills, acting without considering the consequences of their actions. They may engage in behavior they would normally avoid due to difficulty understanding the impact of their actions. This can lead to risky situations, such as unprotected sexual activity or being in dangerous places, potentially causing harm in the short term and damaging relationships and careers in the long run.
Psychosis
Mania is accompanied by psychosis, a severe symptom not present in hypomania, which is associated with various types of bipolar disorder but is less intense. Psychosis involves hallucinations, such as seeing, feeling, or hearing unreal objects, and holding false beliefs, for example, believing the government is conspiring against them. Psychotic individuals often experience extreme confusion, anger, or frustration, making it challenging to reason with them when they are in that state.
Intolerance
Following a manic episode, individuals may experience a depressive mood, often exhibiting severe irritability over minor issues and becoming easily angered, contrary to their usual behavior.
Hopelessness
Depressive episodes can leave individuals feeling completely hopeless, believing that nothing matters in the present or the future. They may struggle to connect with their typical aspirations and goals, overwhelmed by negativity.
Difficulty concentrating
People experiencing depression often find it extremely challenging to focus and may struggle with daily tasks, becoming overwhelmed and easily distracted. This can also affect their performance at work or school.
Mania and Depression
Some individuals experience rapid cycling between mania and depression, displaying symptoms of both disorders almost simultaneously, leading to erratic behavior and mood swings.
Impulsiveness
Those with mixed mania often struggle with impulsivity, leading to risky actions and sudden changes in behavior or conversation topics.
Psychological Causes of Bipolar Disorder
The exact cause of bipolar disorder is unknown, but research suggests several factors increase the risk, including social, environmental, and physical aspects.
This includes:
- Childhood trauma
- Life stressors
- Substance abuse
- Childhood trauma
Experts suggest that significant emotional distress experienced during childhood may contribute to the development of bipolar disorder, potentially affecting emotional regulation.
This includes experiences such as:
- Neglect
- Sexual, physical, or emotional abuse
- Traumatic events
- Losing a parent or caregiver
- Life stressors
Individuals may link stressful events or circumstances in their lives to the onset of bipolar symptoms. Additionally, stress can trigger or worsen symptoms.
Stressors may include:
- Relationship breakups
- Financial concerns
- Trauma
- Losing a loved one
- Discrimination and persecution
- Isolation
- Uncertainty or major life changes
- Time pressure related to studies, work, or job seeking
- Major events such as holidays or weddings
Genetic factors
Having a family member with bipolar disorder may increase an individual’s likelihood of developing the disorder, suggesting a genetic component, although the exact genetic mechanisms are complex.
Hormonal influence on bipolar disorder
Thyroid hormones are believed to significantly impact brain function in adults and have been linked to bipolar disorder and depression. The thyroid gland, located in the neck, releases hormones that regulate growth and development.
Bipolar disorder signs
Bipolar disorder and related conditions manifest in various forms, including depression and mania or hypomania, causing mood and behavior swings that can significantly impact everyday life.
- Bipolar I disorder: Includes at least one manic episode, potentially followed or preceded by severe depression or hypomanic episodes, occasionally leading to psychosis or detachment from reality.
- Bipolar II disorder: Involves major depressive episodes and at least one hypomanic episode, without experiencing a manic episode.
- Cyclothymic disorder: Consists of multiple episodes of hypomania symptoms and depression symptoms over at least two years, or one year in adolescents and teenagers.
- Other types: Include bipolar disorder and associated conditions triggered by specific medications, alcohol, or physical ailments such as multiple sclerosis, stroke, or Cushing’s disease.
Bipolar II disorder should not be considered a milder variation of bipolar I disorder, as individuals with bipolar II disorder may experience prolonged periods of depression, significantly affecting their lives, in contrast to the intense and risky manic episodes associated with bipolar I disorder.
While bipolar disorder can emerge at any age, it is often diagnosed in adolescence or early adulthood, with variations in symptoms and changes over time.
Mania vs. Hypomania
Although manic and hypomanic episodes differ in intensity, they share similarities. Mania is more severe, leading to significant issues with relationships, employment, school, and social activities. Additionally, mania may cause psychosis, requiring hospitalization, and involves at least three of the following symptoms:
- Unusually happy, jittery, or wired feelings
- Elevated energy and excitement
- Exaggerated confidence and well-being
- Reduced need for sleep
- Unusual talkativeness and restlessness
- Racing thoughts
- Inability to focus
- Engaging in reckless behaviors, such as excessive shopping, taking risky actions in relationships, or making unwise investments
- Severe depressive episodes
When the symptoms of a major depressive episode substantially disrupt daily functioning, such as relationships, work, school, or social activities, it is considered a major episode. During such an episode, a person may experience at least five of the following symptoms:
- Feeling of melancholy, emptiness, hopelessness, or tearfulness (in children and teenagers, impatience may be a manifestation of depression)
- Loss of interest or pleasure in almost all activities
- Unintentional weight loss or gain, or changes in appetite (in children, failure to gain weight as expected can point to depression)
- Insomnia or increased sleeping
- Agitation or slowed-down movements
- Fatigue or low energy
- Feelings of excessive or inappropriate guilt or worthlessness
- Difficulty in thinking, concentrating, or making decisions
- Thoughts of death, making plans for suicide, or suicide attempts
Treatment for bipolar disorder
Without proper treatment, mania episodes associated with bipolar disorder can persist for three to six months.
Depressive episodes typically endure for six to twelve months.
Nevertheless, with effective care, the majority of episodes improve.
Most individuals with bipolar illness respond well to a combination of interventions.
Possible approaches may include:
Daily intake of mood stabilizing medications to prevent manic and depressive episodes.
Medication to address primary symptoms of depression and mania as needed; learning to recognize signs and triggers of depressive or manic episodes; psychotherapy such as counseling for relationship enhancement and support for depression.
Lifestyle recommendations, including regular physical activity, engaging in fulfilling hobbies to foster a sense of accomplishment, and guidance on improving sleep and dietary habits.
Many individuals with bipolar disorder can receive the bulk of their treatment without requiring hospitalization.
However, severe symptoms or treatment under the Mental Health Act may necessitate hospitalization to mitigate risks of self-harm or harm to others.
In some instances, individuals may receive day care at a hospital while returning home at night.
FAQ and Answers
How Does a Bipolar Person Feel?
People diagnosed with bipolar disorder may experience manic episodes characterized by intense joy, heightened energy, reduced inhibitions, decreased need for sleep, and intense delight, excitement, or euphoria. The experience of bipolar disorder is unique for each individual and can vary from episode to episode.
How Does Someone with Bipolar Act in a Relationships
Individuals with bipolar disorder may inadvertently cause distress and harm to their partners. Relationship challenges often become apparent after diagnosis and should be addressed. Couples therapy can help by acknowledging that the illness is the underlying cause of detrimental behavior.
Does a Bipolar Person Know Right from Wrong?
Although the symptoms of bipolar disorder can occasionally complicate ethical decision-making, having the condition does not impede an individual’s ability to discern right from wrong.
What Kind of Thoughts Do Bipolar People Have?
While experiences vary, individuals with bipolar disorder often share certain cognitive patterns. These may include manic and/or depressive episodes, episodes of psychosis, thoughts of self-harm, and circular thinking.
Do Bipolar People Fall in Love
According to psychiatrist David H. Brendel, MD, PhD, individuals with bipolar disorder are entitled to the same emotional experiences as anyone else, such as falling in love.
How Does a Bipolar Person Act When Angry
Anger in individuals with bipolar disorder can be irrational, overpowering, and often triggered internally, without an external threat or annoyance. Verbal aggression towards others may be exhibited by individuals with bipolar disorder. Or aggressively merely for being in their company, in other circumstances, they may not even recollect doing so.
How Do You Know if a Person Loves You?
Maintaining Uniformity in Conduct: One of the most significant clues that a person with bipolar disorder is in love with you is constant behavior. Even amidst intense emotions, they will consistently offer you love and support. Sharing Their Struggles: When an individual with bipolar disorder opens up about their struggles with mental health, it demonstrates affection and confidence.
What Happens When a Bipolar Person Falls in Love
According to David Miklowitz, Ph.D., a professor of psychiatry at the University of California, Los Angeles, certain individuals with bipolar disorder may encounter mania as a result of specific aspects of falling in love. Most of this is due to regular changes, which can be both convenient and enjoyable.
Why do Bipolar Say Hurtful Things?
During manic episodes, individuals with bipolar disorder may express themselves more assertively and with less restraint. They may also become unreasonable and harsh, articulating things that they may not have intended or fully contemplated.
Will a Bipolar Person Apologies?
One of the most challenging aspects of coping with bipolar disorder is having to take responsibility for symptomatic behavior. To be a part of society, one must adhere to the same social norms as everyone else. It is not acceptable to use ignorance of mental illness as a justification for inappropriate actions.
When a Bipolar Person Ignores You
There Must Be Space. During a depressive episode, individuals with bipolar disorder may require more personal space. They may choose to overlook or distance themselves from others as a means of self-preservation or because they find social interaction too demanding.
Is Bipolar a Spiritual Problem
Bipolar disorder is a complex spectrum of conditions that requires the occurrence of at least one manic or hypomanic episode. Manic episodes may involve profound religious experiences, which could be delusional or erroneous beliefs.
Can You Argue with a Bipolar
The most crucial things to bear in mind when engaging with an irate, bipolar individual are to maintain your composure, practice effective communication, and refrain from engaging in conflicts with individuals with bipolar disorder. If you enter into a disagreement with a person with bipolar disorder, they may become even more unreasonable or have outbursts.
Are Bipolar People Emotionally Intelligent?
So far, only a few studies have investigated EI in individuals with BD. These studies indicate that while they perform better than individuals with schizophrenia, their EI levels are lower than those of healthy controls.
Do Bipolar People Overthink a Lot
Rumination can result from bipolar disorder, and managing excessive rumination can be challenging in addition to feelings of hopelessness and hypersensitivity. Individuals with mental illness may opt for solitude. Forming connections and engaging in social interactions can be daunting.
In summary, it’s okay, to know that what causes bipolar could be a genetic environmental, condition and stressful life events. Practicing selfcare, meditation and spending quality time with people that love and cares for you will help manage the symptoms. However, there support groups where you can find success stories of individuals with bipolar disorders. please kindly check out Bipolar Life Victoria stories page. and also International Bipolar Foundation (ibpf.org) is an international foundation you can reach out for any support relating to bipolar. One more thing! I want you to know that you are not alone!