When gathering the mental health history of a family I am starting to work with, there are always a few that say there is a history of (diagnosed or undiagnosed) someone living with bipolar. This post talks about Bipolar 1 and Bipolar 2 disorder.

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Bipolar I

First I want to start with what Bipolar is not. It is NOT just mood swings. Throughout my time as a therapist I have had individuals say either themselves or a family member must be bipolar due to “being happy one minute and angry the next.” Bipolar disorder is much more than that.

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In order for someone to get diagnosed with Bipolar I they have to meet certain symptoms that would qualify as a manic episode that lasts at least one week. Those symptoms look like:

• An elevated or irritable mood 
• Decreased need for sleep
• More talkative than usual
• Racing thoughts
• Easily distracted
• Increase energy that may or may not be goal directed
• Excessive involvement in potential harmful activities like buying sprees, foolish investments or unsafe sexual practices

A manic episode in Bipolar I can be followed by a hypomanic or major depressive episode. A hypomanic episode looks just like a manic episode, but the length is shorter. In a major depressive episode, 5 or more of the following must have happened in the same 2-week period and be different from the person’s norm.

1. Depressed mood most of the day, nearly every day
2. Marked loss of interest in activities previously enjoyed
3. Significant weight gain or loss when not dieting
4. Little sleep or too much sleep nearly every day
5. Slow movement that is recognizable by others
6. Fatigue or loss of energy almost every day
7. Feeling worthless
8. Not able to concentrate or indecisiveness
9. Recurring thoughts of death

A person will most likely not be diagnosed with Bipolar I until they are 18 or older. This is due to children being at different developmental stages. 

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Bipolar II

The key difference between Bipolar I and Bipolar II disorder is the symptom criteria. For Bipolar II a person must experience a hypomanic episode AND a major depressive episode. 

With Bipolar II, there is no manic episode that occurs. If one does, then that person most likely has Bipolar I instead. 

Just like with Bipolar 1, children will not be diagnosed with this. 

Treatment

There is no cure for bipolar. The current treatment involves consistent use of medication, therapy and lifestyle changes. This will look different for each person with the disorder.

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CONCLUSION

So there is more to Bipolar than just mood swings. If you want to see an accurate portrayal of Bipolar Disorder, I recommend the show “Big Mood” starring Nicola Coughlan. She plays a character with Bipolar disorder and captures the symptoms of it really well. Disclaimer that it is not kid-friendly.

There are also books that can help you or a loved one understand in more depth what Bipolar is. The Bipolar Disorder Survival Guide by David J. Miklowitz is a good one and there are many more.

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