Finding Treatment for Bipolar Disorder

Bipolar disorder is a serious diagnosis. Without proper treatment, it can be extremely destabilizing—both for the person who has the condition, and for those around them. If you have this diagnosis, it’s vital to get the care you need. For some clients, inpatient rehab is a helpful place to start.

About 2.8% of the population has been diagnosed with bipolar disorder¹ (once called manic-depressive disorder). And 83% of those cases are classified as severe. However, these numbers do not account for cases that go undiagnosed. It’s also frequently misdiagnosed as schizophrenia or borderline personality disorder (BPD). Without a proper understanding of your condition, it’s unlikely for clients to get appropriate treatment for their mental health.

If you think this diagnosis may fit your experience, it’s important to learn more about it. Make sure you talk to a mental health professional before you pursue a particular plan of care.

Understanding Bipolar Disorder

This condition is characterized by “intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes,”² according to the American Psychiatric Association. “These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well.”

While its exact etiology is unknown, experts believe this condition can be caused by a combination of factors. You may have a genetic predisposition to bipolar disorder,³ even if previous generations of your family were never diagnosed. It may also be related to a neurochemical imbalance. Some experts believe it can be caused or exacerbated by adverse life experiences.

The term “bipolar” may lead casual observers to believe that the associated mood swings are simple. That’s far from the truth. Mania⁴ isn’t just happiness; it can include sleeplessness, anxiety, irritability, and disproportionate anger. It can also cause impulsivity, which may lead to excessive spending, promiscuity, or substance misuse. Similarly, depressive episodes aren’t simply bouts of sadness. Symptoms mimic those of major depression, and may include fatigue, oversleeping, trouble concentrating, over- or undereating, and suicidal ideation, in addition to sadness.

Clients with bipolar disorder are also prone to a third emotional state, called hypomania. Hypomania is often characterized as a less severe version of classic mania. Clients still present with energy, impulsivity, and other signs of mania; however, their symptoms are less overwhelming. And unlike mania, “hypomania⁵ does not cause a major deficit in social or occupational functioning.” By definition, it lasts for at least four days, whereas mania lasts for at least a week.

Based on the frequency and severity of the client’s mania, hypomania, and depression, bipolar disorder may be classified in one of three ways.

Bipolar Disorder I

According to experts at Creative Care Calabasas, “bipolar I is the most severe form of the mental health condition.” To qualify for this diagnosis, clients must experience mania for at least one week. Their behavior “must represent a change from the person’s usual behavior and be clear to friends and family. Symptoms must be severe enough to cause dysfunction in work, family, or social activities and responsibilities.” Clients with this type of bipolar disorder also experience depressive episodes that may last for weeks at a time. In severe cases, hospitalization can be necessary.

Bipolar Disorder II

Bipolar II is more often associated with depressive episodes. Clients with this condition experience similar swings, but their mania is both less severe and less frequent. Some experience depressive episodes interspersed with hypomanic episodes, without ever showing symptoms of mania.

Cyclothymic Disorder

Clients with cyclothymic disorder also cycle between depression and hypomania. This condition includes less severe symptoms than other forms of bipolar. It can also take much longer to get an accurate diagnosis. Clients must experience mood swings for at least two years, without ever meeting the exact criteria for bipolar I or bipolar II.

Living With Bipolar Disorder

It’s important to remember that bipolar disorder is a medical diagnosis, and not a reflection of a person’s character. Like any other diagnosis—from diabetes to depression—it can have a huge impact on the rest of your life. Conversely, the events of your life may make your symptoms more or less severe. Clients may have difficulty navigating regular activities as a result of this condition.

Important Life Events

Trauma is linked to the development of many psychiatric conditions, including depression, anxiety, and a number of mood disorders. Bipolar is no exception. Experts agree that “​​childhood trauma⁶ in all its subcomponents appears to be highly associated” with this condition.

And after developing bipolar disorder, various life events may bring on severe mood swings. Both traumatic events and extremely positive experiences may be risk factors.⁷ Research has found that “bipolar patients are highly sensitive to reward, and excessive goal pursuit after goal-attainment events may be one pathway to mania. Negative life events predict depressive symptoms, as do levels of familial expressed emotion.”

Career

When even positive events can trigger your symptoms, it may be difficult to maintain an upward trajectory. For that reason, bipolar disorder interferes with some clients’ ability to work.

One study found that “Occupational disability is one of the most problematic impairments for individuals with bipolar disorder due to high rates of unemployment and work impairments. Current evidence indicates that social stressors at work⁸—such as social isolation, conflict with others, and stigmas—are common experiences for employed individuals with bipolar disorder.”

These social stressors can make or break a clients’ success in the workplace. And for people with bipolar, even more than for other clients, social support is hugely impactful throughout the healing process.

Community Building

Strong relationships are uniquely important for people with this condition. Data suggests that social support⁹ may be directly linked to the severity and frequency of clients’ symptoms.

Some rehab programs have a unique focus on the social aspect of healing. Gould Farm, for instance, is a therapeutic community that treats clients with bipolar disorder. Residents receive clinical care from a team of healthcare providers, and also participate in community efforts. This treatment model is designed to help clients “learn new skills, and others re-discover their strengths, building confidence and self-esteem.”

According to experts, “empathy and understanding from another person can make it easier to cope with bipolar disorder.¹⁰ Social interaction can also provide opportunities to challenge negative ruminative thoughts and prevent the onset of a major mood episode.” A loss of social support, on the other hand, can trigger either mania or depression.

When your diagnosis has such a great impact on so many aspects of life, it can be hard to disentangle your symptoms from your healthy emotional reactions. And remember, not all healthy reactions are positive. For example, it’s perfectly healthy to experience anxiety if you have to switch jobs. Clients with bipolar disorder may struggle to stay present with that anxiety, instead of tipping into a manic episode. This difficulty can lead to unhealthy coping mechanisms, such as substance misuse.