Bipolar and Related Disorders
Mental Health Treatment, Boise, ID
Bipolar disorder was formerly called manic-depressive disorder. It is a mental health condition that has many subtypes but includes episodes of depression-dysthymia AND mania-hypomania.
According to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5), a manic episode is a distinct period of abnormally and persistently elevated expansive or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least one week and present most of the day for nearly every day. During a period of mood disturbance and increased energy, several of the following symptoms may be experienced:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or pressured speech
- Flight of ideas or subjective experience that thoughts are racing
- Increase in goal-directed activity or psychomotor agitation
- Excessive involvement in activities that have a potential for painful consequences
The mood disturbance is sufficiently severe to cause to marked impairment in social or occupational functioning.
A lesser form of mania is called hypomania. According to the DSM-5, a hypomanic episode is a distinct period of abnormally and persistently elevated expansive or irritable mood and abnormally or persistently elevated activity or energy level lasting at least four consecutive days and present most of the day nearly every day. During the period of mood disturbance and increased energy and activity, several of the symptoms of mania (mentioned above) may be present, although to a lesser degree than a full-blown manic episode. The hypomanic episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. The episode is NOT severe enough to cause direct impairment in social or occupational functioning or to necessitate hospitalization. Therefore, it is of a lesser degree of severity vs. a manic episode.
People with bipolar disorder also struggle with symptoms of major depression and/or dysthymia. Please see the section on Depressive Disorders for more information on these specific mood conditions.
Subtypes of bipolar disorder include bipolar I with episodes of both mania and major depression, bipolar II with episodes of hypomania and major depression, and cyclothymic disorder that usually includes episodes of hypomania and dysthymia.
People with bipolar disorder cycle from depressive manic episodes. Depressive episodes may last several months, whereas manic episodes usually last a few days or weeks.
There is effective evidence-based psychopharmacotherapy for bipolar disorder. Most of the initial treatment focuses on mood stabilizing medications to help with periods of mania/hypomania. If the patient’s irritability and mood lability decrease, but he or she remains depressed, antidepressant medication may also be used in treating bipolar disorder. Patients with bipolar disorder definitely benefit from a supportive talk therapy process and other nonmedication-type therapies.