Bipolar Disorders

Bipolar disorder is a brain disorder distinguished by unusual shifts in mood, momentum, and interest levels that can impact your ability to carry out your day-to-day commitments.  

There are different types of bipolar disorder; each is characterized by distinct mood swings including mania or hypomania (emotional highs) and depression (emotional lows).  The highly energized, expansive, or extremely elated behaviors are referred to as manic episodes.  Other symptoms may include:

  • Restlessness
  • Decreased need for sleep
  • Increased self-confidence or grandiosity
  • Excessive talking
  • Racing thoughts or lots of ideas and plans
  • Distractible
  • Hyper-sexual
  • High risk behaviors such as impulsive sex, huge spending sprees, excessive gambling

A less severe manic episode is considered a hypomanic episode.  On the other end of the continuum is the depressed phase distinguished by feeling very sad or hopeless periods.  The fluctuation between moods can significantly impact your sleep, energy, activity, judgment, behavior, and the ability to complete daily tasks. 

You may enjoy the feeling of euphoria you experience with a bipolar disorder. You may enjoy the periods of productivity.  You may not recognize or acknowledge just how disruptive your emotional instability is to you or your loved ones and, therefore, fail to seek or accept treatment. The euphoria is inevitably followed by an emotional crash that leaves you depressed and depleted.  In some instances, you may be left with legal, financial or relationship wreckage created during a euphoric period.

Bipolar disorder does not get better without treatment.  Effective treatment typically includes medication and psychotherapy.  

Bipolar I Disorder

Bipolar I disorder is distinguished by an episode of manic symptoms that last at least 7 days or are serious enough to warrant hospitalization.  The euphoric state can be extreme elation, high energy, expansiveness, or irritable mood.   At times, people experiencing severe symptoms of mania activate a psychotic episode (i.e. a break from reality).  Manic episodes may be preempted or followed by hypomanic or depressive episodes.  It is also possible to experience both symptoms of depression and mania concurrently.  This is known as a mixed episode.

Bipolar II Disorder

Bipolar II disorder is differentiated from bipolar I disorder in that the individual has never experienced a full-scale manic or mixed episode.  Individuals diagnosed with bipolar II disorder have experienced at least one major depressive episode and at least one hypomanic episode.  Hypomanic episodes are characterized by less extreme manic symptoms, the episode lasts at least 4 days, and it is not serious enough to warrant hospitalization  

Cyclothymic Disorder

Cyclothymic disorder or cyclothymia is distinguished by multiple periods of hypomanic symptoms as well as multiple periods of depressive symptoms that last for at least 2 years in adults.  During that time, there are multiple periods of hypomania and depressive symptoms.  Also, the individual may not experience any symptoms for brief periods and they may last for less than 2 months at a time.


Individuals with diagnosed or suspected bipolar disorders should seek the direction of a psychiatrist (MD) who specializes in diagnosing and treating bipolar disorders.  Bipolar disorders are lifelong conditions and the treatment is focused on symptom management.  Depending on the individual’s needs, treatment may include medication, day treatment programs, substance abuse treatment, and hospitalization. 

Individuals who are medication compliant and whose symptoms are effectively managed will benefit from psychotherapy on an outpatient basis.  Therapy can be useful for a) creating consistent routines that help with emotion regulation, b) provision of cognitive behavioral therapy to identify and replace negative beliefs and behaviors, c) teaching coping skills for stressors, and d) family focused therapy for warning sign identification and management.
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