CARE GUIDE Bipolar Disorder

Bipolar Disorder

According to the World Health Organization, bipolar disorder is the sixth leading cause of disability in the world. The condition affects approximately 5.7 million adult Americans—about 2.6 percent of the U.S. population age 18 and older.

There are three types of bipolar disorder:

  • Bipolar I Disorder (mania or a mixed episode):The classic manic-depressive form of the illness, characterized by at least one manic episode or mixed episode. Bipolar I Disorder also involves at least one episode of depression.
  • Bipolar II Disorder (hypomania and depression):In Bipolar II disorder, the person doesn’t experience full-blown manic episodes. Instead, the illness involves episodes of hypomania and severe depression.
  • Cyclothymia (hypomania and mild depression):Cyclothymia is a milder form of bipolar disorder. It also consists of cyclical mood swings, but the symptoms are less severe than full-blown mania or depression

Bipolar disorder symptoms fall into three groups: mania, depression and hypomania.

Symptoms of mania or a manic episode:

  • A long period of feeling overly happy
  • Extremely irritable mood, agitation, feeling jumpy or wired
  • Talking very fast, jumping from one idea to another, having racing thoughts
  • Being easily distracted
  • Increasing goal-oriented activities, such as starting new projects
  • Being restless
  • Sleeping little
  • Having an unrealistic belief in one's abilities
  • Behaving impulsively and taking part in pleasurable, high-risk behaviors, such as spending sprees, impulsive sex and risky business investments.

Symptoms of depression or a depressive episode:

  • A long period of feeling worried or empty
  • Loss of interest in activities once enjoyed, including sex
  • Feeling tired or slowed down
  • Having problems concentrating, remembering and making decisions
  • Being restless or irritable
  • Chang in eating, sleeping or other habits
  • Thoughts of death or suicide, or attempting suicide.

Symptoms of hypomania or hypomanic episode:

Hypomania is a less severe form of mania. People experiencing hypomania are able to carry on with their day-to-day lives and they never lose touch with reality. It often escalates to full-blown mania or is followed by a major depressive episode. Symptoms of hypomania include:

  • Feeling euphoric, energetic and productive
  • Seeming unusually happy to others

Doctors and Specialists

Initially, a diagnosis of bipolar disorder will likely start with your family doctor or general practitioner. You may then be referred to a psychiatrist —a medical doctor who specializes in diagnosing and treating mental health conditions. During the journey of bipolar treatment, you may come into contact with some of the following providers as well:

Social Worker or Counselor: Provide support, education, and guidance to people with bipolar disorder and their families. This mental health professional often works with the psychiatrist to track progress.

Psychiatrists with ECT Fellowship: Electroconvulsive Therapy (ECT)—formerly known as “shock therapy,”—may be recommended if medication and/or psychotherapy does not work.

Holistic Practitioner: A specialist who views the body as a whole, considering physical, mental and spiritual components. Holistic practitioners may recommend herbs and nutritional supplements to control bipolar symptoms along with meditation, diet and exercise programs.

Endocrinologists: Bipolar disorder is often associated with thyroid gland problems. So you may be referred to an endocrinologist, an internist who concentrates on disorders affecting the endocrine system.

Preparing for Your Appointment

After you make an appointment for bipolar disorder diagnosis and treatment, there are some steps you can take to make your visit a smooth one.

  • Write down any symptoms you've had, frequency of symptoms, any aggravations including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, as well as any vitamins or supplements that you're taking. Include the dosage you take.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Make a list of any conditions you’re currently being treated for or have been in the past, along with dates.

You should also bring a list of questions you have about bipolar disorder to your appointment. Review the following list of common concerns before you go, or print it out to take with you.

Questions About My Diagnosis

  • Is bipolar disorder likely causing my symptoms or condition?
  • Other than the most likely cause, what are other possible causes for my symptoms or condition?
  • What kinds of tests will I need?
  • Are there any brochures or other printed material that I can take home with me? What web sites do you recommend I visit for more information?

Questions About My Treatment

  • What treatment is likely to work best for me?
  • Should I see a psychiatrist or other mental health provider? What will that cost, and will my insurance cover seeing a specialist?
  • What are the alternatives to the primary approach that you’re suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Is there a generic alternative to the medicine you’re prescribing me?

Questions About My Lifestyle

  • What are changes required in my current lifestyle including diet? Will I be able to work efficiently?
  • Is it hereditary disease? Will I pass the condition to my children?
  • Does bipolar disorder have anything to do with my disturbed childhood development?
  • Which family members should know about my disorder?
  • If we have a family history of diabetes, blood pressure or cholesterol, could that worsen my bipolar symptoms?

Tests and Diagnosis

There is no specific test that can diagnose bipolar disorder. However, the following tests may be performed to rule out other conditions that may cause similar symptoms.

Psychological Examination

  • Helps to assess your current state of mind and rule out other mental disorders
  • A doctor or mental health provider will talk to you about your thoughts, feelings and behavior patterns. You may be asked to fill out assessment questionnaires.

Complete Blood Count

  • Regular blood test to rule out any physical problems that could be causing bipolar-like symptoms, such as thyroid issues or anemia
  • Creates images of the brain to rule out disorders like stroke and brain tumor


  • Creates images of the brain to rule out disorders like stroke and brain tumor

Medications and Treatment

There are various types of treatment that could be used to treat bipolar disorder. Your physician may want to combine therapies for the best result.


  • Mood Stabilizing Medications: Generally first choice of medications to treat bipolar disorder. Helps to control mania and recurrence of manic and depressive episode.
  • Atypical Antipsychotic Medications: Helps to treat symptoms of bipolar disorder, usually when combined with other psychotic medicines.


  • Cognitive behavioral therapy (CBT): Helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviors
  • Family-focused therapy: It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one
  • Interpersonal and social rhythm therapy: Helps people with bipolar disorder improve their relationships with others and manage their daily routines
  • Psychoeducation: Teaches people with bipolar disorder about the illness and its treatment

Alternative Treatments

  • Electroconvulsive Therapy: Shock therapy, performed only in patients with severe bipolar disorder who don’t respond to other treatments
  • Sleep Medications: Only given when, person with bipolar has trouble sleeping