Bipolar disorder is a medical condition that describes a person who has abnormally abrupt, high and low mood swings (referred to as mania and depression). The disorder is classified into three different types: Type 1, Type 2 and Cyclothymia. Admittedly, referring to the cycles as “high and low mood swings” is an over-simplified definition and yet, to the average observer, this is indeed what bipolar disorder looks like.
Bipolar disorder occurs just as often in men as it does in women and the average age of diagnosis is between 15-25 years of age. This is when symptoms typically appear or begin to affect the quality of life for the person with the disorder. The exact cause and triggers of this disease are not currently known or understood though it seems to occur more often in the relatives of people previously diagnosed with bipolar disorder. Bipolar disorder of any type cannot be diagnosed until a confirmed period of mania has been observed by the practitioner caring for the patient.
Before taking a closer look at the different types of bipolar and how they are assessed, it is necessary to explain the difference between mania and depression.
Mania is characterized by an abnormally intense “upbeat” state of being. This doesn’t mean the person experiencing a manic phase is “happy,” as some think. Rather, the manic phase has more to do with an inflated sense of euphoria and a feeling that they can accomplish anything. Mania is often characterized by an excessive amount of energy, a lack of a need for sleep, diminishing or complete lack of inhibitions, racing thoughts, talkativeness and a propensity towards taking extreme and unnecessary risks (in any area of life including sex, business, and dangerous physical risks, such as driving far too fast). While mania is often associated by the general public with excessive, bubbly cheerfulness, it’s more often associated with extreme irritability and in extreme cases mania can induce hallucinations, both audio and visual. Severe mania actually resembles psychosis in some patients. A person going through a manic phase may feel that they can do anything, that they are above or smarter than everyone else and may appear to be exceedingly ambitious.
Depression, on the other hand, is a period of extreme “low” mental state. A depressed person may find himself always tired, having very low energy, extremely sad, experiencing a sense of despair and have a lack of interest in living day-to-day life. In very extreme cases depression can also be psychotic, involving auditory and visual hallucinations. A person experiencing depression may be sleepy all of the time, feel as though everything in life is falling apart and may have extreme difficulty functioning in day-to-day life.
Type 1 Bipolar
In the past, people tended to refer to bipolar disorder as “manic depression”. As the condition has become better understood, that term has fallen out of use because bipolar is now understood to encompass more than one set of symptoms. Type 1 bipolar most closely resembles what the older term “manic depression” described. A person with Type 1 bipolar disorder has had at least one fully manic episode and his or her life is marked with periods of major depression.
Type 2 Bipolar
Type 2 bipolar is similar to Type 1, however, people with Type 2 bipolar disease never experience full-blown mania. Instead, they have periods of hypomania (characterized by elevated levels of energy and a tendency towards impulsiveness that never get as extreme as mania). In general, for a person with Type 2 bipolar disease, they experience periods of both hypomania and depression and in a cyclical pattern.
Cyclothymia is a milder form of bipolar disorder characterized by less severe periods of depression and hypomania. These mood swings are cyclical in an extreme way and can happen as often as several times in one day, making it easy for a patient to be misdiagnosed as having depression alone. Depression symptoms tend to stand out more, particularly in people with energetic, passionate personalities anyway. The nature of this type of bipolar disorder makes it very difficult to diagnose as a practitioner may never actually get to see a hypomanic episode.
Regardless of the type of bipolar disorder a person has, understanding that it is a medical condition that requires early diagnosis and comprehensive treatment plan – both are key to leading a healthy and productive life.