Understanding bipolar disorder

Being informed about mental health disorders is an invaluable way to start breaking down the stigmas we have around them.

Being informed about mental health disorders is an invaluable way to start breaking down the stigmas we have around them.

Understanding bipolar disorder

There are many misconceptions when it comes to bipolar disorder. Some people do not want to tell others about they are bipolar because they feel ashamed or fear judgement. It would be nice if all mental health disorders became more understood and less taboo, but we’ll start with bipolar disorder today.

The basics

There are two types of bipolar disorder: Bipolar I and Bipolar II. Both type I and II are characterized by swings between elevated moods and periods of depression, but with Bipolar I the manic episodes are more extreme in nature.

Bipolar I Disorder

To be diagnosed with Bipolar I a person would have experienced one or more manic episodes or mixed episodes (that’s when symptoms of both mania and depression are present within the same period), the symptoms cause social or occupational distress or impairment, and the occurrence is not better explained by another mental health disorder

What is a manic episode

  • A persistent elevated, expansive, or irritable mood for at least one week and present for most of the day, nearly every day
  • At least 3 of the following (4 if irritable) are present during the episode
    • Inflated self-esteem or grandiosity
    • Decreased need for sleep
    • Increased talkativeness
    • Flight of ideas or racing thoughts
    • Distractibility
    • Increase in goal-directed activity or psychomotor agitation
    • Increase in risky behavior
  • Level of severity is enough to cause social or occupational impairment, hospitalization, or psychotic features
  • Symptoms are not due to a substance or medical condition

What is a mixed episode

  • Criteria for a manic and major depressive episode are met almost every day for at least a week

What is a major depressive episode

  • At least 5 of the following are present in a two week period nearly every day; at least one symptom is either depressed mood or loss of interest/please.
    • Depressed mood most of the day
    • Diminished interest in nearly all activities most of the day
    • Significant change in weight or appetite
    • Insomnia or hyperinsomnia
    • Psychomotor agitation or retardation
    • Fatigue or decreased energy
    • Inappropriate guilt or feelings of worthlessness
    • Difficulty concentrating or making decisions
    • Recurrent thoughts of death, suicidal thoughts, plans, or attempts
  • Symptoms do not meet the criteria for a mixed episode
  • Level of severity is sufficient enough to cause social or occupational impairment, hospitalization, or psychotic features
  • Symptoms are not due to a substance or medical condition

Bipolar II Disorder

Bipolar II disorder is characterized by episodes of euphoric highs (hypomania) and depressed lows. Hypomania is different from mania in that, even though it can cause impairment in the individuals social or occupational life, it is not as severe. Also, hypomania is not characterized by psychosis.

In order to be diagnosed with Bipolar II disorder, a person will meet the criteria for at least one hypomanic episode and at least one major depressive episode; they have never experienced a manic episode; the symptoms cannot be better explained by a different mental health disorder; and, the unpredictable swings between the hypomanic and major depressive episodes causes a clinically significant amount of distress or impairment in social, occupational, or other important areas of functioning.

What is hypomania

  • A persistent elevated, expansive, or irritable mood for at least one week and present for most of the day, nearly every day
  • At least 3 of the following (4 if irritable) are present during the episode
    • Inflated self-esteem or grandiosity
    • Decreased need for sleep
    • Increased talkativeness
    • Flight of ideas or racing thoughts
    • Distractibility
    • Increase in goal-directed activity or psychomotor agitation
    • Increase in risky behavior
  • During the episode, the person is noticeably changed from when non-symptomatic
  • Others can notice the change in mood and functioning
  • The episode is NOT severe enough to cause social or occupational impairment or require hospitalization
  • Symptoms are not due to a substance or medical condition

Break it all down

Although the criteria for a manic and hypomanic episode appear similar the important distinction is a hypomanic episode is not severe enough to cause notable impairment in social or occupational functioning, or necessitate hospitalization.

To be diagnosed with Bipolar II disorder a person must have NEVER experienced a manic episode.

If you are in the Vancouver, WA or Portland, OR area and are looking for counseling related to mood disorders, please fill out the form below or call me at 360-284-7008.

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Tamara Duarte

Tamara Duarte is a counselor, author, speaker, and activist. Her private practice, Get Centered Counseling in Vancouver WA, helps women with food and body issues learn to love themselves, their body, their life, and their relationships. Her life’s work is steeped in personal experience, having fifteen years in recovery for anorexia, in addition to being a breast cancer survivor. An up and coming force in the counseling community, Tamara has been published in a textbook called Treatment Strategies for Substance and Process Addictions, and has sat on a panel at the American Counseling Association Conference, where she spoke to her peers on strategies and tools to use with clients struggling with eating disorders. Having a deep, personal understanding of what it takes to recover from this condition, she seeks to be an example to those she treats, to let them know that recovery is possible. Currently developing a podcast which addresses the cultural issues that promote body shame, self-esteem issues and eating disorders, Tamara lives in Vancouver, Washington, with her husband and best friend, Adam, enjoying life to the fullest with their two beautiful children, Jacob and Chloe.