Bipolar Disorder

Bipolar disorder targets and changes a person's behavior, thoughts, sense of well-being and moods. Episodes or phases of higher or lower moods are noticeable and these phases can last for hours, days, weeks or months, and will often interfere with an individual's activities of daily living. Bipolar disorder affects more than 2 million Americans - about 3 out of every 100 adults. It affects people of all ages, race, ethnicity, gender, education or occupation.

What is Bipolar Disorder?

Bipolar disorder, also known as manic depression, is a chronically recurring condition involving moods that swing between the highs of mania and the lows of depression.

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may experience bouts of high energy and confidence, or anger and irritability. Mood shifts may occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time. This is known as having a “mixed episode.”

Bipolar disorder most often starts in young adulthood, but also occurs in children and adolescents. The condition is often confused with other mood- or personality-related disorders, such as attention-deficit-hyperactivity disorder, schizophrenia and borderline personality disorder.

Types of Bipolar Disorder

Bipolar disorder is divided into several subtypes. Each has a different pattern of symptoms. Types of bipolar disorder include:

Bipolar I disorder: Mood swings with bipolar I cause significant difficulty in your daily life and relationships. Manic episodes can be severe and dangerous.

Bipolar II disorder: Bipolar II is less severe than bipolar I. You may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine. Instead of full-blown mania, you have hypomania — a less severe form of mania. In bipolar II, periods of depression typically last longer than periods of hypomania.

Cyclothymic disorder: Cyclothymic disorder, also known as cyclothymia, is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disruptive, but the highs and lows are not as severe as they are with other types of bipolar disorder.

What are the Symptoms of Bipolar Disorder?

Bipolar disorder symptoms reflect a range of moods. The exact symptoms of bipolar disorder vary from person to person. For some people, depression is the most troubling. For other people, manic symptoms are the main concern. A person with bipolar disorder may experience any mix of the symptoms below.

Signs and symptoms of the depressive phase of bipolar disorder can include:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Low appetite or increased appetite
  • Fatigue 
  • Loss of interest in activities once considered enjoyable
  • Problems concentrating
  • Irritability
  • Chronic pain without a known cause
  • Frequent absences from work or school

Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:

  • Euphoria
  • Inflated self-esteem
  • Poor judgment
  • Rapid speech
  • Racing thoughts
  • Aggressive behavior
  • Agitation or irritation
  • Increased physical activity
  • Risky behavior
  • Spending sprees or unwise financial choices
  • Increased drive to perform or achieve goals
  • Increased sex drive
  • Decreased need for sleep
  • Easily distracted 
  • Careless or dangerous use of drugs or alcohol
  • Frequent absences from work or school
  • Delusions or a break from reality (psychosis) 
  •  Poor performance at work or school

How is Bipolar Disorder Treated?

Bipolar disorder requires lifelong treatment, even during periods when you feel better. Treatment is usually guided by a psychiatrist skilled in treating the condition. If you are behaving dangerously or feel suicidal, your doctor may refer you to one of our locations for hospitalization.

At Sentara, our inpatient treatment approach includes a team of psychiatrists, therapists, nurses, social workers and medical professionals. Our experts will work with you to determine a treatment plan, which may include medications and individual, group or family counseling. Continued outpatient treatment is important for managing your disorder in the long term. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.

If you are suffering from a substance abuse disorder, it may be more difficult to manage bipolar disorder. We help you treat these substance abuse issues as well in order to make the most progress possible.

If you think you or someone you love may be struggling with bipolar disorder, please contact us so the Sentara psychiatric team can recommend the best next steps for you or your family.