What is Bipolar Disorder and How is it Managed?

Depressed African american woman sitting in bed with arms crossedMany people experience mood highs and lows and the majority of them don’t have true bipolar disorder. Extreme mood swings may be caused by a number of things, including but not limited to anxiety, panic, trauma, anger, ADHD, Autism Spectrum Disorder, stress, lack of sleep and certain medications or recreational drugs. A thorough evaluation must be done by a clinical psychologist or psychiatrist in order to diagnose bipolar disorder and rule out other causes for these symptoms. It is important to seek an evaluation from a qualified mental health provider and diagnostician as bipolar disorder is very often misdiagnosed, leading to inappropriate treatment.

The good news is that bipolar disorder is usually very manageable when treated by a professional who has expertise in managing it.

What is Bipolar Disorder?

Bipolar disorder, previously called manic depression, is a disorder of the brain that causes changes in mood. These mood swings are extreme in nature and cause distress and difficulty with day to day functioning. There are three primary types of bipolar disorder.

Bipolar I Disorder

At least one episode of true mania (not hypo-mania, described below) and this manic episode was not caused by medication or another mental illness. Usually additional manic and hypo-manic episodes will be seen along with depressive episodes at varying times. It is also possible to have depression with symptoms of mania occurring at the same time.

Bipolar II Disorder

This is characterized by cycling between depressive episodes and hypo-manic episodes, but no full manic episodes.

Cyclothymic Disorder

There have been at least two years (1 year for children and teens) of hypo-mania and limited symptoms of depression, but no full-blow mania or full-blown depression. Many people with cyclothymia never seek treatment, but may have trouble keeping jobs or sustaining healthy relationships due to their illness and not feeling like they have control over their lives or their emotions.

Mania and Hypomania

Cartoon image of mood swings The symptoms of mania and hypo-mania are similar, but mania is more severe. Mania symptoms may cause problems in school, work, and relationships/social life, whereas hypo-mania is often enjoyable and can lead to greater productivity and motivation. These are the mood “highs” in bipolar disorder, but they aren’t always positive.  They are often characterized by anger, irritability and agitation, rather than happiness and euphoria.  It is also possible that full-blown mania may lead to psychosis and require hospitalization.  Both mania and hypo mania may include some of following:

  • Feeling up
  • Increased Energy
  • Increased Activity, motivation, productivity
  • Feeling “Upbeat”, “Jumpy”, or “Wired”
  • Difficulty Sleeping
  • Racing Thoughts
  • Talking Quickly About Different Things
  • Feeling Agitated, Irritable or angry
  • Feeling Like You Can do Many Things at Once
  • Engaging in Risky Behaviors, Like over-spending, gambling, Risky Sexual Behaviors or excessive drug or alcohol use


Depression is the “low” mood in bipolar disorder and episodes cause difficulty in day-to-day tasks such as work, school, social activities, and relationships. Depressive may include some of the following symptoms:

  • Feeling sad, down, hopeless
  • Decreased Energy
  • Decreased Activity
  • Sleeping Difficulties (too much or too little)
  • Feeling Nothing is Enjoyable
  • Feeling Worried and Empty
  • Difficulty Concentrating
  • Forgetful
  • Difficulty Eating (too much or too little)
  • Feeling Tired or Run Down
  • Suicidal Thoughts

Risk Factors

Scientists and researchers have studied bipolar disorder and agree that not just one factor puts someone at risk. It is likely many factors may contribute to increased risk of developing bipolar disorder.

Brain Structure and Functioning

Some research has shown that people with bipolar disorder have differences in brain functioning than people who are healthy or suffer from other mental illnesses.


Research has indicated a very strong genetic factor to bipolar disorder. However, genes are not the only factor. There have been some twin studies done where only one of two identical twins (with the same genes) will develop bipolar disorder.

Family History

Bipolar disorder is believed to run in families and this might not only be due to genetics, but also the family environment. It has been found many children who have an immediate family member with bipolar disorder are more likely to develop it as well. It is important to know that most people who have a family member with bipolar disorder will not develop it themselves.

Can Bipolar Disorder be Treated?

Bipolar disorder may last a lifetime for many. Fortunately, with proper treatment, even the most severe cases can be treated. Bipolar disorder is usually treated with a combination of medications and therapy. Continuous treatment, even between episodes, may help manage mood swings.


Psychotherapy can be an effective way to treat bipolar disorder. A psychologist or counselor will be able to talk with you and your family about bipolar disorder. They will provide education, support, and direction. Some forms of psychotherapy used in the treatment of bipolar disorder are:


Medications may be needed to control the symptoms of bipolar disorder. It is important to remember that most people will need to try multiple medications before finding one that works the best. Because treating bipolar disorder can be complicated and often requires more than one medication, it is important to see a specialized psychiatric prescriber (a board-certified psychiatrist or psychiatric nurse practitioner), rather than seeking treatment from your primary care provider. Common medications used for bipolar treatment include:

Schedule an Appointment

If you think you or a loved one are experiencing symptoms of bipolar disorder, there is help for you. Stepwell Mental Health and Wellness, in Boulder, Colorado, has trained psychologists and psychiatric prescribers who are able to provide you with therapy and if needed, an appropriate medication evaluation.

Still have questions about treatment for bipolar disorder? We can discuss your specific situation and determine if therapy might benefit you. Schedule a free 15-minute consultation or your first appointment through our secure Client Portal or contact us.