The Ups and Downs of Bipolar Disorder

MS Broudy Ph.D
December 9, 2019

Bipolar disorder is a psychiatric disorder characterized by a combination of three emotional states: manic, hypomanic, and depressed mood. It is estimated that 4.4 percent of American adults experience bipolar disorder during their lives. Age of onset is usually early adulthood but almost three percent of adolescents experience bipolar. Here are the symptoms of bipolar disorder and the most common treatments.


Symptoms of Mania and Depression

All variations of bipolar disorder are made up of symptoms of a manic and/or depressive episode. Episodes are usually recurring, although there may be periods where symptoms do not appear.


For a diagnosis of a manic episode, an individual needs to be experiencing an elevated or irritable mood and at least three manic symptoms for at least one week. These symptoms are severe enough to disrupt regular functioning:

  • Display of grandiosity
  • Less need for sleep
  • Pressured speech, talking more than usual
  • Easily distracted
  • Increase in risky behaviors
  • Overscheduling of activities, tasks
  • Racing thoughts


Hypomania is a less severe form of a manic episode. Symptoms only need to occur for four days and they are not severe enough to impair everyday functioning.


For a diagnosis of major depression, an individual must experience depressed mood and/or a loss of pleasure in previously enjoyable activities for at least two weeks. They also must have five or more of the following symptoms:

  • Depressed Mood
  • Loss of pleasure in previously enjoyable activities
  • Significant weight loss or weight gain, or decrease or increase in appetite nearly.
  • A slowing down of thought and a reduction of physical movement
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death and/or suicidal thoughts or actions

The Three Designations of Bipolar Illness

Bipolar disorder has three designations: Bipolar I, Bipolar II, and Cyclothymia. All three are made up of either manic and/or depressive symptoms.

Bipolar I

A bipolar I diagnosis requires the presence of a manic episode. You may or may not also experience a depressive episode.

Bipolar II

A bipolar II diagnosis requires a depressive episode and hypomania but not a full manic episode.


Cyclothymia is a combination of hypomanic symptoms and depressive symptoms, but not severe enough to meet the criteria for a full-blown manic and depressive episode. Symptoms must be present for at least two years.


It is almost always recommended that bipolar I and II be addressed with a combination of psychotropic medication and psychotherapy.


The most common medications prescribed for the treatment of bipolar are mood stabilizers (e.g., lithium and valproate, an anti-convulsant) and anti-depressants. Antipsychotic medication has also been used with some success, primarily to treat manic symptoms. Individuals who prove resistant to medication are sometimes recommended to undergo electroconvulsive therapy (ECT).


Psychotherapy is often used with bipolar to cope with the symptoms of the disorder. Cognitive-Behavioral Therapy (CBT), in addition to its effectiveness with depressive symptoms, can be used to help deal with potential triggers by instituting healthy behaviors, such as mindfulness meditation. Family-focused therapy educates family members on bipolar warning signs and how to encourage the individual to use coping skills and comply with treatment. Interpersonal and Social Rhythm Therapy (IPSRT) focuses on teaching people to recognize triggers and do what is necessary to prevent future bipolar episodes.

Bipolar disorder is a serious illness that may require hospitalization. Fortunately, a combination of medication and psychotherapy can successfully manage its symptoms. If you believe you suffer from bipolar disorder, please seek treatment as soon as possible.

MS Broudy Ph.D

MS Broudy is a psychologist, writer, and consultant. He has a Ph.D. in Clinical Psychology and a master’s degree in Social Psychology. He has spent over 20 years providing therapy and assessment services for a diverse set of clients. MS specializes in writing about mental health, parenting, and wellness. He has his own blog,, where he writes about psychological issues.