Bipolar disorder can disrupt a person’s mood, energy, and activity level, often resulting in difficulty in living your normal life. Historically, the diagnosis was referred to as manic-depression, since bipolar disorder often switches between episodes of depression and episodes of mania. In some cases, people with this diagnosis can experience both simultaneously, called a mixed episode.
A depressive episode refers to a period of persistently sad mood or diminished interest in activities, resulting in distress or impairment. Additionally, depressive episodes may also include over/under sleeping, difficulty concentrating, significant weight loss/gain, forgetting things, decreased energy, feeling slow or restless, social withdrawal, decreased activity, feeling worthless/guilty, and thoughts of death/suicide.
A manic episode refers to a period of unusual and consistently elated (i.e., feeling “high”), expansive (i.e., feeling especially important or talented), or irritable mood alongside unusually and consistently increased activity or energy. Additionally, manic episodes may also include decreased sleepiness, racing thoughts, distractibility, overcommitting (e.g., believing you can start many new projects/activities without tiring), unusual talkativeness, and engaging in uncharacteristic risky behavior (e.g., shopping sprees, sex with multiple partners, unsafe driving, etc.).
The severity and length of mood episodes vary by person and specific occurrence, with the most extreme cases resulting in hospitalization and/or symptoms of psychosis (i.e., hallucinations and delusions). For a person to qualify for a diagnosis of bipolar disorder, they must experience mania in the form of either a manic or hypomanic episode. Hypomanic episodes are less extreme than manic episodes, have a shorter duration, and do not result in hospitalization. Although some individuals with bipolar disorder experience multiple episodes each year, others may experience only one or two. The term “rapid cycling” refers to experiencing more than three episodes of mania or depression within a single year.
The symptoms of bipolar disorder can make it look like several other diagnoses (i.e., major depressive disorder, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and certain personality disorders), making diagnosis difficult. In some cases, bipolar disorder includes symptoms of psychosis, which can make diagnosing it even more challenging. Furthermore, bipolar disorder can exist alongside other mental disorders (e.g., anxiety disorders, attention-deficit/hyperactivity disorder, and substance use disorder) and places individuals at increased risk for physical problems (e.g., thyroid and heart disease, diabetes, migraines, and obesity). If you have any concerns that you or a loved one might have any mental health diagnosis, consult with a licensed mental health or medical professional.
Bipolar disorder is treated with medication (i.e., mood stabilizers and antipsychotics) and psychotherapy. Although bipolar disorder is an ongoing condition, treatment can help empower people to have more control over their symptoms and remain engaged in valued activities. Psychotherapy is effective in treating symptoms of depression and managing behaviors related to manic and hypomanic episodes. Psychotherapy can be used to provide information and educate, challenge and revise unhelpful thoughts and behaviors, improve communication, and increase familial support and understanding. Treatment may also include tracking patterns among daily mood symptoms, life events, medication responses, and sleep.
Despite a handful of examples (e.g., “Gata” on Dave, “Sonny” Corinthos on General Hospital, Ian on Shameless, Pat and Tiffany in Silver Linings Playbook, and Charlie on King of California), bipolar disorder has rarely been explicitly portrayed within video games and other media. These examples have been lauded for their authenticity. Gerard Kearns, Bradley Cooper, and Michael Douglas leveraged extensive research and observation to accurately portray the disorder, while Maurice Benard and Jennifer Lawrence used first-hand experience based off their own diagnosis of bipolar disorder. Overall, this underrepresentation could be due to several factors, including the complexity of the diagnosis, the common misperception that mania/hypomania is pleasant/desirable, and the danger severe mania poses. Furthermore, media more frequently focuses on characters who experience either pure depression or psychosis, neither of which sufficiently represent bipolar disorder when they occur independently.
Curious about the diagnostic series? Check out the introduction here.
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If you live in the US and you’re having suicidal thoughts, reach out to the Suicide & Crisis Lifeline or call/text 988. If you’re outside the US, you can find local crisis lines at Suicide.org. If you’re even debating whether you should call them, you should call them. The Suicide & Crisis Lifeline handles all psychological crises, not just suicide.