If you have bipolar disorder, you probably go through really high highs and really low lows. These mood swings can mess with your daily life. Doctors think these shifts happen because of a chemical imbalance in the brain, and it’s usually something you deal with your whole life. Back in 2020, about seven million Americans had this condition. Keep reading to find out more about bipolar depression, how it’s treated, and how a mix of medicine and therapy (online or in person) can help you have fewer manic or depressive episodes.
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Do you have a tough time with your bipolar depression symptoms?
An online therapist can help.
What is bipolar depression?
Bipolar depression, also called manic depression in the past, is a mental illness that causes big mood swings. You’ll likely feel extreme highs (mania or hypomania) and lows (depression), according to the Mayo Clinic. When you’re depressed, you might feel hopeless, or lose interest and pleasure in things you used to enjoy, which is called anhedonia. When your mood shifts to mania or the less extreme hypomania, you might feel super happy, very energetic, or get really annoyed easily. These mood swings can mess with your decisions, sleep, actions, energy, and how well you can focus or think straight.
Types of bipolar depression
Doctors usually figure out what kind of bipolar depression you have by looking at how often and how bad your manic, depressive, and hypomanic episodes have been. It’s good to know that bipolar II isn’t necessarily less serious; it’s usually seen as a different diagnosis.
Bipolar I disorder
If you’ve had at least one manic episode, which might come before or after hypomanic or major depressive episodes, you might have bipolar I disorder. With bipolar I, the manic episodes are really strong and can really mess up your daily life. Mania can even cause psychosis, where you lose touch with reality. People with bipolar I often have more severe highs (manic episodes) that can be dangerous. Getting diagnosed and treated early is often key to managing bipolar I.
Bipolar II disorder
If you’ve had at least one hypomanic episode and one major depressive episode, but never a full-blown manic one, you might have bipolar II disorder. People with bipolar II have less severe highs (hypomania), but their depressive periods tend to be worse and can last a long time. Managing bipolar II often means long-term care to cut down on depressive episodes.
Cyclothymia
Cyclothymia is sometimes called bipolar III and it’s a type of mood disorder. For at least two years (or one year for kids and teens), you’ve had lots of hypomania and depressive symptoms, but not severe enough to be called major depression. The mood swings aren’t as intense as with other kinds of bipolar disorder.
Other problems that often come with bipolar disorder
Bipolar disorders often pop up with other mental health issues, such as psychosis, anxiety, problems with alcohol or drugs, PTSD, eating disorders, and ADHD.
What causes bipolar depression and manic episodes?
We don’t know the exact cause of bipolar disorders yet, but many doctors think several things might make someone get this mental health condition. Brain differences and chemical imbalances might play a part, though we don’t fully get how important they are. Your genes and family history of mental illness could also be a factor. If you have a close family member, like a sibling or parent, with bipolar depression, you’re about ten times more likely to get it yourself.
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Signs and symptoms of bipolar disorder or bipolar depression
Early signs of bipolar depression can be feeling sad or hopeless, trouble sleeping, and low energy. The main thing about this disorder is usually a back-and-forth shift between two kinds of extreme episodes—manic (or hypomanic) highs and depressive lows, with no clear pattern.
Mania and hypomania
Mania is usually worse than hypomania and can really mess up your daily life, with stronger symptoms and less control over your feelings and actions. This is different from agitated depression, which usually has both depressive and manic symptoms. Mania symptoms typically stick around for about a week, while hypomania usually lasts at least four days. Both manic and hypomanic episodes usually need three or more of these symptoms:
- Feeling unusually upbeat, like you’re jumpy or wired with tons of energy.
- Being super active, feeling full of energy or easily annoyed.
- A really strong sense of confidence or feeling great; you might feel euphoric.
- Not needing or being able to sleep much.
- You might talk a lot and can’t stop your thoughts from spilling out.
- Your thoughts might race, making it hard to focus.
- You might get distracted easily.
- You might make bad choices, like risky sexual behavior, spending too much, or making quick, bad investments.
- Depressive episodes
- Major depressive episodes often come with symptoms so bad they really affect your daily life and usually last longer than manic episodes. You generally need five or more of these symptoms to count as a depressive episode.
Thoughts, plans, threats, or attempts of suicide.
Suicide rates are higher for people with bipolar disorder, so it’s super important to get help if manic or depressive symptoms get worse. If you or someone you know is having suicidal thoughts, get help right away. You can call the National Suicide Prevention Lifeline at 988 anytime.
Related Article: How To Help A Suicidal Friend
Mixed manic and depressive episodes
During a mixed episode, you might have symptoms from both manic and depressive episodes at the same time. For example, you might feel incredibly energized while also feeling completely hopeless or very sad.
Differences in bipolar disorder symptoms by gender
Research shows that women often start showing bipolar depression symptoms later in life than men and tend to have mood patterns that change with the seasons more often. Studies also say that women are more likely to have mixed mania, rapid cycling, and depressive episodes more often than men. Mixed mania is when manic (or hypomanic) and depressive (or mood) episodes happen at the same time or very close together. Rapid cycling bipolar disorder means you’ve had four or more depressive, hypomanic, and manic episodes in a year. Women with bipolar disorder are more likely to experience these variations. Men with bipolar disorders tend to have more issues with substance and alcohol use, while women are usually more likely to have other mental health problems at the same time.
How is bipolar depression diagnosed?
To figure out which type of bipolar depression you have, your mental healthcare provider will probably use different ways to check your symptoms against set guidelines. This will include a long chat about your medical past and any mental health experiences you’ve had. Be ready for it to take a while.
Comparing mood features of bipolar depression and borderline personality disorder
Bipolar depression and borderline personality disorder (BPD) often have a lot of the same symptoms and can easily be mixed up because their mood issues look similar. A trained mental health professional should be able to tell the two conditions apart.
A man in a green sweatshirt sits on a black couch and comforts the woman beside him during therapy.
Do you have a tough time with your bipolar depression symptoms?
An online therapist can help.
Treatments for bipolar depression
The main goal of bipolar depression treatment is to get your emotions and behavior to a stable place. Many people find that the best treatment mixes therapy, medicine, spending time with others, and having good support. Bipolar depression can last a lifetime, so it’s really important to keep up with treatment even when things get tough or you feel down.
Related Article: How To Handle Depression During The Holidays
Medicine for bipolar depression
Mood-stabilizing medicines are often key to a bipolar depression treatment plan. They can help balance brain chemicals and stop mood swings. Mood stabilizers can also lessen problems that come with bipolar disorder, like seeing or hearing things that aren’t there, being agitated, and sleep issues. Doctors might use antipsychotic drugs during really bad manic episodes, and antidepressants or anti-anxiety medicines can help with other symptoms. Some medicines can have side effects, so it’s important to talk to a doctor before starting or stopping any medication.
Psychotherapy and talk therapy treatment
Therapy services often offer different kinds of talk therapy, like cognitive behavioral, interpersonal, and family therapy. Talk therapy can be a good part of a full treatment plan for bipolar depression. Working with a therapist can help you learn ways to cope and communicate better, spot and change bad thinking patterns and actions, and help you deal with many symptoms of your mental health condition.
Cognitive behavioral therapy (CBT) has been shown to make mania less intense. CBT usually focuses on seeing unhealthy actions and beliefs and swapping them for healthier, more positive ones. CBT can also help you figure out what sets off your episodes and teach you ways to handle your symptoms.
Interpersonal and social rhythm therapy (IPSRT) usually focuses on getting your daily habits, like when you eat, sleep, and wake up, on a regular schedule. A consistent routine often makes managing your mood easier.
Family therapy can help you and your loved ones learn how to talk to each other, how to support each other, and ways to handle your symptoms and what triggers them.
Related Article: How to Convince Yourself Not to Commit Suicide: A Compassionate Guide for Hard Moments
Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) for mood stability and better mental health
Bipolar disorder is something you deal with your whole life, and finding the right treatment can take time. If your bipolar disorder symptoms are really bad or don’t get better with other treatments, you might want to think about electroconvulsive therapy (ECT). This treatment can quickly make bipolar depression symptoms better. During ECT, your doctor sends electric currents through your brain to help with depressive symptoms. This therapy is considered safe and works well.
Coping with the manic and depressive episodes of bipolar depression
While your therapist or doctor will probably create a treatment plan for your bipolar depression—which should also include coping skills—there are lifestyle changes and ways of thinking you can try on your own to help handle your symptoms.
- Build a support system with family, friends, and doctors.
- Keep track of your moods and watch for changes in your symptoms and what triggers them.
- Take all your medicines exactly as your doctor tells you.
- Don’t use alcohol or drugs.
- Take care of yourself by getting enough sleep, eating healthy food, and exercising.
- Try to keep your stress low and find good ways to deal with it.
Talk therapy for managing mental health symptoms and treating bipolar depression
Living with bipolar depression can be tough, but working with a therapist or mental health expert can teach you good ways to cope. These skills can help stop mood swings and allow you to communicate better, so you can manage your symptoms and live with as little disruption as possible. People with bipolar depression sometimes have trouble making it to appointments regularly, and they’ve really liked how easy and flexible virtual therapy platforms are.
A study from 2019 found that online therapy for major depression symptoms could work just as well as going to a clinic in person. People who had never tried traditional face-to-face therapy generally got better results during the study.