bipolar disorder
Last updatedWhat to know
There are three types of bipolar disorder: bipolar I, bipolar II, and cyclothymia. Bipolar I (pronounced bipolar one) has the most severe symptoms, and it is what most people think of when they hear “bipolar disorder.” Bipolar I is characterized by mood episodes, which are extended emotional and psychological states that are extreme enough to impact one’s daily life.
A depressive episode is a period of low mood (sadness, hopelessness, guilt, or numbness) lasting at least two weeks. Typical symptoms include difficulty enjoying activities, fatigue, changes in appetite, and frequent thoughts of death. The criteria for a depressive mood episode are the same for both clinical depression and bipolar disorder, but people with bipolar I will also have manic episodes.
A manic episode is one week or longer of unusually elevated mood (euphoria, anxiety, or irritability). Common signs of a manic episode are risk-taking behavior, racing thoughts, distractibility, and a decreased need for sleep. Some individuals may experience psychosis during a manic episode.
Bipolar II has discrete mood episodes like bipolar I. However, elevated moods in bipolar II take on a milder form called hypomania. Cyclothymia symptoms tend to be the least severe but most pervasive. Someone with cyclothymia may not meet criteria for a mania or depression, but their mood episodes may be more frequent, and any symptom-free periods will only last a few weeks at most.
Manic and depressive episodes do not alternate at a one-to-one ratio. Most individuals have many more depressive episodes than manic ones. Around 10 percent of people diagnosed with bipolar disorder only have one manic episode in their lifetimes.
Labels like “manic-depressive” and related terms like “maniac” can stigmatize people with bipolar disorder and blur the boundary between genuine manic episodes and everyday spurts of high energy or amped-up creativity.
Having mood swings or ambivalent feelings is not the same as having bipolar disorder, even though people will sometimes refer to those experiences as such in casual conversation. Mood swings are quick, temporary shifts in mood. People with bipolar disorder are typically in one mood state for weeks on end, and those with type I or II can often have months-long periods of stable mood between episodes. The notion that people with bipolar disorder are somehow oversensitive or indecisive is a stereotype that can discourage people from getting help.
When deciding whether to mention a specific diagnosis of bipolar disorder, there are several things to consider. Is it pertinent to your story? Is it a formal diagnosis you’ve verified? Do you have the person’s permission? People’s experiences with bipolar disorder change, as do their comfort levels with sharing, and yet your story will persist; weigh carefully whether to report specific diagnoses. Phrases like “X has bipolar disorder” or “X is being treated for bipolar disorder” (versus “is bipolar”) are ways to frame a diagnosis as just one aspect of someone’s identity that doesn’t define them.
Additional resources
- What Are Bipolar Disorders? (American Psychiatric Association)
- Longitudinal Course of Bipolar I Disorder: Duration of Mood Episodes (JAMA Psychiatry)
- Cyclothymic Disorder (National Library of Medicine)
Summary
Bipolar disorder is a mood disorder that used to be called “manic depression,” characterized by alternating episodes of unusually low mood (depression) and elevated mood (mania). When deciding whether to mention a specific diagnosis of bipolar disorder, there are several things to consider. Is it pertinent to your story? Is it a formal diagnosis you’ve verified? Do you have the person’s permission? Phrases like “X has bipolar disorder” or “X is being treated for bipolar disorder” (versus “is bipolar”) are ways to frame a diagnosis as just one aspect of someone’s identity that doesn’t define them.