If you’ve been diagnosed with bipolar disorder, it’s important to know there are effective treatments available and, most important, that you are not alone — the National Alliance on Mental Illness estimates that 7 million U.S. adults have bipolar disorder.
Since the start of the COVID-19 pandemic, the percentage of adults experiencing depression or anxiety symptoms has increased to over 40%, according to the CDC.
“We know there is a relationship between exposure to stress and the development of mental health disorders,” says Dr. Katharine Liang, M.D., Ph.D., a consulting psychiatrist at Seattle Anxiety Specialists who studies the mental health effects of stress. “However I don’t think the pandemic fully explains the increase we are seeing. The mental health crisis we keep hearing about is a result of a perfect storm of these stressors together with a critical mass of mental health becoming more socially acceptable to talk about. Celebrities are increasingly discussing mental health on social media and other platforms, so folks are more willing to seek help.” Mental health wellness entered the public sphere earlier this year when well-known athletes like tennis player Naomi Osaka and gymnast Simone Biles put their mental well-being above competing in the French Open and the Olympics.
While Osaka and Biles cited depression and anxiety as issues they dealt with, bipolar disorder is harder to diagnose and requires a more complex and long-term treatment plan.
There are different levels of severity of bipolar disorder, but the “defining difference between a bipolar disorder versus anxiety or depression are the manic, hypomanic and mixed episodes,” Dr. Misty Tu, M.D., the medical director and psychiatrist at Seattle Anxiety Specialists says.
Tu and Liang say there are a number of distinguishing markers of bipolar disorder.
- Manic episodes are characterized by intense behavior like inflated self-esteem, excessive and erratic spending or chronic sleeplessness.
- Manic episodes tend to last for an extended period of time.
- Hypomanic episodes tend to be less intense and last a few days.
- People with bipolar disorder display symptoms without the influence of drugs or alcohol.
- Bipolar symptoms include more agitation than anxiety.
- Severe manic episodes can be marked with hallucinations and/or delusions.
- Most people suffer from both depression and mania.
Liang said that bipolar disorder is complex and can be challenging to diagnose and adding to that complexity is that doctors are dependent on patients to self-report their symptoms.
Background on bipolar disorder
Bipolar disorder was previously referred to as manic depression, but that term was abandoned in the 1980s and the term “bipolar” was embraced to capture more accurately the “two poles” of mania and depression.
The exact cause of bipolar disorder isn’t known, but researchers have identified some things that seem to contribute to the likelihood of the illness such as a difference in brain structure and function and genetics, the National Institute of Mental Health reports.
Bipolar disorder is defined as a chronic mental health condition and there is no known cure. Some people may experience a remission in their symptoms for months, or even years, Tu said, while others may become sicker after multiple episodes, particularly if they aren’t taking recommended medications.
What to do if you’re diagnosed with bipolar disorder
A bipolar diagnosis can be devastating, so it’s important to make sure there’s a balanced treatment plan that includes therapy and medication. The best thing anyone can do once they’ve been diagnosed is to create a treatment plan with their mental health specialist and physician.
“Medications used to treat bipolar disorder are more complex than antidepressants. A primary care doctor is always a good place to start asking questions, but you will usually be referred to a psychiatrist,” Tu says.
Many of the medications have side effects, so it’s key to understand the medications you’ve been prescribed. Medications also aren’t a one-size-fits-all solution. Doctors will frequently slowly increase the amount to find the right dosage, something Seattle Anxiety Specialists refer to as “slow medicine.”
“Slow medicine is about ensuring that we use only as much medication as needed,” Tu says, adding that since there are so many different medications available, the clinic uses a “multimodal approach with general health and wellness, therapy and medications.”
As a patient, it’s important to let your doctors know if you struggle more with depression than manic episodes so that the right medications can be prescribed. It’s also important to recognize your symptoms so that you can alert your doctor if you’re experiencing any increase, or decrease, in symptoms.
What to expect after a diagnosis
“Bipolar disorder can cause a lot of turmoil in someone’s life,” Tu says. “Medications can help improve the stability of an individual’s mood, but this does not address underlying negative beliefs, fears, anxieties and trauma. All of these can still be present after someone is stabilized on medications. Some individuals need more support because of the toll the mental illness takes on their lives.”
While there’s a broad range of the severity of bipolar disorder, both Tu and Liang say there’s a variety of ways to help people. For example, some people may require fewer medications but need more one-on-one therapy sessions. Whatever the treatment plan is, it’s also important to maintain your physical health as well by getting enough sleep, eating well, exercising and managing your stress.
It’s important to remind yourself that while bipolar disorder is a long-term illness, the right treatment plan, support network and routine appointments with your doctors can help you live a full and healthy life.
Seattle Anxiety Specialists, PLLC is a private psychiatry and psychotherapy practice in downtown Seattle, providing evidence-based treatments and in-depth self-exploration for anxiety and conditions that create anxiety including phobias, depression, GAD, OCD, PTSD, ADHD, OCPD and bipolar.