Eating for bipolar disorder is a natural way to treat and manage the difficult symptoms associated with this mental health disorder.  With the knowledge of which foods to eat for bipolar disorder management, you can begin to make small changes to your diet.  In choosing the best foods for bipolar disorder, chances are you may notice a significant change in how you experience symptoms and notice an overall increase in wellbeing.

Eating for Bipolar Disorder

Eating for bipolar disorder may look different depending on the specific person.  Although there isn’t one specific bipolar diet every person with bipolar disorder is recommended to follow, there are certain foods every person with bipolar disorder may want to try for symptom management.

Best Foods for Bipolar Disorder

Research indicates there are many foods that one could benefit from incorporating into his or her diet if living with bipolar disorder.  Diet is a great approach to naturally managing bipolar symptoms. If you have bipolar disorder, try incorporating the following five foods into your diet:

• Whole grains – not only do whole grains have a positive effect on your heart and digestive system, they are essential when mindfully eating for bipolar disorder, as they tend to have a calming effect on the mind. Whole grains are some of the best natural foods for bipolar disorder you can choose.  Try whole grain pasta, brown rice, oatmeal or quinoa.
• Beans – beans are a primary part of any healthy diet, yet individuals with bipolar disorder may benefit from focusing on increasing their intake of pinto, garbanzo, and mung beans, which have the highest concentration of vitamin B9. Vitamin B9 helps sustain adequate homocysteine levels, which, when too low, can increase bipolar disorder symptoms.   
• Dark Chocolate – chocolate is made from cocoa beans, which have various “mood-lifting” ingredients, including phenylethylamine (known to relieve symptoms of depression).  Phenylethylamine is found mostly in dark chocolate.
• Tofu – tofu is made from the curds of soybean milk and, in general, is considered to be one of the most “health-giving” foods available. Tofu is a highly nutritious source of protein and contains omega-3s.  Omega-3’s contribute to mood stability.
• Turkey – this may seem like an odd choice, but turkey, which is high in the amino acid tryptophan, is a vital part of eating for bipolar disorder. Tryptophane helps your body make serotonin, and increased levels of serotonin are helpful with bipolar depression.

Worst Foods for Bipolar Disorder

• Caffeine – Although small amounts of caffeine don’t tend to exacerbate the symptoms of bipolar disorder, caffeine can cause sleep deprivation, which can trigger mania and mood swings. Generally, caffeinated beverages like cola and coffee don't mix well with bipolar disorder.
• Sugar – Eating a diet high in sugar isn’t recommended for anyone, but especially for those with bipolar disorder. Research has shown sugar can interfere with bipolar medication treatments and make them less effective.
• Alcohol – Alcohol is a depressant for anyone, but if you have bipolar disorder, you are more prone to being affected by depressants. Not only can alcohol affect mood, but it can also negatively interact with medication. High-fat foods – those with bipolar could benefit from limiting their trans- and saturated fat intake. These fats can significantly delay the beneficial effects of bipolar medications.
• Grapefruit – This citrus fruit is known to negatively interact with many commonly prescribed bipolar medications.

Making small, gradual changes to your diet is a good place to start.  If you are anxious to begin eating for bipolar disorder and want to make major changes to your diet, it is advised you seek the advice of a medical professional.

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The idea of bipolar depression in teens often surprises people because bipolar disorder is frequently thought of as a mental disorder of adulthood. However, adolescents (and even children) can and do develop bipolar disorder, which includes bipolar depression.

The illness in adolescents can differ slightly from the illness in adults. Symptoms of bipolar depression in teens can be more intense and occur more frequently than adult symptoms; additionally, teenagers sometimes experience psychotic symptoms during both depressive and manic episodes, whereas adults who experience delusions and hallucinations do so in mania. These differences are due, at least partially, to the nature of adolescence.

Remembering teens’ developmental stages is helpful for parents, family members, and the adolescents themselves.  The adolescent brain is different from an adult’s brain. The brain continues to develop and change through the teen years. Further, their inner world is a sea of raging hormones, wreaking havoc on their emotions. The teen years also involve pulling away from parents and family to find a place among peers as well as to build independence. If bipolar depression sets in during the ups and downs and stress of growing up, the consequences can be crushing.

True to adolescence, teenagers sometimes resist help, especially from parents, even though bipolar depression in teens is treatable. Parents beware, too, that your son or daughter’s symptoms will likely be worse at home than when they’re out in the world. As exasperating as this can be, it’s a compliment. Home is a safe haven where they know they’re loved. They can stop hiding their symptoms when they’re home.

Let’s look at what bipolar depression is like for teens and how parents and family members can help.

Bipolar Depression in Teens: Symptoms

It can sometimes be hard to tell the difference between ordinary teen moodiness and what’s more serious, like bipolar depression. Further complicating the picture is the fact that sometimes depression in teens manifests more as irritability than sadness. If your teen is suddenly more irritable than usual, and is short-tempered for two weeks or longer, they might have bipolar depression. These are some other signs to watch for:

• Frequent sadness and/or irritability
• Becoming emotional quickly, including frequent crying
• Sullenness
• Problems with decision-making and concentration
• Unusual fatigue
• Lethargy, lack of motivation
• Quitting activities once enjoyed
• Drop in grades
• Feeling worthless
• Sleeping too much or too little
• Eating too much or too little
• Preoccupation with death, talk of suicide or wanting to go away and stop being a burden

Bipolar depression in teens can make them feel removed from life. This, of course, perpetuates the depression. It’s possible to disrupt that vicious circle. Here are some ways to help your teen recover.

How Parents Can Help a Teen with Bipolar Depression

Your teen can break free from bipolar depression, and you can help with the process. Family involvement is one of the treatments, along with medication and individual therapy, that has been shown to improve bipolar depression. Your chances of success will likely be higher when you remember the unique developmental stage of adolescence mentioned above.

While doing so might be challenging because of bipolar depression symptoms, sit with your teen and create a plan. Establish some ground rules together before jumping into discussions about treating and managing depression. Perhaps you might agree that you won’t treat your teen like a child or try to control them, and they promise not to shut you out or argue. Create ground rules that are important to you, your teen, and the rest of the family.

Other approaches that many families with a teen struggling with bipolar depression have found helpful include:

• Keeping stress levels low at home (de-clutter, solve problems respectfully, keep noise levels down, etc.)
• Creating a routine to increase stability and reduce feelings of unpredictability and chaos
• Helping your teen track symptoms because when they can spot patterns and triggers, they can start to use coping skills right away to keep bipolar depression to a minimum
• Developing coping skills
• Maintaining open communication by giving everyone a chance to be heard and to listen nonjudgmentally
• Helping your teen identify and describe feelings
• Talking with your teen to help them separate themselves from the illness
• Choosing your battles and concentrating on issues that are important to the family while letting other, less important, concepts go
• Establishing a healthy lifestyle for the whole family: exercise, nutrition, hobbies, and fun

Bipolar depression in teens can be challenging for everyone. With support, your teen has an excellent chance of dealing with it effectively and once again embracing life.

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Many people don’t know it, but there are multiple types of bipolar disorder and this article is designed to explore the differences between bipolar I and bipolar II. Bipolar I (also known as bipolar disorder type I or bipolar 1) and bipolar II (also known as bipolar disorder type II or bipolar 2) both affect about one percent of the population of the United States with bipolar II being the slightly more prevalent mental illness. Both types of bipolar disorder can be incredibly disabling but both can also be managed with medication, therapy and lifestyle changes.

Bipolar disorder type I contains severely elevated or irritable episodes known as manias alongside deep depressions. Bipolar disorder type II, on the other hand, contains elevated or irritable episodes that are less severe and known as hypomanias alongside its deep depressions.

Bipolar Disorder Type I and Bipolar Disorder Type II Similarities

Bipolar disorder I and bipolar disorder II are sort of like fraternal twins – most of their DNA is the same. For bipolar disorder type I and bipolar

disorder type II, the following are the same:

• Both types of bipolar disorder are mental illnesses as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
• Both types of bipolar disorder are considered serious mental illnesses.
• Both types of bipolar disorder experience the same major depression symptoms and episodes.
• Both types of bipolar disorder can experience mood episodes with mixed features wherein elevated or irritated and depressed symptoms occur together.
• Both types of bipolar disorder are diagnosed primarily through personal interviews.
• Both types of bipolar disorder are treated with the same types of medication: primarily anticonvulsants, antipsychotics and mood stabilizers.
• Both types of bipolar are treated with the same types of therapy such as cognitive behavioral therapy, interpersonal/social rhythm therapy and family-focused therapy.

Differences Between Bipolar Disorder Type I and Type II

One of the most important differences between bipolar I and bipolar II is the fact that psychosis can occur in bipolar disorder type I mania but not in bipolar disorder type II hypomania, by definition. (Psychosis is the presence of delusions [false beliefs held in spite of contrary evidence] and hallucinations [false experiences with any sense].) Psychotic symptoms can occur in bipolar disorder type I or type II depressions, however.

Other differences between bipolar I and bipolar II include:

• Bipolar disorder type II occurs more frequently in women ("How Bipolar Disorder Symptoms Affect Women Uniquely").
• Those with bipolar disorder type I are often hospitalized during a manic episode whereas those with bipolar type II are typically first seen and treated while in a depression.
• Those with bipolar disorder type I should not be treated with an antidepressant alone as they have a greater risk of switching into a mania as a reaction to an antidepressant.

There may be additional differences between bipolar I and bipolar II that are not yet known due to lack of research comparing some aspects of the two illnesses.

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Because people often just say they have “bipolar disorder,” many don’t know there are several types of bipolar disorder. Indeed, the type of bipolar disorder that a person has matters when it comes to understanding the illness. Read on to learn about how many types of bipolar disorder there are, what they’re like, and which type of bipolar disorder is most severe.

How Many Types of Bipolar Disorder Are There?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the manual that defines all types of mental illness in the United States and many other places around the world. According to the DSM-5, there are four different types of bipolar disorder:

1. Bipolar disorder type I
2. Bipolar disorder type II
3. Cyclothymic disorder
4. Other specified bipolar and related disorders

Number four was previously known as “bipolar not otherwise specified” or “bipolar NOS” and is still sometimes referred to in that way.

Bipolar Disorder Type I

Bipolar disorder type I is thought of as “classic” bipolar disorder, perhaps because it was identified the earliest. In bipolar disorder type I, the person experiences elevated mood states known as manias and low mood states known as depressions (also known as major depressions). A person with bipolar disorder type I may also experience periods with few-to-no symptoms and these are known as euthymia. Bipolar disorder type I is also often accompanied by psychosis (the presence of delusions and hallucinations).

Bipolar Disorder Type II

Bipolar disorder type II is very similar to type I except that people with type II don’t experience the full “high” of a mania, rather, they experience a somewhat less elevated mood known as hypomania (literally, “less than” mania). Mania and hypomania both have the same symptoms but with hypomania being less severe. People with bipolar disorder type II experience the same types of depressions but do not experience psychosis. Bipolar type II also may contain euthymic periods, where there are few-to-no symptoms.

Cyclothymic Disorder

People with cyclothymic disorder, often referred to as cyclothymia, experience both high and low mood states but these states do not meet the full criteria of mania, hypomania or major depression.

Other Specified Bipolar and Related Disorder

The DSM-5 includes the other specified bipolar and related disorder diagnosis as a catch-all for those who experience bipolar-type symptoms but do not officially meet the criteria for any of the above types of bipolar disorder. This diagnostic category may have been included to encourage research into new types of bipolar disorder.

Which Type of Bipolar Disorder Is Most Severe?

People often ask, “Which type of bipolar disorder is the most severe?” This is an understandable question as, with four types of bipolar disorder, it’s human nature to want to group or rank them in some way.

Cyclothymic disorder is typically considered milder, however, bipolar disorder type I and type II simply can’t be ranked by severity. When it comes to mania, bipolar disorder type I is more severe, by definition. When it comes to depression, one might consider bipolar disorder type II more severe as those with type II experience more days depressed than those of type I. Finally, people experience bipolar disorder in their own way and some people with bipolar disorder type I find it extremely debilitating while others with bipolar disorder type II find it just as debilitating.

In short, the severity of any type of bipolar disorder is individual and the only way to find out how severe it is, is to talk to the person with it.

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Can mood stabilizers for kids ever be safe, and are they recommended? Adolescence and early adulthood is the most common time for bipolar onset, but what about children with bipolar disorder? Although we often hear about the disorder developing in adults, bipolar disorder can occur in children of any age. Early treatment can help manage a child’s bipolar symptoms, prevent or delay episodes and decrease the impact of mental health problems in later life. Mood stabilizers for kids are just one of the available options for child-onset bipolar disorder, but they are the most commonly prescribed. Here, we’ll examine the safety and effectiveness of mood stabilizers in children and dispel some common myths.

Mood Stabilizers for Kids: Do They Need Them, and Are They Safe?

Mood stabilizers for kids can be safe as long as a licensed medical professional prescribes them and the child’s health is carefully monitored. If you believe your child is showing signs of bipolar disorder, your physician will run a series of psychiatric tests and physical exams to rule out other causes of his or her symptoms. Your child will then most likely be referred to a child psychologist or psychiatrist who specializes in mood disorders in children.

Mood stabilizers for kids include:

• Lithium (Lithobid)
  
  There is limited research into this area, but findings show that lithium is safe and may be effective in treating the symptoms of bipolar disorder in children and adolescents.
   
• Carbamazepine (Carbatrol, Equetro)
  
  Carbamazepine is known to be effective as a mood stabilizer in children and teenagers with bipolar disorder. It is also used as an anticonvulsant.
   
• Sodium valproate (Depakote)
  
  Limited studies show that sodium valproate is safe and effective in reducing symptoms of mania in children with bipolar disorder.
  
  If your child’s symptoms are severely impacting his or her life, or if your doctor believes they pose a risk to your child’s safety, a mood stabilizer may be prescribed. Other, less common forms of treatment for bipolar disorder in children include antipsychotic medications, antidepressants and antipsychotic-antidepressant combinations. Your child may also be referred for talking therapy and closely monitored.  

What are the indications of bipolar disorder in children?

As in adults, the symptoms of bipolar disorder in children include mood “swings” from hyperactivity and mania to depression. Because children are prone to emotional highs and lows in their early years and during times of hormonal and environmental change (e.g., starting school or going through puberty), bipolar disorder can be difficult to identify. What’s more, several other childhood disorders can cause bipolar-like symptoms, including anxiety disorders and attention deficit disorders (ADHD).

Symptoms of bipolar disorder in children are similar to the signs we see in adults. However, young children may be more irritable than adults when experiencing mania, and they are more likely to have symptoms of psychosis – such as hearing or seeing things that aren’t real. Bipolar depression in children may present in physical symptoms such as general aches and pains, as well as low mood, feelings of hopelessness and loss of interest in once-enjoyed activities.

Bipolar disorder in children also cycles more quickly. While adults tend to experience "episodes" that last for weeks, months or years, in children, multiple episodes can occur within a single day.

What are the age recommendations for mood stabilizers for kids?

Mood stabilizers have primarily been developed for and tested on adults, and there is no set age recommendation for any drug. Many of these medications are not officially approved for children and teens, though professional guidelines direct their use for child-onset bipolar disorder. The FDA approves lithium for the treatment of manic symptoms in children aged 12 and over.

Mood Stabilizers in Children: What Are the Side-Effects?

Side-effects of mood stabilizers in children are similar to those experienced in adults, although not everyone has them. Your child may experience nausea and vomiting, skin rashes, slurred speech, changes in vision or hallucinations. All side-effects should be noted and reported to your child’s doctor.

Children who take mood stabilizers appear to be more prone to side-effects such as weight gain and changes in blood sugar. If your child is prescribed a lithium carbonate medication, they will need to have regular blood tests (about once every two weeks initially) to measure the lithium levels in the blood and monitor kidney function, as high levels of lithium in the blood can be life-threatening. Some non-prescription medications can increase lithium levels, so make sure you check with your doctor before giving your child any over-the-counter medications while they are taking mood stabilizers.

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The safety of mood stabilizers in pregnancy is something many women with bipolar disorder will have to contemplate at some stage. When it comes to psychiatric drugs in pregnancy, however, the FDA has little information about pregnant women because they are not typically included in medical trials and research. If you are being treated for bipolar disorder and you are pregnant, trying to conceive or breastfeeding, you will need to work with your doctor to consider the risks and benefits of your particular medication. But when it comes to mood stabilizers in pregnancy, what do we know?

Considerations for Mood Stabilizers in Pregnancy

Are mood stabilizers safe in pregnancy? Unfortunately, the answer to this question is not as clear-cut as medical professionals would like it to be.

Mood stabilizers are commonly prescribed for patients with bipolar disorder to treat acute manic or depressive episodes and prevent future recurrence of symptoms. In pregnancy, however, doctors and psychiatrists must evaluate the benefits of mood stabilizers for the expecting mother, while also minimizing risks to the unborn child.

The issue is further complicated by the fact that women with bipolar disorder have a 50% chance of relapse during the pregnancy and the early postpartum period, and this recurrence risk is reported to be two or three times higher if they discontinue a prescribed mood stabilizer. One study found that women who stopped taking mood stabilizers in pregnancy spent around 40% of the gestation period in episodes (manic or depressive), compared to 8.8% of women who continued taking their medication.

If you’re concerned about taking mood stabilizers during pregnancy, you should discuss your options with your doctor. Never stop taking bipolar medication without medical guidance.

Mood Stabilizers During Pregnancy: Facts You Should Know

Although there are many things we don’t know about the safety of mood stabilizers during pregnancy, there are certain facts to consider.

Lithium (Lithobid) is considered the safest bipolar drug during the second and third trimester: According to the U.S. National Library of Medicine, lithium (Lithobid) “appears to be safe” during the latter stages of pregnancy.

Valproate (Depakene) and carbamazepine (Carbatrol, Equetro) carry risks when taken in the first trimester: The National Library of Medicine also concluded in 2015 that use of valproate during the first trimester is associated with major malformation and development decay, with a higher risk of autism spectrum disorder in the unborn child. Carbamazepine is also associated with a higher risk of major congenital malformation, which is why it is not recommended for use in the first trimester.

Valproate is considered safe while breastfeeding: Although it is contravened during pregnancy, valproate is deemed to be safe for breastfeeding women.

Lamotrigine (Lamictal) could be safer than other anti-seizure drugs: The same study printed in the National Library of Medicine references lamotrigine as "more favorable than other antiepileptics” during pregnancy and lactation.

Typical and atypical antipsychotics are considered safe: Again, the data on antipsychotic medications such as Olanzapine (Zyprexa) in pregnancy is non-conclusive, but these drugs are considered “a good option” during pregnancy for women with bipolar disorder.

Management of bipolar disorder when pregnant or breastfeeding is different for everyone: Your doctor may decide that stopping your medication and triggering mania or depression is riskier than taking mood stabilizers in pregnancy to control your symptoms. Your doctors will need to consider your current mental state, any previous relapses while off medication, your age, the nature of the pregnancy and other unique factors to determine the best course of treatment going forward.

If you are being treated for bipolar disorder and are pregnant, trying to conceive or breastfeeding, you should check with your doctor about the risks and benefits of taking mood stabilizers in pregnancy.

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The list of bipolar disorder medications is long and complex, but it's important to understand your options when it comes to treating this condition. The majority of people diagnosed with bipolar disorder take some form of medication to manage their symptoms. There is, however, a surviving stigma around psychiatric medicines, and many people are dangerously misinformed. Here, you can discover the official list of bipolar disorder medications as well as their common side-effects.

List of Bipolar Disorder Medications and What They’re Used For

Bipolar disorder medications are used to treat the symptoms of mania, hypomania, and depression that occur in people with bipolar, a brain disorder affecting 2.8% of the adult population. Bipolar disorder cannot be cured, but there are several medications approved by the U.S. Food and Drug Association (FDA) to help patients manage their symptoms.

Mood stabilizers

First up on the list of medications for bipolar is mood stabilizers. Mood stabilizers help balance brain chemicals to prevent mania, hypomania and major depressive episodes in people with bipolar disorder. Anti-convulsant medications used to treat seizures are often prescribed as mood stabilizers, particularly for patients who experience mixed states (depression and mania/hypomania at the same time) or rapid cycling bipolar disorder.

Mood stabilizers commonly used to treat bipolar disorder include:

• Lithium (Lithobid, Eskalith, Lithonate)
• Lamotrigine (Lamictal)
• Oxcarbazepine (Trileptal)
• Carbamazepine (Carbatrol, Equetro)
• Valproic acid/valproate (Depakene)
• Divalproex sodium (Depakote)

Antipsychotics

According to the FDA, antipsychotic medications (including newer drugs labeled atypical antipsychotics) are often the first line of treatment in severely manic patients to control symptoms such as hallucinations and delusions. Several medications of this type have also proven long-term effectiveness in preventing episodes of mania and depression. Patients with bipolar disorder may be prescribed antipsychotic medications alone or alongside another mood stabilizer.

Common bipolar medications in this category include:

• Olanzapine (Zyprexa)
• Risperidone (Risperdal)
• Quetiapine (Seroquel)
• Aripiprazole (Abilify)
• Ziprasidone (Geodon)
• Lurasidone (Latuda)
• Asenapine (Saphris)
• Cariprazine  (Vraylar)
• Clozapine (Clozaril)
• Olanzapine (Zyprexa)

Antidepressant-antipsychotics

Antidepressant-antipsychotics (Symbyax) combine the antidepressant fluoxetine and the antipsychotic olanzapine. This medication works as both an antidepressant and a mood stabilizer.

Antidepressants

Although antidepressants are not commonly used in the treatment of bipolar disorder, they are sometimes prescribed alongside a mood stabilizer or antipsychotic for the management of depressive symptoms in bipolar.

Some antidepressants can trigger manic episodes in patients with bipolar disorder, and they also increase a patient’s risk of cardiac problems when combined with antipsychotics, which is why they are mostly avoided. However, if you are diagnosed with bipolar disorder, your doctor will examine your symptoms and weigh the side-effects with your symptoms to determine the best course of treatment.  

Common Bipolar Medications: What Are the Side-Effects?

Bipolar disorder medications can have several side-effects. Some of them may be serious, so it’s important to know when to seek medical attention.

Here is a list of common bipolar medications and their side-effects.

Side-effects of mood stabilizers

The side-effects of mood stabilizer medications can range from mild to severe. If you experience any of these side-effects, you should seek medical attention immediately.

• Itching and skin rashes
• Frequent urination and excessive thirst
• Tremor
• Nausea and/or vomiting
• Slurred speech
• Blackouts
• Irregular or pounding heartbeat
• Changes in vision
• Seizures
• Hallucinations
• Loss of coordination
• Swelling in the eyes, face, lips, throat, tongue, hands, feet, ankles and/or lower legs.

See also "Side-Effects of Mood Stabilizers and How to Manage Them".

Side-effects of antipsychotic medications

Antipsychotics can have many side-effects and risks. According to the FDA, common side-effects of antipsychotic medications include:

• Dizziness
• Drowsiness
• Weight gain
• Dry mouth
• Constipation
• Vomiting and/or nausea
• Restlessness
• Blurred vision
• Seizures
• Uncontrollable movements, such as tremors or ticks
• Reduced white blood cells, which fight infections
• Low blood pressure

The risk of developing certain side-effects such as weight gain, restlessness, and uncontrollable movements is higher with atypical antipsychotics. For this reason, patients taking these medications will be monitored closely by their doctor.

Long-term use of antipsychotic medications can also lead to a condition called tardive dyskinesia (TD), which presents as involuntary muscle spasms, typically around the mouth. If you think you have TD, you should talk to your doctor before stopping your medication.

Side-effects of antidepressants and antidepressant-antipsychotics

Side-effects from antidepressants are relatively common, but some are more severe than others. The most reported side-effects listed by the FDA include:

• Nausea and/or vomiting
• Diarrhea
• Sleepiness
• Sexual problems, including erectile dysfunction and reduced libido
• Weight gain

Less common side-effects include:

• Suicidal thoughts or attempts
• Panic attacks
• Trouble sleeping
• New or worsening depression or anxiety
• Feeling agitated or restless
• Irritability
• Anger or aggressiveness
• Mania displayed through an extreme increase in talking and activity
• Any other dramatic changes in mood or behavior.

Side-effects of olanzapine and fluoxetine antidepressant-antipsychotics (Symbyax) include dizziness, drowsiness, increased appetite, trouble sleeping, swelling in the hands and feet, constipation, diarrhea, and dry mouth.

Common bipolar medication side-effects should still be reported to your doctor. There is a whole list of bipolar disorder medications, and if one does not work well for you, or you experience an adverse reaction, your doctor may suggest adjusting your dose or trying you on a new drug.

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Bipolar disorder is a serious mental illness that is hard to accurately describe in a sentence or two. That is because it is a nuanced illness with so many people experiencing it in so many ways. That said, the overarching principles of bipolar disorder is that it is a chronic, lifelong mental illness that remains a challenging struggle for those who have it.

Bipolar disorder is also sometimes called manic depressive illness.

Bipolar Disorder Definition

Of course, like all illnesses, bipolar disorder has a medical definition. In this case, the definition for bipolar disorder comes from a book called the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 is the most up-to-date version of that reference, which defines all mental illnesses. (We’ll be talking more about bipolar disorder and the DSM-5 in just a bit.)

Bipolar Disorder Definition – Moods

Bipolar disorder is characterized by periods of highly elevated or irritated mood and energy, known as manic or hypomanic moods depending on their severity. These alternate with periods of very deep, profound, low mood and energy, known as depressed moods. Symptoms of depression can cooccur alongside the symptoms of mania or hypomania and these are known as mixed moods. It is also possible to have periods of time where few, if any, symptoms are present and these are known as euthymic moods.

A mood that meets the following criteria is known as an “episode.”

Bipolar Disorder Criteria

Of course, just experiencing one instance of depression doesn’t qualify as bipolar disorder. The following are the bipolar disorder criteria:

• If a person experiences both depressions and manias, this is known as bipolar type I.
• If a person experiences both depressions and hypomanias (less severe than manias), then this is known as bipolar type II.
• Individuals who experience symptoms of depression and hypomanic episodes but do not meet the full criteria for their diagnosis are given a diagnosis of cyclothymia (considered less severe than bipolar disorder types I and II).
• It is also possible to have a form of bipolar disorder that doesn’t neatly fit into the above categories but, at the doctor’s discretion, still warrants a bipolar disorder diagnosis, and this is known as an “other bipolar and related disorder.”

For more on the types of bipolar disorder, see our article, “What Are the Types of Bipolar Disorder.” 

The DSM-5 Criteria for Bipolar Disorder Moods

It’s important to understand what a mood episode really is in order to understand what fully constitutes bipolar disorder.

The DSM-5 Criteria for Bipolar Mania

The DSM-5 is very specific in what mania is. For a diagnosis of mania, the mood must be present for at least one week consecutively and lead to hospitalization or major impairment in occupational or social functioning or cause danger to the person experiencing it or others.

The mood must be a profound disturbance characterized by elation, irritability, or expansiveness (defined as being marked by an abnormal euphoric state and by delusions of grandeur [a false impression of one’s own importance]). These three criteria are known as gateway criteria, as one or more is required for a diagnosis.

On top of the gateway criteria being met, at least three of the following symptoms must be present:

• Grandiosity (defined as having an exaggerated belief in one's importance, sometimes reaching delusional proportions)
• Diminished need for sleep
• Excessive talking or pressured speech
• Racing thoughts or flight of ideas
• Clear evidence of distractibility
• Increased level of goal-focused activity at home, at work, or sexually
• Excessive pleasurable activities, often with painful consequences

In order to be considered mania, the mood may not be a result of substance abuse or a medical condition.

The DSM-5 Criteria for Bipolar Hypomania

Hypomania literally means “less than mania.” So, while mania and hypomania basically have the same symptoms, it’s their severity that differs.

For a diagnosis of hypomania, the mood must be present for at least four consecutive days. The gateway criteria which one must meet are: elevated, expansive or irritable mood. At least three of the following also must be present:

• Grandiosity or inflated self-esteem
• Diminished need for sleep
• Pressured speech
• Racing thoughts or flight of ideas
• Clear evidence of distractibility
• Increased level of goal-focused activity at home, at work, or sexually
• Engaging in activities with a high potential for painful consequences

The mood disturbance must be observable to others and may not be as the result of substance abuse or a medical condition. Hypomanias are not severe enough to cause social or occupational impairment.

The DSM-5 Criteria for Bipolar Depression

When depression occurs in bipolar disorder, it’s often termed “bipolar depression” but in fact, it’s actually an occurrence of major depressive disorder. Bipolar disorder, then, is a mix of unipolar depression (major depressive disorder) and the above elevated moods.

Major depressive episodes are characterized as the person experiences five or more of the following symptoms during a two-week period, with at least one of the symptoms being either a depressed mood or characterized by a loss of pleasure or interest:

• Depressed mood
• Markedly diminished pleasure or interest in nearly all activities (also known as anhedonia)
• Significant weight loss or gain or significant loss or increase in appetite
• Hypersomnia (sleeping too much) or insomnia
• Psychomotor retardation (psychological and physical slowing) or agitation (psychological and physical restlessness)
• Loss of energy or fatigue
• Feelings of worthlessness or excessive guilt
• Decreased concentration ability or marked indecisiveness
• Preoccupation with death or suicide; has a plan for suicide or has attempted suicide

Symptoms of major depression must cause significant impairment or distress and can’t be as a result of a medical condition or substance abuse.

The DSM-5 Bipolar Specifiers

The above are the primarily identified moods in bipolar disorder. However, there can be specific, common characteristics of moods that also need to be noted. Specifiers add more detail to a mood to indicate what is truly happening for the person.

The specifiers currently available in the DSM-5 are:

• With mixed features – when the diagnosed mood (either depression or hypomania/mania) presents with symptoms of its opposite mood (this is often called a mixed mood)
• With anxious distress – when the mood episode occurs with symptoms of anxiety
• With rapid cycling – when four or more distinct mood episodes (either mania or depression) occur within one year
• With psychotic features – when the mood episode occurs with the symptoms of psychosis (the presence of delusions and/or hallucinations), this may not occur in hypomania, by definition
• With catatonia – when the mood episode occurs with a syndrome characterized by muscular rigidity and mental stupor, sometimes alternating with great excitement and confusion
• Peripartum onset (also known as postpartum onset) – when the mood episode occurs during pregnancy up to four weeks after delivery
• Seasonal pattern – when the onset and remission of major depressive episodes are at specific times of the year
• With atypical features – when the depression occurs with a specific combination of features such as oversleeping, a heavy feeling in the arms or legs and mood that improves in reaction to positive events
• With melancholic features – when the depression occurs with specific depression features such as a lack a reactivity to positive events, significant anorexia or weight loss or depression that’s regularly worse in the morning

To use a specifier, a doctor would diagnose a mood (depression, mania or hypomania) and then attach one or more specifiers to it as necessary. Specifiers and mood diagnoses change over time.

Treatment of Bipolar Disorder

Bipolar disorder, while not curable, is a treatable condition. With bipolar medications, therapy and lifestyle changes, many people with bipolar disorder lead full, productive lives ("What Are the Best Medications, Treatments for Bipolar Depression?").

The first thing that is generally assessed when you’re getting treated is the possibility of a dangerous condition. For example, a doctor would be looking for dangerous conditions or states like:

• Suicidality
• Danger to the self or others
• Acute or chronic psychosis
• Delirium (a temporary state of mental confusion characterized by anxiety, disorientation, memory impairment, hallucinations, trembling, and incoherent speech)
• Catatonia
• An inability to function
• A total loss of control
• Medical conditions that require monitoring

The presence of these types of conditions, regardless as to mood type, will dictate whether inpatient (residing in a psychiatric hospital) or outpatient (living at home) treatment is right for you. Dangerous conditions or states tend to require inpatient stays. If you are admitted as an inpatient, the staff at the facility will work to stabilize you, likely on medication, so you can function and are not at risk, and then you can be transitioned to outpatient care.

Medication is the number one way psychiatrists treat bipolar disorder. Medications used to treat bipolar disorder fall into the classes of mood stabilizers, anticonvulsants and antipsychotics ("List of Bipolar Depression Medications and Their Side-Effects"). Depending on the medication, it might be best suited for a manic, mixed or depressive state or the maintenance of bipolar disorder.

Psychotherapy can also be a very important part of treatment for bipolar disorder. There are five evidence-based psychotherapies used to treat bipolar disorder, according to Jim Phelps MD, of PsychEducation.org. They include:

• Prodrome detection therapy – allows someone to learn about the early warning signs of a bipolar mood episode and what to do about them
• Psychoeducation – allows for learning the facts about mental illness
• Cognitive therapy – involves several components including identifying dysfunctional beliefs and encourages medication adherence
• Interpersonal/social rhythm therapy – involves understanding the importance of routine in daily life
• Family-focused therapy – involves components of the above therapies but includes all members of the family

There are many lifestyle changes that can also help with bipolar disorder treatment. According to the Mayo Clinic, these include:

• Ceasing use of alcohol and drugs
• Forming healthy relationships
• Creating a healthy routine including exercise
• Checking before taking any additional supplements or medications, even those sold over the counter
• Keeping a mood chart

Many people who enter treatment for bipolar disorder are at the end of their rope and feel they may never get better. The good news is, this is almost universally not true. While it can take time and patience, treatment for bipolar disorder works for many people every day.

article references

What's going on at HealthyPlace this week?

• You Are Strong Despite What Mental Illness Tells You
• From the HealthyPlace Mental Health Blogs
• Victims of Verbal Abuse Suffer Physical Ailments Too
• Most Popular HealthyPlace Articles Shared by Facebook Fans
• Positive Affirmation for When Life Feels Too Hard

Living with mental health challenges can be exhausting and discouraging. Symptoms of mental illness can get in the way of your ability to be how you want to be and live how you want to live. Not only that, they are often unpredictable. Sometimes they’re relatively mild and other times debilitating. Just when you think you’ve adjusted with how things are, things suddenly can change, throwing you for another loop and making you feel like you’re starting over, maybe even worse than before. It can be hard, too, to find people who truly understand the depths of what you have to endure every single day.

The purpose of this message is to let you know that you are amazingly strong. You are doing incredible things. Whether or not others understand, the most important thing is that you understand. Pause for a moment and turn inward. Gift yourself with soothing, deep breaths. Reflect on all the incredible things about you and what you do. This is just a partial list to get you started. Own each one, and then keep going. Build a list that honors and celebrates you and let yourself sit with it at least once a day.

• You are awake, and your mind and body are functioning.
• You are incredibly brave.
• You are persistent, persevering even when you wonder why or don’t have the energy.
• You are loving, and love is life’s driving force.
• You are intelligent and wise, able to figure out all the complex nuances of living with mental illness.

Above all, you are. You are valuable. You matter.

Recommended Video

Never Give Up! Mental Illness Can't Deny You a Miracle - Never give up -- mental illness can often deny you peace of mind, but it can't deny you a miracle. Shelby Tweten reminds us to hold out for the miracles. Watch.

Articles Related to Celebrating You

• The Language That Defines Mental Illness
• Five Character Strengths of People Living with Anxiety
• Using Your Strengths When You Feel Weak Improves Your Mood
• The Strength and Tenacity of Recovering Addicts
• Staying Strong Through Verbal Abuse
• Atonement and Self-Esteem: Forgiving Yourself Builds You Up
• How to Find Self-Love in Three Steps
• You’re Worth the Hard Work to Build Self-Esteem
• Change Your View to Build Your Self-Esteem
• How I Changed My Viewpoint to Build Self-Esteem

Today's Question: What inner strengths and qualities do you draw on to show yourself that you’re stronger than your mental health challenges? We invite you to participate by sharing your thoughts, experiences, and knowledge on the HealthyPlace Facebook page.

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From the HealthyPlace Mental Health Blogs

On all our blogs, your comments and observations are welcomed.

• Be Kind to Your Body this Holiday Season
• The Holidays Can Cause a Bipolar Mood Swing
• What Do Thoughts of Hurting Yourself Mean?
• How to Avoid Verbal Abuse During Controversial Conversations
• 10 Years Smoke-Free Despite Schizoaffective Disorder
• If You’re Struggling with Mental Health, It’s Okay—So Am I
• How I Cope When Time Triggers My Anxiety

Feel free to share your thoughts and comments at the bottom of any blog post. And visit the mental health blogs homepage for the latest posts.

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From the HealthyPlace YouTube Channel

Experiencing physical pain can be a common symptom with victims of verbal abuse. Do you suffer with any of these symptoms? Take a look.

Subscribe to the HealthyPlace YouTube channel

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Most Popular HealthyPlace Articles Shared by Facebook Fans

Here are the top 3 mental health articles HealthyPlace Facebook fans are recommending you read:

1. Suicide Isn’t Stupid: Stigmatizing It Ignores Pain
2. Mindfulness and Anxiety Around the Holidays
3. Why the Glorification of Taylor Swift Harms People Like Me

If you haven't already, I hope you'll like us on Facebook too. There are a lot of wonderful, supportive people there.

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Positive Affirmation for When Life Feels Too Hard

“Remember the time you thought you never could survive? You did, and you can do it again.”

Read more positive affirmations for when life feels too hard.

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That's it for now. If you know of anyone who can benefit from this newsletter or the HealthyPlace.com site, I hope you'll pass this onto them. Please share the newsletter on any social network you belong to. For updates throughout the week, follow us on Twitter, like us on Facebook, subscribe to our YouTube channel, or follow us on Instagram.

Thank you,
Deborah

Community Partner Team
HealthyPlace.com - America's Mental Health Channel
"When you're at HealthyPlace.com, you're never alone."
http://www.healthyplace.com