Bipolar disorder, also called manic-depressive illness, is a lifelong disorder of the brain characterized by periods of mood swings, shifts in energy, levels of activity, and the ability to carry out everyday tasks. When an individual is having a bipolar episode, they may either feel “up” and experience “manic” symptoms, or they may feel “down” and depressed. The overall pattern of fluctuation between these manic and depressive episodes is what defines bipolar disorder.
Symptoms also often overlap between bipolar disorder and depression, often making the diagnosis of early bipolar disorder symptoms difficult. What follows are answers to commonly asked questions like: “Do I have bipolar disorder?” “Is there a bipolar disorder test?” “What causes bipolar disorder?”
Environmental Risk Factors and Triggers for Bipolar Disorder
Researchers now know that environmental risk factors and experiences contribute to the risk of developing bipolar disorder. These other factors that are associated with a greater risk of bipolar disorder include drug exposure (particularly to cocaine), sexual or physical abuse, head injury, preterm birth, and other types of stress.
As noted in Healthline, a stressful event often serves as a trigger for the onset of bipolar disorder. These include the loss of a job or a sudden change in work or personal life. A major event, such as the death of a loved one, is another trigger for the development of bipolar disorder. The publication also noted that seasonal factors may be a contributor to developing the disorder, as the change from winter to spring, with the increasing hours of bright daytime sunshine, is known to affect the pineal gland, which, in turn, may influence the onset of the mania and depression of bipolar disease.
What Factors Contribute to Higher Development?
Numerous studies found that alcohol and drug use and physical and sexual abuse are factors contributing to a higher development of bipolar disorder. For example, research published in Schizophrenia Bulletin notes that there is converging evidence of a prospective association between cannabis use and bipolar disorder. Researchers point out that substance use and bipolar disorder have high rates of co-occurrence and that cannabis is the drug most frequently used in bipolar disorder.
Another finding is that cannabis use results in worse treatment compliance for bipolar disorder and more hospitalizations. There is also a cross-sectional link between misuse of substances and the adolescent onset of bipolar disorder. Researchers note that there may be an association between adolescent cannabis use and bipolar disorder in adulthood.
Researchers found that cannabis use among those with pre-existing bipolar disorder worsens manic symptoms and may also serve as a contributing factor to the start of manic-type symptoms in those with no evidence of pre-existing bipolar disorder. More men than women engage in the harmful use of cannabis, and researchers found that cannabis “use in men may be much more important in the pathway to hypomania” (bipolar disorder).
Genetic Factors
Is bipolar genetic? As with many disorders, both those pertaining to substance abuse and mental health disorders, numerous studies show that there are likely genetic underpinnings that may mean a predisposition toward bipolar disorder in some individuals whose family members have the disorder. Some studies with identical twins have found that the lifetime chance of one twin also developing bipolar disorder when the other twin has it ranges from 40 to 70 percent, while it’s 5 to 10 percent among close relatives.
According to the National Institute of Mental Health (NIMH), referencing data from the National Comorbidity Survey Replication (NCS-R), about 2.8 percent of U.S. adults have an experience with bipolar disorder in any given year. Furthermore, an estimated 4.4 percent will experience bipolar disorder at some point in their lifetime. First-degree relatives of those with bipolar disorder share an estimated 50 percent of genes.
Researchers at the National Institutes of Health (NIH) say that irregularities that may be found in many genes could combine to increase the likelihood of someone developing bipolar disorder, although exactly how and when this occurs remains unclear. Just having a genetic predisposition to bipolar disorder doesn’t mean someone will wind up getting diagnosed with bipolar disorder. Also, being genetically predisposed to the disorder is not sufficient to trigger the development of bipolar disorder, as other factors, including environmental, are likely necessary to do so.
The Unique Signs of Bipolar Subtypes
Bipolar disorder can be understood as mood changes or changes in state along a continuum. This continuum consists of depression on one end and mania on the other. The various subtypes of bipolar differ in the severity of each state and in how long the person spends in each stage.
The severity of symptoms and impact on the quality of life differ between each subtype. They also differ in terms of treatment and clinical picture. Recognizing early bipolar disorder symptoms and getting diagnosed as early as possible could help eliminate confusion so you can start working on a solution right away.
You may be asking yourself, “Do I have bipolar disorder?” or “Which type of bipolar do I have?” However, before understanding the key differences between bipolar I and bipolar II, it’s necessary to understand the characteristics of mania and depression, the two poles of bipolar disorder.
Depression often leads to maladaptive sleeping behaviors, including insomnia, sleeping too much and disturbed nocturnal sleep. Individuals may also experience changes in weight, including gaining or losing significant amounts of weight.
Mania and hypomania share the same characteristics, although mania tends to be more severe and may lead to hospitalization.
Bipolar I is often considered the most severe of the subtypes. It consists of highly manic episodes in which the individual may even neglect to sleep, followed by episodes of extreme depression. Individuals with bipolar I disorder may need to be hospitalized due to the severity of their episodes.
In certain cases, the severe mania may trigger a psychotic episode in which the individual is disconnected from reality.
Spotting Signs in Others
If you notice something off in the behavior of loved ones, family, friends, or co-workers, they could be just going through a rough time. Maybe it’s an accumulation of stress or a problem they’re wrestling with. However, repeated and multiple signs that manifest that are associated with bipolar disorder may be cause for concern. According to Medical News Today, here’s what to look for to spot signs that may indicate the presence of bipolar disorder in others:
- Trouble sleeping.
- Exhibiting tremendous energy.
- Acting as if they can achieve and do anything they want.
- Looking and acting “wired,” agitated, or jumpy.
- Belief they have greater importance or better connections than others.
- Displays of anger and aggression if their behavior or views are challenged.
- Frequent engagement in risky behavior, including unsafe driving, risky sex, overspending, reckless consumption of alcohol or other drugs.
- Hallucinations or delusions, causing them to see, feel, or hear things not in reality.
- Inability to realize their inappropriate behavior or potential consequences resulting from it.
Spotting Signs in Yourself
Anecdotal reports from individuals with bipolar disorder who recounted incidents and feelings they recall from their adolescence point to certain signs that were potentially indicative of the condition, a diagnosis that was later confirmed. As is typical, many of these individuals say they experienced mania. During this manic period, they behaved in ways that damaged relationships, including engaging in promiscuous activity and other risky behavior, such as drug and alcohol abuse. They also recalled having boundless energy, lack of sleep, and feeling extreme frustration.
Be on the lookout for the following signs of bipolar disorder:
- Repeated episodes of major depression.
- First major depressive episode before age 25.
- While depressed, losing contact with reality.
- First-degree relative has bipolar disorder.
- Mood and energy levels higher than most people – when you’re not depressed.
- Overeating and sleeping too much when you are depressed.
- Developing mania or hypomania when you were taking an antidepressant.
- If taking an antidepressant, it stopped working in a few months.
- Unsuccessful results after trying several different antidepressants.
When Can It Be Diagnosed?
According to several analyses, nearly 50 percent of individuals begin to show symptoms before the age of 21. Unfortunately, a review of more than two dozen surveys shows a lag of about 6 years from the onset of early symptoms of bipolar disorder and the start of treatment targeted to the disorder. So, while symptoms may start to appear in adolescence, the disorder often goes undiagnosed, meaning treatment is either not initiated or symptoms are treated as something else.
For example, as a 2019 study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging noted, bipolar disorder is initially misdiagnosed as major depressive disorder in about 60 percent of individuals seeking mental health disorder diagnosis. Researchers said the two disorders share some symptoms, especially since bipolar disorder first often manifests in a depressive phase, and this can delay accurate diagnosis by up to 10 years. In addition, depression typically starts during adolescence, which could cloud a diagnosis of bipolar disorder. Furthermore, a core problem in both major depressive disorder and bipolar disorder is emotion processing.
Avoid Self-Diagnosis
The tendency to try to figure out if you have bipolar disorder is not unusual, especially if you’ve spotted what you believe are signs in yourself. Trying to diagnose yourself is likely to cause you unnecessary worry, however, and there’s no need to put yourself through this scenario. Your best option is to see a mental health professional who can conduct appropriate tests and make a determination whether you have bipolar disorder, another mental health disorder, no mental health disorder, or perhaps symptoms resulting from substance misuse.
Importance of Early Identification of a Disorder
As with any physical or mental disorder, catching bipolar disorder early can reduce the overall pain and mental anguish associated with having an unknown problem. Being able to recognize the early symptoms means being able to seek help faster. Though it can arise at any time during a person’s life, bipolar disorder is typically diagnosed between the teens and early 20s.
The sooner someone is diagnosed with bipolar disorder, the sooner effective treatment can be personalized for his or her condition. The problem that many of those who’ve suffered with undiagnosed bipolar disorder for years go through is that their denial of symptoms, or fear or shame about getting diagnosed with bipolar disorder, means that they’ve needlessly reduced their quality of life. Rather than working toward life-affirming goals or enjoying relationships with loved ones and others, someone who hides their fear of having the disease relegates themselves to shuffling through life missing opportunities. Often, they stay isolated, shying away from friendships, masking their episodes or saying they’re just sad or happy.
Untreated bipolar disorder has another tragic statistic in that those with it are 50 times more likely to engage in self-harm than individuals in the general population. Also, those with bipolar disorder are 12 times more likely to commit suicide (a statistic that is higher than for people diagnosed with schizophrenia).
On the other hand, when someone with symptoms of bipolar disorder seeks help early, they’re being proactive and can get the assistance they need to learn how to manage and cope with bipolar.
Can This Help With Successful Treatment?
Early diagnosis of bipolar disorder is critically important in being able to get the disorder under control and lead a productive life. Effective treatment can put an end to constant mood swings and the awful insecurities characteristic of the disorder. In addition, early detection can reduce some of the complications so often associated with bipolar disorder, including substance abuse, self-harm, and suicide. With the right type of treatment, most bipolar disorder symptoms can be relieved, the intensity of many manic episodes reduced, and daily functioning restored.
