Understanding Bipolar Disorder: Types, Triggers, and Treatment

Verified By Dr. Mukesh Jha | 16-Apr-2025

Bipolar disorder remains widely misunderstood, despite impacting millions of individuals worldwide. In India alone, thousands silently battle its symptoms every year, often without a clear diagnosis or appropriate support. As a psychiatrist, I have seen first-hand how the right treatment and awareness can transform lives.

This comprehensive blog aims to educate readers about bipolar disorder, its types, triggers, and effective treatment options, helping individuals and their families better navigate the condition.

What Is Bipolar Disorder?

Bipolar disorder is a long-term mental illness characterized by extreme changes in mood, energy, and activity levels. These mood changes go beyond ordinary highs and lows. Individuals may alternate between manic episodes (feeling overly energetic or euphoric) and depressive episodes (feeling very low or hopeless), often without warning.

These intense mood swings can disrupt relationships, careers, education, and day-to-day life.

Dispelling Myths About Bipolar Disorder

Let’s clear some common misconceptions:

• Myth 1: Bipolar disorder is just extreme moodiness.
  • Reality: It’s a medical condition involving severe mood episodes that impair daily functioning.
• Myth 2: Individuals with bipolar disorder cannot lead normal lives.
  • Reality: With proper treatment, many people live fulfilling, stable lives.
• Myth 3: Manic phases are just periods of extra energy.
  • Reality: Manic episodes can lead to risky behavior, financial trouble, or even hospitalization.

Also read: Unraveling the Mysteries of Schizophrenia in Adolescents

Types of Bipolar Disorder

Understanding the types of bipolar disorder is key for accurate diagnosis and management.

1. Bipolar I Disorder

This form involves:

• The person must have experienced at least one manic episode that lasted a week or led to hospitalization.
• Often followed by major depressive episodes
• May include psychotic symptoms such as delusions or hallucinations

Example: A person might go on a shopping spree worth lakhs during mania, followed by a phase of severe depression lasting weeks.

2. Bipolar II Disorder

This type is defined by:

• At least one hypomanic episode (less intense than mania)
• At least one major depressive episode
• No full manic episodes

Hypomania may go unrecognized, especially if it feels like an energetic or productive period, but the depressive phases are often deeply impairing.

3. Cyclothymic Disorder (Cyclothymia)

This is a less severe but long-lasting type of bipolar disorder, marked by:

• Persistent mood changes lasting for at least two years
• Episodes of elevated mood (hypomanic symptoms) and low mood (mild depressive symptoms)
• Symptoms that do not fully meet the diagnostic standards for mania or major depression

4. Bipolar Disorder – Other Specified and Unspecified

In some cases, mood symptoms don’t neatly fit into the above categories. These may still cause significant distress and need medical attention.

Causes and Risk Factors of Bipolar Disorder

A mix of genetic influences, brain chemistry, and environmental triggers is believed to contribute to the development of bipolar disorder

1. Genetic Links

• Having a family history is an important factor.
• People with close relatives, such as parents or siblings, who have bipolar disorder face an increased risk.
• Still, a family history does not guarantee that someone will develop the disorder.

2. Brain Structure and Chemical Imbalance

• Abnormal levels of neurotransmitters like dopamine, serotonin, and norepinephrine are linked to mood disorders.
• Neuroimaging has shown structural and functional differences in brain areas responsible for mood regulation.

3. Environmental Triggers

• Stressful life events like job loss, trauma, or grief
• Sleep disturbances or erratic daily schedules
• Substance abuse, including alcohol and recreational drugs
• Hormonal changes, especially in postpartum women

These factors can trigger episodes in people who are genetically predisposed to bipolar disorder.

Also read: How to Handle Anxiety in Children?

Symptoms to Watch Out For

Symptoms of a Manic Episode:

• Elevated or irritable mood
• Inflated self-esteem or grandiosity
• Reduced need for sleep
• Increased talkativeness or fast speech
• Racing thoughts
• Risky behaviors (overspending, reckless driving, impulsive decisions)

Symptoms of a Hypomanic Episode:

• Similar to mania but less intense
• No psychosis or need for hospitalization
• Still noticeable to others and may interfere with work or relationships

Symptoms of a Depressive Episode:

• Persistent sadness or hopelessness
• Fatigue and low energy
• Difficulty concentrating
• Changes in sleep and appetite
• Feelings of guilt or worthlessness
• Suicidal thoughts or behavior

To be diagnosed with a major depressive episode, these symptoms need to last for a minimum of two weeks.

Diagnosing Bipolar Disorder

Diagnosing bipolar disorder can be challenging, especially if the patient only presents during a depressive phase.

Steps in Diagnosis:

• Comprehensive clinical assessment
• Mood history and symptom tracking
• Family input and background
• Ruling out physical causes (e.g., thyroid conditions)
• Evaluation for substance use disorders

Timely diagnosis is essential to avoid mismanagement. For example, prescribing antidepressants alone without a mood stabilizer can worsen bipolar symptoms.

Treatment Options for Bipolar Disorder

While bipolar disorder is a lifelong condition, it can be effectively managed with appropriate treatment.

1. Medication

Medication plays a crucial role in controlling mood fluctuations and reducing the chances of future manic or depressive episodes.

Doctors may prescribe:

• Mood stabilizers to maintain emotional balance and prevent extreme highs and lows.
• Antipsychotic medications to manage symptoms of mania or depression, especially when psychosis is present.
• Antidepressants, used cautiously and typically in combination with mood stabilizers, to address prolonged depressive phases.
• Short-term medications to relieve associated symptoms like severe anxiety, agitation, or insomnia.

The selection of medication is tailored to each individual, considering factors such as the specific type of bipolar disorder, symptom severity, other health issues, and how the patient responds to treatment. Following your psychiatrist’s guidance and attending regular check-ups to modify the medication are essential.

2. Psychotherapy

Medication helps correct the brain’s chemical imbalances in bipolar disorder, while psychotherapy is essential for achieving lasting emotional balance and enhancing overall well-being. It supports individuals in gaining insight into their condition, managing symptoms, and developing effective coping strategies.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a commonly used treatment for bipolar disorder. It assists individuals in recognizing and altering harmful thoughts and behaviors that affect their emotional stability.

For instance, during a depressive episode, a person might think they have failed, and CBT helps them question this belief and adopt a more realistic outlook. Additionally, it provides tools for problem-solving and managing stress.

Interpersonal and Social Rhythm Therapy (IPSRT)

This therapy emphasizes the importance of maintaining daily routines—including sleeping, eating, and social interactions—to stabilize biological rhythms.

People with bipolar disorder often have irregular routines that can trigger mood episodes. IPSRT helps establish consistency in these areas, reducing the chances of relapse. It also improves interpersonal relationships by addressing conflicts and enhancing communication skills.

Family Therapy

Bipolar disorder impacts not just the person diagnosed but also their family. Family therapy helps educate loved ones about the illness and guides them on how to offer support while avoiding behaviors that may unintentionally reinforce problems.

It strengthens relationships, reduces misunderstandings, and helps family members recognize early warning signs of a mood episode.

Psychoeducation

Knowledge is power. Psychoeducation equips individuals and their loved ones with the information they need to understand bipolar disorder, including its symptoms, triggers, treatment options, and warning signs.

When patients and families can identify early symptoms—like changes in sleep or energy levels—they can act quickly and prevent full-blown episodes. This proactive approach greatly improves long-term outcomes.

3. Lifestyle Management

Daily lifestyle choices significantly influence the course and severity of bipolar disorder. A structured, balanced lifestyle can help individuals maintain emotional stability and avoid mood swings.

Maintain a Regular Routine

Sticking to a daily schedule—especially for sleep, meals, and exercise—can stabilize mood and energy levels. Sleep disturbances are a common trigger for manic and depressive episodes, so establishing good sleep hygiene is critical.

Avoid Alcohol and Drugs

Using substances can reduce how well treatment works and may intensify symptoms. Even occasional alcohol use can trigger mood episodes. For maintaining long-term mental health, it is best to avoid all substances completely.

Exercise Regularly

Physical activity, such as walking, swimming, or yoga, boosts endorphins and reduces stress. It helps combat depressive symptoms, improves sleep quality, and enhances self-esteem. Engaging in about 30 minutes of moderate physical activity on most days can have a significant positive impact

Practice Mindfulness and Relaxation Techniques

Mind-body practices like yoga, meditation, and deep breathing exercises can improve emotional regulation and reduce anxiety. These practices ground the mind, promote relaxation, and improve awareness of one’s mood and triggers.

Stay Connected with a Support System

Isolation can worsen bipolar symptoms, especially during depressive episodes. Staying in touch with family, friends, or support groups provides emotional support and helps individuals feel understood and valued. Having regular conversations with someone can provide crucial support during difficult moments.

4. Hospitalization When Needed

In certain situations, outpatient care may not be sufficient to manage the intensity of symptoms. In such cases, hospitalization becomes necessary to protect the individual and others while providing intensive treatment.

When Hospitalization is Recommended:

• Severe manic or depressive episodes: When symptoms become overwhelming and impair basic functioning.
• Risk of self-harm or harm to others: If the individual expresses suicidal thoughts or behaves aggressively or recklessly.
• When hallucinations, delusions, or extreme disconnection from reality occur.

Inpatient treatment provides a secure and organized setting where mental health specialists work closely to manage symptoms. This care often involves modifying medications, providing therapy, and continuous observation. After stabilization, patients are gradually moved to outpatient care with a personalized plan for ongoing recovery.

Also read: What is the difference between Alzheimer's and Dementia?

Living Well with Bipolar Disorder

With proper treatment, many individuals with bipolar disorder are able to live fulfilling and successful lives. Consistent medical follow-ups, sticking to prescribed medications, and having a strong support network are essential for ongoing recovery and stability.

When to Seek Professional Help

If you notice the following signs in yourself or someone you care about:

• Rapid mood changes without clear cause
• Episodes of high energy, excessive talking, or reckless behavior
• Persistent low mood, fatigue, or suicidal thoughts
• Difficulty maintaining relationships or functioning at work

Please consult a psychiatrist. Early intervention leads to better outcomes.

Final Thoughts

Bipolar disorder is a medical condition, not a reflection of personal weakness or character flaws. It needs proper diagnosis, professional care, and evidence-based treatment. With the right support and management, people with bipolar disorder can lead fulfilling, balanced, and productive lives.