Bipolar disorder is one of the most misunderstood mental health conditions out there. If your perception of the illness is mainly shaped by pop culture depictions like Carrie’s counterterrorist exploits on Homeland, then spoiler alert: The reality of bipolar disorder is much more nuanced than it may seem. Keep reading to learn 14 key facts about bipolar disorder that everyone should know.
1. Bipolar disorder is a mental illness characterized by dramatic shifts in mood and behavior.
These shifts are referred to as “mood episodes,” according to the National Institute of Mental Health (NIMH). There are two main types of episodes: manic episodes and depressive episodes. (Hence why bipolar disorder used to be referred to as manic depression.)
In between these episodes, a person with bipolar disorder may have periods without symptoms of either mania or depression.
2. Bipolar depressive episodes tend to look a lot like classic depression.
Without knowing somebody’s medical history, it’s virtually impossible to determine whether their depression is the result of bipolar disorder or something like major depressive disorder, Dolores Malaspina, M.D., director of the Psychosis Program in the department of psychiatry at the Icahn School of Medicine at Mount Sinai, tells SELF.
But in general, the NIMH highlights these as the signs and symptoms of a bipolar depressive episode:
- Unusually low energy
- Decreased activity levels
- Feelings of hopelessness and despair
- Loss of enjoyment in activities
- Sleeping too little or too much
- Feeling worried or empty
- Eating too little or too much
- Trouble concentrating or remembering things
- Suicidal thoughts
Severe episodes of depression can also involve psychosis involving delusions or hallucinations, the NIMH notes.
3. Manic episodes are more complicated than simply being “up.”
Experiencing mania doesn’t necessarily mean a person is running around feeling invincible and happy, says Dr. Malaspina.
As the NIMH explains, there are many different signs and symptoms of mania:
- Unusually high energy
- Increased activity levels
- Feeling wired or jumpy
- Feelings of elation
- Feelings of agitation or irritability
- Feelings of overconfidence
- Trouble sleeping
- Talking unusually quickly
- Trying to take on too many things at once
- Engaging in risky behavior, such as taking sexual or financial risks you wouldn’t otherwise
4. Hypomania can involve many of the same symptoms of mania but on a less severe scale.
“There are very different severities of the mood elevation,” Wendy Marsh, M.D., director of the Bipolar Disorders Specialty Clinic and an associate professor in the department of psychiatry at the University of Massachusetts Medical School, tells SELF. At the lower end of the spectrum is hypomania, which is when a person doesn’t experience a full-blown manic episode, but only some of the symptoms on a milder scale. “It can seem like useful, goal-oriented energy,” Dr. Malaspina says.
Some people only ever experience hypomania, but it’s also possible to experience full mania, which can eventually become dangerous. “You can have too much belief in yourself…[and] very poor judgment,” says Dr. Malaspina. This can contribute to behavior like having unprotected sex or investing all your money in a business venture, she says. This grandiose thinking can also escalate into delusion. “When someone has mania, they really need to be under a doctor’s care,” Dr. Malaspina says.