No one's mood is stable 100% of the time. It's normal to feel down when you hit a rough patch and elated when life goes your way.
But if you have bipolar disorder, the highs and lows are a lot more extreme, and they can sometimes seem random. The good news is that with treatment and some hard work, you can control the impact this disease has on your life.
Symptoms of Bipolar Disorder
Doctors aren’t sure what causes this condition, which is also called manic depression. It could have to do with brain structure -- the pathways or circuits that control mood, behavior, and thinking. Or it could be brain chemistry. It’s likely genetic, since it often runs in families. Anyone can get bipolar disorder at any age, but most people show symptoms before the age of 25.
Manic periods (hypomania or mania), which tend to happen less often than depressed ones, involve unusual bursts of energy.
What’s the difference between being happy and manic? "You'll feel much more energetic than you do at your baseline, have racing thoughts, talk louder and faster than normal, and notice a decreased need for sleep," says Joseph Calabrese, MD. He's the director of the mood disorders program at Case Western Reserve University.
Also, your judgment will be off. "People do things quickly without thinking about the consequences," Calabrese says. For example, you might spend too much money, have impulsive sex, or get into trouble with the law. During full-blown mania, you could have feelings that you’re better or more important than other people. You may even hear and see things that aren't there.
How to Get Help
About 10 million Americans have bipolar disorder, but many don't know it. "Between 20 and 40 percent of people with bipolar disorder are not properly diagnosed or not diagnosed at all," Calabrese says.
Why? Most people don’t seek help unless they're feeling down. "Bipolar disorder can get missed if a person starts with a depressive episode," says Ken Duckworth, MD. He's the medical director of NAMI, the National Alliance on Mental Illness, and an assistant clinical professor at Harvard University Medical School.
It’s a catch-22. If you show up at the doctor’s and appear depressed, you’re likely to get an antidepressant. If you have bipolar disorder, that drug may not work and can sometimes bring on mania. The right treatment is a drug that evens out your mood, like lithium. It can help prevent both depressive and manic episodes.
If you’re in a so-called manic phase, you can feel so happy and productive that you don’t want to come down. But "depression always follows mania," Calabrese says. "You can't have your cake and eat it, too."
Clues to a Diagnosis
If you think you might have bipolar disorder, bring a family member with you when you go to the doctor. "Family members will recognize periods of mood elevation," Calabrese says.
A thorough review of your family history will also help, even if you don’t have relatives who were diagnosed with bipolar disorder. But if a parent has it, there’s a higher chance you’ll get it, too.
Others abuse alcohol or drugs, which can also cause mood swings or symptoms that mimic mania or depression.
Your doctor will have to sort out a lot of complex symptoms to make a diagnosis. So, be honest with him about what’s going on with you.
You'll also have to be willing to devote time to the process. A doctor can't diagnose bipolar disorder in 30 minutes, Calabrese says.
The Effort Is Worth It
If you have trouble finding a good doctor, reach out to a local academic medical center, Duckworth says.
Also, medication is only part of the fix, he says. You need to keep stress in check, get regular exercise, and get enough sleep. "Don't do shift work, be careful with alcohol and drugs, mind your stress levels, and seek loving relationships," he says.
It takes work to manage this illness, but the effort is worth it. “People who have it can and do achieve wellness and lead extraordinary, healthy, happy, productive lives,” says Allen Doederlein, president of the Depression and Bipolar Support Alliance (DBSA).