Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology

Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology


Maybe you’ve heard the term “bipolar”
used to describe someone who’s moody, or who has mood swings, but this colloquial use
of the term is really different from bipolar disorder. Bipolar disorder, which used to be called
manic depression, is a serious mental illness that causes a person to have dramatic shifts
in emotions, mood, and energy levels: moving from extreme lows to extreme highs. But these shifts don’t happen moment to
moment, they usually happen over several days or weeks. There are a few different types of bipolar
disorders, but there are some common features. First, the low moods are identical to those
in a related disorder – major depressive disorder, also known as unipolar depression. Individuals with this can feel hopeless and
discouraged, lack energy and mental focus, and can have physical symptoms like eating
and sleeping too much or too little. But along with these lows, the thing that
sets bipolar disorders apart from unipolar depression is that individuals can have periods
of high moods, which are called manic episodes or hypomanic episodes, depending on their
level of severity. In a manic state, people can feel energetic,
overly happy or optimistic, even euphoric with really high self-esteem. And on the surface, these might seem like
very positive characteristics, but when an individual is in a full manic episode, these
symptoms can reach a dangerous extreme. A person experiencing mania might invest all
of their money in a risky business venture or behave recklessly. Individuals might talk pressured speech, where
they talk constantly at a rapid-fire pace, or they might have racing thoughts and might
feel ‘wired,’ as if they don’t need sleep. Manic episodes can also include delusions
of grandeur, for example they might believe that they are on a personal mission from god,
or that they have supernatural power. And they might make poor decisions without
any regard for later consequences. One way to understand these swings is by charting
them on a graph. So let’s say y-axis is mood, with mania
and depression being on the far ends of the axis, and the x-axis is time. The average healthy individual might have
normal ups and downs throughout their life, and they might even have some pretty serious
lows once-in-awhile, maybe after losing a job or moving to a new place and feeling lonely. An individual with unipolar depression though,
might have the normal highs, but they might have some crushing lows that last for a long
period of time and may not have an obvious trigger. Now, for the bipolar disorders, the first
one is called Bipolar 1, and these are people that have some major lows that last at least
2 weeks, and some major highs that last at least a week or require hospitalization. That said, untreated manic episodes can last
as long as 3-6 months. Depression is seen in most cases, but is not
required for a diagnosis. The second one is called Bipolar-2, and this
is when a person experiences similar lows, and has additional highs called “hypomania”,
which are less severe manic episodes than we see in Bipolar 1. To qualify for a diagnosis, these hypomanic
states need to last at least four days. Once again though, these symptoms generally
last a few weeks to a few months. Alright the third one is called cyclothymia,
or sometimes cyclothymic disorder, and these individuals have milder lows as well as the
milder highs or “hypomania” like you see in Bipolar-2, and they cycle back and forth
between these two over a period lasting at least 2 years. Sometimes, people with Bipolar disorder can
show other, less common symptoms as well, for example having what are referred to as
mixed episodes—experiencing symptoms of both depression and mania at the same time. Another symptom they might have is rapid cycling,
which describes a situation where a person has 4 or more episodes of depression or mania
within a given year. Like most mental health conditions, the exact
underlying cause of bipolar disorder isn’t known, and there is no single “bipolar gene”
identified, but it’s thought that there are genetic and environmental factors that
play a part. For example, one interesting clue is that
people with family members who have bipolar disorder are 10 times more likely to have
it themselves. Another clue is that some drugs and medications
can trigger manic episodes, like selective serotonin reuptake inhibitors (or SSRIs). It’s also worth mentioning that people with
bipolar disorder often have other disorders like anxiety disorders, substance use disorders,
ADHD, and personality disorders as well, making diagnosis and treatment a real challenge. Even though there’s no cure for bipolar
disorder, identifying and treating individuals is really important, since there’s a real
danger that the person could harm themselves or commit suicide. One of the oldest treatments is also one of
the most effective treatments, and that’s lithium salts. Lithium acts as a mood stabilizer—smoothing
out the highs and lows they experience. That said, it is much better at treating manic
rather than depressive episodes, and so individuals who take it often have to take other medications
as well, which can be problematic since some antidepressants (like the SSRIs) can trigger
manic episodes in individuals who are predisposed to them. Other treatment options include antipsychotics,
anticonvulsants, and benzodiazepines, but many of these—including lithium—have side
effects that can be severe and lead to non-adherence which can be dangerous for an individual. Now, unlike certain disorders like unipolar
depression, psychological interventions, like talk therapy, or cognitive-behavioral therapy
are not particularly effective in treating the manic episodes of bipolar disorder. Having said that, they can still be very helpful
tools to help individuals with bipolar disorder in general—especially after a manic episode
has ended. They can also help an individual handle stressful
situations that might otherwise lead a manic episode, thereby helping to prevent a potential
manic episode in the first place. Alright, so super fast recap: bipolar disorder
is a mental disorder characterized by depression, periods of lowered mood, as well as mania,
periods of heightened mood. Thanks for watching, you can help support
us by donating on patreon, or subscribing to our channel, or telling your friends about
us on social media.

72 comments

  1. My doctor thinks I may have bipolar disorder because I experience most of the symptoms (as well as other crazy things outside of the list.) So I have to go back to the doctor next week for a followup and then make plans to see a psychologist. Honestly, I'm scared and really hope I don't have it and if I do I don't know how I'm going to bring it up to my father or other family members. He's not abusive or anything but he's a health nut and pretty ignorant when it comes to most mental disorders and doesn't really believe in my depression or anxiety all that much.

  2. I am really moody violent impulsive but I dont think I have bipolar disorder because none of these emotions last very long.

  3. I don't know if I am.
    I've been struggling to find out if I am actually bipolar.
    I have some simtoms, like always speaking really and have racing thoughts, but I normally have several changes of mood in the same day, plus I am pretty energetic and then feel weak, or lazyer than usual.
    I'm a teenager, so I don't know if I have a serious mental problem, weird personality and attitudes or if I'm just growing up.

  4. Bi polar disorder is simply confusion. Confusion for a multitude of reasons. An unhappy childhood,family problems or just.simply not knowing what u want or confusion about which direction in life to follow. Self knowledge cures bi polar. Read the last chapter of Blessings by Mary Craig.

  5. Is it possible that I'm diagnosed with bipolar because all of the symptoms and present risk is positive?

    Sorry for my English…

  6. One thing i can say about having bipolar myself is that medication is a must. Medication helped to control my mania and also take me out of psychosis twice. People close to though do not always understand that and think their "sage" advice can take the place of antipsychotics and mood stabilizers. Like what if I had a broken leg?Are you going to tell me it's all in my head or that I should pray to God? No, you're going to give me medicine. Same for having a mental illness. Can we please end the shaming from nonmedication believers?

  7. The drugs can be very dangerous, lithium can damage your heart, Benzos are addicting antipsychotics cause tardive diskenesea(look it up)

  8. To all of you bipolar,

    You are all beautiful human beings like all other non-bipolar because to me, bipolar sounds more like a «box» you all put yourselves in because an «expert» listened to your problems in your head and told you with no physical evidence: you are bipolar 😮 !!! Please don't believe this bullshit, like you need pills to «cure» bipolarity because it's a disease? No, it's your personality! and embrace it Jesus !

    Yes, you might work differently than the rest of human beings, because today being different is like a crime right!? You, bipolar are passionate individuals who actually care about a lot of useful things , you have drive to lead people to the top with your contagious charisma!

    I know it's not easy to thrive with all those compulsive thoughts and depressions you may suffer, but hey, have you ever heard about someone who lived a life with no challenges and only happy moods? Personally, I don't, and if this person exists his life must not be really interesting!

    Listening to what y'all describe as bipolar resembles a lot to my own personality and I never considered myself bipolar and never will!

    I went through multiple depressions never seeking help in the fear of judgment, thought about killing myself often, had a difficult childhood, I have a lot of reasons to hate this world, you know the bipolar starter pack right here! but I choose to embrace every day no matter what happens, no matter how I feel because our time here is limited and I prefer to spend it in good thoughts rather than think about useless negative shit that just brings you back down.

    Now you know that bipolarity is a blessing, not a disease, if you think it's a disease, you've probably face a lot of defeat in your life and all blame it on yourself and your fake disease bipolarity. All I can say to you is never give up, and if you really are not happy and want to change for the better please, please read the book: Think and grow rich from Napoleon Hill and you might just find what you've been looking for your entire life. God bless you!

  9. Please read,
    After months of having random mood swings, feeling such levels of emotion I’ve started researching about Bipolar. For random reasons I feel so depressed for days on end then it changes to happiness and being so energetic when I am, I talk faster than normal. I really need help with this and I don’t know if I am bipolar. If anyone can help, please comment.

  10. damn i've been going thru this for the whole of 2019 so far…ok i really should have seen a psychologist when i thought i had depression and suicidal thoughts back then. now one question: can the depressive episodes be like poofed away if for ex. i see my crush or i see someone i like or listen to smth i love? bcos i don't want to think i have this disorder but i really might just have it. i even told myself that either before or after my menstruation, i get a depressive ep that i can't explain and thought was normal

  11. Ever heard of lamotrigine? It’s a mood stabiliser and should have less side effects though some brands can maybe make you a bit nauseous – you can ask your psychiatrist 🙂 nobody knows why it works but it has helped a lot of people since it’s not as harsh as lithium and works with antidepressants like sertraline for some people – getting less severe swings is definitely worth trying to achieve 🙂

  12. This low is making me WISH I was manic right now in some ways. I’m about to lose my job to this bullshit because I can’t find the motivation to go to work. I fucking hate this shit.

  13. I want to see a therapist because I know I’m very different from other people but my family said no. My friends mom was a therapist so she diagnosed me with PTSD and bipolar disorder

  14. I don’t want to see a therapist or doctor. I’m afraid of what they’re going to tell me and I can’t afford medication or treatment.

  15. Some weeks I try to kill myself, then the next I will think about it and not even care because I’m so happy. What does this mean?

  16. Try to explain your highs and lows to others. Try to explain that your bipolar disorder is not a choice..
    You'll have people hate you. They'll blame you. It's horror, even with medication it's not entirely fixed

  17. I'm bipolar and not all of these symptoms are accurate it's different for everyone and bipolar disorder isn't as extreme as everyone makes it out to be.

  18. Stop diagnosing yourself just because you're happy one day and sad the next doesn't mean you're bipolar it's a very serious mental disorder and has more to do with than just feeling sad and happy back and forth mania and depression differ from sadness and being happy go see a psychiatrist and stop labeling yourself just because you're moody and emotional doesn't mean you're mentally ill!!!!

  19. I wrote a rap song about being bipolar and sza. I would really appreciate if someone could check it out on my channel. It is called Giedre Mok – If i was bipolar (original rap) let me know what you think! love you all!

  20. Bipolar 2, diagnosed. It is real, and I can go from 0-10 in a second! It's a good trait. I live my life and have a Kid that looks up to me! I would call the disorder alert, with extreme anxiety. Manage it without pills, you'll be good to go

  21. I'm watching this cause I was litterally just going insane lmao.. I was in the kitchen and started jumping around as if I was hyper for no reason and I closed my eyes and it felt like I was in a whole other world and I started floating with so many thoughts in my head ay once and I didn't even realize I was still home jumping around until my brother cam downstairs but instead of seeing my brother I saw a weird priest holding a bible telling me something so I screamed and threw whatever I was ripping apart in my hands and fell on the floor and he was very comfused and then when he went back upstairs I just sat on the floor for a while shaking and crying for no reason and now I'm here like wut

  22. I hate when I’m having a mani moment and I’m talking and my bf doesn’t feel like listening bc that triggers me right into a low smh

  23. I really think I am Bi poler, but I am scared to brink this up to my mother, because she always scolds me when I bring stuff up like this.

    any advice

  24. help? i have severe mood swings. I am extremly hype at any reason as i experiencing it again rn. And i tend to have suicidal thoughts or have negative thought about myself sometimes i end up doing it. I cannot control my mood and commonly i tend to hurt someone unintentionally. I wanted to kill someone but i don't fvck1*• want!!!! i dont get why im extremely happy at the middle of the night and burst out to crying. And i have memory issue too that just by speaking i forgot how to. i am not self diagnosing it's just way too uhm confusing for me because i didn't experience any of this before.

  25. Soooooo…. 99% of humanity is bipolar? Why is this even a diagnosis? It seems like a natural flow of life. You have highs and you have lows. Whats wrong with that? Many things affect our life state… climate, weather, food exercise, hormones, sex… etc. A combination of these will give you periodic highs and periodic lows that last a few days to a few weeks. There is nothing wrong with this… why is this a diagnosis? ($$$$$$$) Its normal human and animal behavior. This happens everywhere and with almost everyone.

    My friend was diagnosed "bipolar"… he has always been the same… but now that has been diagnosed is depressed (after the diagnosis)… nothing in him changed… this diagnosis is bull****! The diagnosis itself leads to problems, because now people think they arn't normal, and believe it. Its all psychosomatic. Someone convinced you that you are sick? Well guess what, now you will be, because you believed it.

    Ups and downs are a normal cycle of life. Im all for a good healthy diet and excersise. This will help everyone normalize all kinds of levels and have a more stable life. BUT, just because you have a little more or less highs or lows than someone else at a given time, does not mean you are sick, or that you have a disorder. That is complete BS. Eat healthy, and excersize, have sex, and sleep. You will be fine.

  26. But what are the reasons for the mood swings change? I literally have things in life that trigger me feeling depressed and the reason I feel mania is to fight the doubt of orhers

  27. I think the worst part about having a mood disorder is when you finally get diagnosed and then the husband and other family members constantly make jokes about being crazy or if you want to discuss what's going on they tell you to take another pill.
    I don't think the world nor people understand how hard it is to live like this. I've acknowledged that this illness never goes away, I can only take medication.
    That's enough to make a person just give up on life.
    I've learned to keep to myself, stay quiet and pretend I'm normal.
    It's "easier," on the family when they think I'm falling in line according to social standards.

    It's sad to know so many people suffer alone with zero support from family and friends. It's like you became pitiful and family just interact with you because they have to.

  28. Thanks! Watching this because I want to educate myself with mental matters. I believe that mental health is important. I am diagnosed with Major Depression and PTSD. (Not self diagnosed) I want to be a better support for my friends in therapy who have Bipolar Disorder❤️

  29. I have this shit for maybe a year or more and its bullshit. Like cancelling plans at the last minute, distant your self to society, being useless ,outburst on simple things,i cant even sleep at night for months. I know im weak but im sorry I cant handle it but am itrying so dont tell me to snap out of it or saying that i just over react i didnt choose to have this shit

  30. I need help, why is it that in random days of the week i shift between being social and active then suddenly i think about something and end up preferring to be alone and feel so hopeless and barely talking for the rest of the day

  31. this is scary dude ! My mom has manic depression and like for a month she can be so sick and sleepy and then the next day she just wakes up all energetic and mean…

  32. Im a bipolar 2 to describe best, but also experiencing cyclothimic disroder for the past 2 1/2 years. And i know why, its due to the large stress and trauma i experienced in 2016, it was so sudden and abrupt, i know that it is the cause of my large mood shifts and my crying for no reason.(i do self harm, its not a joke.) but later id laugh it off not knowing why im doing such things to myself. Bipolar disorder is a serious matter. im not on any kind of meds, because im just too scared to mention anythuing about bipolarity. My parents know my large mood shifts, bvut brush it off as teenage problems. i dont blame them.

  33. I’m on the watch for bipolar 1 by my psychiatrist. I say my odds of having bipolar are very high because it runs in both sides of my family

  34. i GOT – TALKING excessively, racing thoughts, hostility, less sleep, extream fatigue, prolonged sadness, poor nutrition what was that mean ? my friend know me for being talking so loud at school but im fuck up right now. iwanna end this shit help me please.

  35. I think im bipolar, have those manic symptoms now, few days ago I wanted to shoot myself! Killing myself was all I thought about. I need help but haven't asked anyone. I don't know what to do.

  36. ti'll now im still thinking what's wrong with me…
    "when I was a kid I had a friend, but idk her name I think i forgot. It was a lovely sunny day I was very happy and good at the moment but minutes later I got mad at her without any reason, and sometimes I want to kill myself. Until I grew up I met many friends but, sometimes I think I hate them or it was wrong to befriend with them."
    well I guess I need to see a psychiatrist

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