Not Just a Made-Up Stereotype: Exploring What Bipolar Disorder Really Is By San Diego Psychiatrist

With bipolar disorder, you may often feel powerless when things go out of control, and getting things back in order can be an overwhelming challenge. The extreme and sudden mood shifts and erratic behaviors are not easy to deal with not only for you but also for your loved ones. Like you, a lot of individuals with the same conditions can understand how difficult having this mental condition can be and how a San Diego bipolar treatment plan is necessary.

Medication and a regular psychiatric consultation are highly valuable. In addition to these, there are other exercises and routines that you can adopt to make continuous progress. Having an in-depth understanding of the condition, knowing the contributing factors, and solutions will equip you, your family and friends, in your pursuit of a normal and well-adjusted life despite the challenges that bipolar disorder brings.

What is Bipolar Disorder?

Bipolar disorder (manic-depressive disorder) is a mental health condition characterized by alternating periods of depression and elevated mood. Some individuals may display either just depression or elevated mood, which makes the condition misleading.

Bipolar disorder may develop at any age, but the condition usually manifests during teens or early 20s. National Institute on Mental Illness’ recent statistics shows that 2.6% or about 5.7 million American adults are affected.

With bipolar disorder, a bipolar individual experiences rapid mood shifts – from euphoric to depressed. During the euphoric state, you become hyperactive, passionate, highly inspired, and sharp. The depressive state, meanwhile leaves the person feeling extremely sad, fatigued, and disinterested in daily activities.

Unfortunately, bipolar disorder has no known cure yet but experts have developed several treatment approaches and medications to help a bipolar individual manage the symptoms and lead a productive life.

What Are the Four Types of Bipolar Disorder?

A psychiatric specialist can determine the type of bipolar disorder that you have through meticulous interviews and the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria. It has four primary types and they are classified depending on the severity and frequency of the symptoms. These are bipolar 1, bipolar 2, cyclothymic, and unspecified.
It is important to understand what type of bipolar disorder you have, as it will impact the approach to developing a San Diego bipolar treatment plan with our specialists.

We see in movies how individuals with bipolar disorder are portrayed but are these representations accurate? San Diego psychiatrists and mental care providers say there are instances where this is close to reality. Bipolar I is the most common type of bipolar disorder. It typically comes with one or more severe manic episodes lasting for seven days or more, such as:

  • Mania
  • Euphoria
  • Irritability
  • Decreased sleep
  • Talkativeness
  • Easily distracted
  • Hallucinations

Bipolar I occurs with or without depression. The depression can last for more than two weeks and most often, the attack can lead to hospitalization.

So if bipolar I can be the up and down mood swings we often associate with bipolar disorder, how is bipolar II different? Bipolar II is characterized by episodes of hypomania mainly with bouts of depression, which are less severe than the symptoms of bipolar I. And while individuals display similar signs and symptoms of bipolar I, they are comparatively more functional.

Their effectiveness in dealing with the daily demands of life has a turning point though. At first, they may appear perfectly fine even with minimal sleep. They can get a lot of things done at work or can study for long hours in and out of school. Some professionals with bipolar disorder 2 are even successful, working at least 60 hours a week. But after a few days, they crash. Depression and/or hypomania sets in, until they can no longer function as usual.

  • Strattera
  • Wellbutrin
  • TCAs (Tricyclic antidepressants)
  • Effexor
  • Qelbree

Strattera is the most-prescribed ADHD medicine in both children and adults because it has fewer side effects compared to TCAs. Non-stimulant medicines may have side effects similar to stimulants but with less intensity.

Cyclothymic bipolar disorder shows longer-lasting symptoms – at least two years in adults and one year in children. The major symptoms include depression and hypomania, although these do not meet the diagnostic requirements. In this case, an individual may feel euphoric for a moment and then suddenly shift to feeling down and out the next. The shifts are not as extreme as bipolar I but the impacts can also be restricting.

In between these episodes, a person may experience normal moods for as short as eight weeks or less.

Unspecified Bipolar Disorder

Some individuals with bipolar disorder could experience symptoms that do not match any of the three types of bipolar disorder. However, one may still have the same symptoms but on a different level or degree. This type of bipolar disorder would fall under the “unspecified” or “mixed” category.

Bipolar Disorder Symptoms

Because bipolar disorder is also viewed as a spectrum, mental health care providers must carefully evaluate a patient to find out if there were episodes of the following symptoms:

Mania and Hypomania

Mania and hypomania are characterized by feelings of euphoria or ecstasy. People with bipolar disorder display overexcited behavior during this state. Mania and hypomania differ in terms of intensity. Mania is more severe than hypomania.

Other symptoms include:

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Inability to concentrate

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Rapid speech

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Trouble sleeping

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Displaying risky behaviors such as sexual promiscuity

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Substance or alcohol abuse


Due to low levels of dopamine in the brain, depression sets in when you have bipolar disorder. At this point, you experience the following:

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Deep sadness and feelings of hopelessness

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Lack of energy and motivation

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Difficulty concentrating and completing tasks

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Loss of appetite

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Weight loss or weight gain

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Inability to sleep or oversleeping

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Feelings of guilt

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Disinterest in daily activities

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Having suicidal thoughts

How Does Depression and Bipolar Disorder Differ From One Another?

Depression is a major symptom of bipolar disorder and people get confused sometimes between the two mental illnesses. People who are depressed can manage to lead a normal and happy life on the surface and then switch to being downcast. So how can you tell the difference?

Ryan Thebo explains: “The distinction between bipolar disorder versus depression or unipolar, as we would call it, is a gray area really for many patients and mental care providers as well. For example, individuals back in their 20s may have had depression most times, and then a few days of elevated mood within that period. And while battling depression, they stayed up and studied a lot. They were more social, impulsive, and doing what normal people their age do.”

The distinction would then depend on the patient’s symptoms no matter when they occurred and the details should be accurate in order to come up with an accurate diagnosis. Accuracy is key in determining whether the condition is depression (unipolar) or bipolar with hypomanic episodes. This is because it will help mental care providers formulate an appropriate San Diego bipolar program of treatment.

How Similar Symptoms of Bipolar Disorder and Depression Can Cause Misdiagnosis

Often, individuals with bipolar disorder are mistakenly diagnosed with unipolar depression, especially when episodes of depression outnumber the episodes of mania. It also happens because patients are most likely to seek treatment during their depressive state and not during their manic state.

When you are misdiagnosed, the consequences can be serious. Your time for recovery may take longer and your condition may become more severe. Taking the wrong medication like some anti-depressants can also cause manic episodes or rapid cycling. In the Journal of Clinical Psychiatry, a study conducted showed that 55% of bipolar individuals who took anti-depressants suffered episodes of mania after.

To avoid such dire repercussions, find a psychiatric specialist who performs a thorough test and evaluates your medical history. You as a patient should also cooperate and be truthful about your condition and experiences. Bipolar disorder can be a scary diagnosis for a lot of individuals, but facing this reality is key to recovery.

Causes of Bipolar Disorder

The exact cause of bipolar disorder is yet unknown but as a result of years-long studies, medical experts have come up with several theories with the help of scientific methods, such as neuroimaging using functional magnetic resonance imaging (fMRI). This technique involves producing images of the brain’s structure and/or activities to help scientists identify which areas are affected or how the nervous system works in people with bipolar disorder. These neuroimaging studies aim to look at early developmental processes in terms of pruning that occur in the prefrontal cortex and other brain networks. Pruning means the taking away of unnecessary neuro connections.

The findings suggest a multitude of factors that can cause bipolar disorder.

Genetics and Epigenetics

Research suggests that in most cases, around 60-80 percent accounts for genetics as a major factor in developing bipolar disorder. It means that if a parent has bipolar disorder, the condition may be passed down to the offspring.

Chemical Imbalance or the Dopamine Hypothesis

Bipolar disorder is often linked to chemical imbalance. Those who experience mania are believed to have high levels of dopamine in the brain causing hypomania. Dopamine is also called the pleasure hormone and too much of it in the brain makes a bipolar person feel euphoric. In this state, the risk-taking behavior and impulsiveness increase while the need for sleep decreases.

After this euphoric state, the dopamine level drops. This would be followed by phases of depression, lack of energy and motivation, irritability, and the like.

Changes in the Pre-frontal Cortex

Bipolar disorder may also be caused by changes and disruptions in the prefrontal cortex and other brain networks responsible for regulating the emotions. These brain networks include the limbic system or the emotional center of the brain.

Is Medication the Only Treatment for Bipolar Disorder?

We often see on TV and in movies where characters with bipolar disorder have fits of euphoria, depression, and hallucination when they fail to take their pills. Claire Danes’s Carrie Mathison in the series Homeland is a good example. But is this dramatized or inspired by a real-life situation?

According to our team of San Diego psychiatric specialists, there’s truth to this. Medication is necessary to balance the brain chemicals involved with bipolar symptoms. However, there are alternative treatments that you can practice in your daily life to manage depressive and hypomanic episodes, such as:

  • Complete and quality sleep
  • Using BB (blue light blocking) glasses)
  • Psychotherapy in support of medication
  • Lifestyle adjustments

Remember that these practices do not eliminate the need for medication, but they can help reduce mood episodes significantly. Consult your healthcare providers for guidance before making these adjustments.

Look Forward to Better Days with a Quality San Diego Bipolar Treatment Program

Even with bipolar disorder, there is hope that life will get better with a comprehensive San Diego bipolar treatment plan. The results may not be instant, but consistent therapy and proper medication will result in long-term improvement.

Each case of bipolar disorder is unique in terms of symptoms and how your body responds to medications. Start working with a reliable team of psychiatric care providers that offers a full-scale treatment program designed specifically for your condition.

San Diego Psychiatrists, Psychiatric Care NPs specializes in bipolar disorder and other mental illnesses. Our team of psychiatric care providers is trained and experienced in treating individuals with different types of bipolar disorder. We conduct an in-depth assessment and evaluation of your medical history to help us formulate a treatment program that is right for you.

Let our bipolar disorder psychiatric specialists help you. Schedule an appointment with us to discuss your options.