By Dr. David Woo - August 1, 2022

Bipolar disorder, previously known as manic depression, is a mental health condition that affects approximately 40 million people worldwide.(1) People with bipolar disorder experience extreme mood swings, referred to as “mood episodes,” that can last for weeks. These mood swings consist of strong emotional highs, called “manic episodes,” and lows, called “depressive episodes.”

Types of Bipolar

Bipolar disorder is classified into four different diagnoses:(2,3,4,5)

1. Bipolar I: having one or more mood episodes of mania that lasts seven days or more with or without also experiencing a depressive episode.
2. Bipolar II: experiencing a change in mood between depressive episodes and moderate or minor manic episodes, as opposed to a full-blown manic episode.
3. Cyclothymic disorder: often considered a milder form of bipolar disorder, people with cyclothymic may experience milder forms of depressive and manic episodes, with periods of unaffected mood in between lasting no longer than eight weeks.
4. Unspecified bipolar disorder: the term used when someone does not meet the specific criteria for any of the above bipolar diagnoses, but they experience periods of abnormal mood elevation (mania). 

Signs and Symptoms of Bipolar Disorder

The signs and symptoms of bipolar disorder are marked by the mood episode the patient is experiencing, whether they are in a “high” or a “low.”

There are two classifications for the elevated mood episodes associated with bipolar. These are known as mania, the more extreme of the two, and hypomania, the less extreme. Both mania and hypomania are present when a patient displays three or more of the following symptoms:(3)

• Excited talkativeness (talking more than usual and very fast)
• Being easily distracted
• Impaired decision-making skills
• Racing thoughts
• Being unusually antsy or excited
• Increased energy
• Euphoria (feelings of abundant happiness and sense of well-being)
• Decreased need for sleep

Depressive episodes are defined when a patient experiences five or more of the following symptoms:(3)

• Significant feelings of sadness or hopelessness
• Loss of interest and pleasure in activities that one used to enjoy
• Notable, unexplained changes in weight and/or appetite
• Changes in normal sleep patterns, such as insomnia or oversleeping
• Lethargy
• Inactivity
• Overwhelming feelings of shame, guilt, and worthlessness
• Difficulty focusing or making decisions
• Suicidal thoughts

Treatment Options for Bipolar Disorder

Bipolar disorder is a lifelong condition that requires continued treatment, even through durations when the person is not experiencing symptoms.(6) There are different treatment options for bipolar disorder. 

Medication

Medication is the most common treatment for bipolar disorder. Prescription drugs may include mood stabilizers, antipsychotics, or antidepressants. It’s important for patients to take medication as prescribed. Failure to do so may increase the risk of relapse (symptom return).(6)

Psychotherapy (“Talk” Therapy)

Psychotherapy, such as talk therapy, can be helpful as a preventative approach for coping with one’s diagnosis and learning to avoid things that can trigger a mood episode. 

One type of therapy, called cognitive-behavioral therapy (CBT) is a form of psychotherapy where patients learn to reframe unhealthy thought patterns and behaviors into positive ones. This type of therapy can be especially helpful in helping patients to recognize thoughts or behaviors that trigger their symptoms. (6)

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a non-invasive outpatient treatment that uses electromagnetic pulses to stimulate areas of the brain to relieve symptoms of a variety of mental health conditions. Research suggests that TMS may be helpful in reducing symptoms of bipolar disorder and, in some cases, achieving remission, even for patients who have not seen positive results from prescription bipolar medications.(7,8)

Contact a Licensed Psychiatrist if You or a Loved One Are Experiencing Symptoms of Bipolar

If you or a loved one are suffering from symptoms of bipolar disorder, it is important to seek help from a licensed psychiatrist. Only a doctor can diagnose bipolar disorder, and symptoms of bipolar disorder can be managed with the right treatment. 

Contact us at Madison Ave TMS & Psychiatry to learn more about treatment for bipolar disorder.

Resources:

1. World Health Organization. Mental Disorders. Published June, 08, 2022. Link. Accessed July 05, 2022.

2. Bipolar Disorder. National Alliance on Mental Illness. Reviewed August 2017. Link. Accessed July 5, 2022.

3. Bipolar Disorder. MayoClinic. Published February 16, 2021. Link. Accessed July 5, 2022.

4. Bipolar disorder statistics 2022. SingleCare. Published February 15, 2022. Link. Accessed July 5, 2022.

5. The History of Bipolar Disorder. WebMd. Updated September 3, 2020. Link. Accessed July 5, 2022.

6. Bipolar Disorder. MayoClinic. Published Feb 16, 2021. Link. Accessed July 5, 2022.

7. Goldwaser EL, Daddario K, Aaronson ST. A retrospective analysis of bipolar depression treated with transcranial magnetic stimulation. Brain Behav. 2020;10(12):e01805. Link. Accessed July 5, 2022.

8. Gold AK, Ornelas AC, Cirillo P, et al. Clinical applications of transcranial magnetic stimulation in bipolar disorder. Brain Behav. 2019;9(10):e01419. Link. Accessed July 5, 2022.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.