Question 1

How is bipolar treated?

Accepted Answer

Bipolar disorder is frequently treated with medication and psychotherapy. The most common medications include:

Mood stabilizers with lithium metal in the form of a pill are very effective in managing mood swings.
Carbamazepine (Tegretol) is used to treat mania and bipolar depression. It helps prevent the extreme highs and lows that are common among bipolar patients.
Lamotrigine (Lamictal) is used for the maintenance treatment of patients with bipolar disorder. It helps delay bouts of mood swing, depression, and mania. It is most recommended for patients who experience extreme lows.
Valproate (Depakote) valproate is an antiseizure drug that helps manage mood swings. It works faster than lithium and is used for 'off label' prevention of lows and highs.
Antipsychotics such as quetiapine, asenapine, risperidone, and olanzapine are used to treat hypomanic episodes.
Benzodiazepines such as alprazolam, lorazepam, and diazepam act as mild tranquilizers and are used for the short-term symptoms of hypomania such as agitation and insomnia.
Antidepressants such as seroquel and fluoxetine are used to manage depression.

Patients may undergo psychotherapy with a social worker, therapist, or psychologist. The therapy can help the patient cope with the mood swings, leading to a reduced need for medical care and improved wellbeing.

Psychotherapy can help patients recognize the warning signs and prevent a relapse before it starts. Some common treatment methods include family-focused therapy, dialectical behavior therapy (DBT), and cognitive behavior therapy (CBT).

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Question 2

Does bipolar worsen with age?

Accepted Answer

Research suggests that bipolar disorder worsens with age. There is a significant increase in depressive episodes as the patient ages, and the episodes tend to become more severe and frequent. The average age-of-onset for bipolar is around 25 years-old, but symptoms could appear in the teens.

The research indicates that the severity of the depressive episodes is higher for patients who had an earlier-age-of-onset than those whose illness started late. However, the persistence of manic and hypomanic symptoms is not dependent on the age of onset. This implies that the depressive symptoms increase in persistence over decades for patients who acquire the illness as young adults.

Patients who are under the age of 30 at the onset experience a higher frequency of depressive episodes during the third, fourth and fifth decades of their life. In contrast, people who had their first symptoms at 45 years or older are stable most of the time with isolated episodes of depression.

Patients who have an early onset are more likely to have depression for 30% of the time while those who get it when they are older than 45 years-old experience depression 22% of the time. It seems that people who have bipolar disorder while the brain is developing have the severest manifestations of the disease in later life.

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Question 3

Is bipolar 1 or 2 worse?

Accepted Answer

Bipolar 1 is not worse than bipolar 2, only that it has a broader spectrum of expression than bipolar 2. People with bipolar 1 can experience manic episodes, hypomanic episodes, depressive episodes, and mixed episodes. Persons with bipolar 2 mostly experience hypomanic episodes and depressive episodes.

In both cases, the patient experiences maniac episodes characterized by elevated mood, which manifests in the form of euphoria or irritability. They may also experience hyperactivity, increased energy, inflated self-image, and excessive spending. In severe manic episodes, the person may start grandiose, unrealistic projects. The patient may also behave strangely and become delusional. Depressive episodes are very similar to clinical depression with low energy levels, foul mood, feelings of worthlessness or guilt, loss of pleasure, and suicidal ideation.

The main difference is that patients with bipolar 1 experience manic episodes while those with bipolar 2 experience hypomanic episodes. However, both sets of patients experience depressive episodes. What's more, depressive episodes in bipolar 2 are more prolonged than in bipolar 1.

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Question 4

Who is a famous person with bipolar disorder?

Accepted Answer

Many famous people have been diagnosed with bipolar disorder, including actress Carrie Fisher, actor Mel Gibson, Nirvana's Kurt Cobain, rapper Kanye West, singer Demi Lovato, and actress Catherine Zeta-Jones.

In an interview with Good Housekeeping in 2016, Zeta-Jones said, "The fact that there was a name for my emotions and that a professional could talk me through my symptoms was very liberating. There are amazing highs and very low lows. My goal is to be consistently in the middle."

It's estimated to affect up to 3% of the population, so there are likely many more famous people with bipolar disorder who choose not to disclose their diagnosis. Some may worry it could negatively impact their career. However, when a famous person is open about having bipolar disorder, it helps to normalize it and reduce the stigma against mental illness.

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Question 5

What are the 4 types of bipolar?

Accepted Answer

Bipolar disorder is a serious mental condition made up of the following four (4) subtypes:

Bipolar I disorder - this type of bipolar disorder is characterized by cycles of mania lasting at least seven days, and appear with psychotic features, followed by periods of depression that usually last at least two weeks.
Bipolar II disorder - people with bipolar II don't experience mania. Instead, they have periods of extreme depression and hypomania, which is a more mild form of mania.
Cyclothymic disorder - can be classified as a more mild form of bipolar disorder. It consists of mood swings, but the highs and lows are not severe enough to be classified as other types of bipolar.
Bipolar disorder caused by another medical disorder or substance abuse disorder - sometimes bipolar symptoms may not follow patterns, or they can appear due to drug abuse. This form of bipolar disorder is for cases that don't fit into the other categories.

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Question 6

Does bipolar run in families?

Accepted Answer

While the causes of bipolar disorder are unknown, there are several causes of bipolar disorder, and family history is one of the risk factors. Research suggest that persons whose relatives have the condition have a 10% increase in the risk of developing bipolar disorder.

Consider the following:

A child whose parent has bipolar disorder has a 15 to 30% chance of developing the condition.
If both parents have bipolar disorder, the risk increases to between 50 and 75%.
If one child has bipolar disorder, the risk of another child developing the condition is 15 to 25%.
If one twin has the condition, there is a 40 to 70% chance the other one will get it.
Overall, genetic factors are responsible for 60 to 80% of the cases of bipolar disorder.

However, it is rare for health practitioners to find families where bipolar disorder affects several members across generations. Most cases are isolated, with the disorder affecting only one member of the family. Further, it is possible that environmental factors such as stress and abuse increase the risk of developing the condition.

Parent quiz: Child mental health checklist

This 3-minute, online quiz can be used if you think your child is having emotional, attentional, or behavioral difficulties.

Need to find a therapist near you? Check out the Monarch Directory by SimplePractice to find licensed mental health therapists with availability and online booking.

How is bipolar treated?

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