Tag: Bipolar

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BPD vs. Bipolar: 6 Key Distinctions for Better Treatment

Mood swings, emotional intensity, relationship challenges—these experiences can be part of both bipolar disorder and borderline personality disorder (BPD). But while they may look similar on the surface, they’re different conditions that require distinct treatment approaches.

Understanding these differences isn’t just helpful, it’s essential for finding the right kind of support. Let’s explore what makes each condition unique, from symptoms to treatment options.

1. Understanding the Basics: What Are These Conditions?

Bipolar disorder causes emotional dysregulation by affecting how your brain regulates mood, leading to distinct periods of depression and mania (intense high-energy states). These episodes typically last weeks or months, with periods of stable mood in between. Moods tend to follow a wave pattern: they rise into mania (or hypomania), fall into depression, then level out before the cycle begins again.

Borderline personality disorder (BPD), on the other hand, involves intense emotions that can shift much more quickly1—sometimes within hours or days. It primarily affects how you view yourself and how you relate to others. People with BPD often have strong feelings that can be triggered by relationship stress or fears of abandonment.

Both conditions shape how you experience emotions, but in different ways. With bipolar, mood changes come in longer cycles and aren’t necessarily triggered by outside events. With BPD, intense emotions are usually triggered by relationship stress, life changes, or perceived rejection.

Both bipolar and BPD are among the most commonly diagnosed mental health conditions.2

2. Distinct Symptom Patterns: How They Present Differently

Both bipolar disorder and BPD involve intense emotions and mood shifts, but they show up in different ways.

Bipolar Disorder Symptoms

Episodes of mania with:

  • High energy levels and less need for sleep
  • Racing thoughts and fast speech
  • Impulsivity, risky behavior and big spending
  • Feeling unusually confident or powerful

Depressive episodes with:

  • Deep sadness or hopelessness
  • Loss of interest in activities
  • Changes in sleep and appetite
  • Low energy and trouble concentrating

People with bipolar II disorder might also have hypomanic episodes which have similar symptoms to manic episodes but are less severe and shorter-lasting.

Symptoms of BPD

  • Quick, intense mood changes that last hours or days
  • Intense fear of abandonment
  • Unstable self-image and sense of identity
  • Pattern of intense, unsteady interpersonal relationships
  • Impulsive behaviors when upset
  • Strong feelings of emptiness
  • Hard time controlling anger
  • Periods of paranoia or disconnection from reality

You don’t need to have all these symptoms to have either condition. Some people might experience different combinations of symptoms, and they can range from mild to severe.

Both of these conditions are known to increase the risk of substance abuse. Learn more about this link in our guide to co-occurring addiction and mental health disorders.

An Important Note About Diagnosis

It’s natural to recognize parts of yourself when reading about these conditions. However, experiences of mental health conditions can overlap: What looks like bipolar disorder might be BPD,3 or vice versa. Sometimes people even experience both conditions together (also known as comorbidity).

Only a qualified mental health professional give you a proper diagnosis because they’ll look at your full history, not just current symptoms. They’ll want to understand your mood patterns over time, how your emotions typically shift, and what tends to trigger changes in how you feel.

If you’re concerned about your well-being, start by talking with your therapist or primary care doctor. They can refer you to a mental health specialist who has experience diagnosing and treating mood disorders. During your evaluation, be open about what you’re experiencing. The more information you share, the better equipped your provider will be to understand your situation and recommend effective treatment.

3. Daily Impact: How Each Condition Affects Functioning

Mood Patterns and Episodes

With bipolar disorder, moods typically shift between 2 primary states. During manic episodes, you might feel extremely energetic, need less sleep, talk faster, and take more risks than usual. During depressive episodes, you might have trouble getting out of bed, lose interest in activities you usually enjoy, and feel overwhelmed by sadness or hopelessness. These episodes often last weeks or months.

BPD’s emotional instability can entail more frequent and intense shifts: Happiness might suddenly turn to anger, or confidence might quickly become self-doubt. These changes are often connected to what’s happening in your life, especially in close relationships. You might feel things more deeply than others seem to, making both positive and negative emotions seem overwhelming.

Self-Image and Identity

People with bipolar disorder usually maintain a stable sense of who they are, though their self-confidence might change during manic or depressive episodes. During mania, they might feel invincible; during depression, they might feel worthless.

With BPD, your sense of self might feel less consistent. You might struggle to clearly understand who you are, what you value, or what you want in life. This can make it hard to set long-term goals or make decisions that feel true to yourself.

Relationships and Social Connections

In bipolar disorder, mood episodes can strain relationships. During mania, you might make impulsive decisions or become overly involved in others’ lives. During depression, you might withdraw from friends and family.

With BPD, relationships often feel unstable and intense. You might worry deeply about abandonment while also struggling to trust others. This can lead to a pattern of unstable relationships that become strained by conflicts or misunderstandings.

4. Root Causes: Biological vs. Environmental Factors

Let’s talk about what might contribute to these conditions. 

With bipolar disorder, genetics play a big role—if you have a family history of bipolar, you might be more likely to experience it yourself. Your brain’s structure and chemistry are key players too. While environmental factors like major stress or trauma can trigger symptoms, biological factors tend to be the stronger influence.

BPD often develops because of early life experiences,4 especially in your relationships with parents or caregivers. While genes play some role, the environment you grow up in usually matters more—things like childhood trauma, having unreliable parents, or dealing with long-term stress. People typically start noticing BPD symptoms as young adults, when the ways they learned to handle emotions and relationships start causing more problems in their lives.

For both conditions, understanding these causes helps guide treatment approaches. Bipolar disorder often responds well to medications that help stabilize brain chemistry, while BPD typically improves with therapy that helps you build new relationship skills and coping strategies.

5. Evidence-Based Approaches: Tailored Treatment Strategies for Each Condition

Even though bipolar disorder and BPD are different conditions, both have effective treatments that can help you feel better and manage symptoms. Let’s look at what works best for each:

For Bipolar Disorder

Mood stabilizers are usually the foundation of bipolar treatment. These medications help prevent extreme mood swings and make episodes less intense when they do occur. Your doctor might also recommend other medications, such as antipsychotics or antidepressants, to help with specific symptoms like depression or trouble sleeping.

Therapy is essential, too. A good therapist can help you:

  • Stick to your treatment plan
  • Spot early warning signs of mood episodes
  • Develop strategies to manage stress
  • Keep your relationships healthy during tough times

Lifestyle changes make a big difference. Regular sleep schedules, stress management, and avoiding alcohol and drugs can help prevent mood episodes. Many people find that tracking their moods, either with an app or in a journal, helps them notice patterns and stay more stable over time.

In some cases, people with bipolar might require inpatient treatment or hospitalization—especially if they’re at risk of self-harm or struggling to manage their emotions safely. A structured setting can offer stabilization, therapy, and support to help get symptoms under control.

For Borderline Personality Disorder

The most effective treatment for BPD is usually therapy, especially dialectical behavior therapy (DBT). DBT teaches practical skills for:

  • Managing intense emotions
  • Improving relationships
  • Making decisions when emotions are high
  • Dealing with stress without using self-destructive behaviors

Other types of psychotherapy, such as cognitive behavioral therapy (CBT), mentalization-based therapy (MBT), or schema therapy5 can also help. These approaches help understand your emotions and ways of thinking, and teach healthy emotional regulation and coping strategies.

Support groups can also be valuable. Connecting with others who understand what you’re going through helps you feel less alone. Some people also find that medication helps with specific symptoms like anxiety or depression, though it’s not usually the main treatment.

6. Dual Diagnosis: When Both Conditions Occur Together

Sometimes people experience both bipolar disorder and BPD6 at the same time. In fact, it’s somewhat common for these conditions to overlap—one study on the relationship between bipolar and BPD7 found:

  • 20% of patients with BPD had bipolar disorder
  • 20% of bipolar II patients had BPD
  • 10% of bipolar I patients had BPD

This makes sense because both conditions affect how you feel emotions and relate to others, though in different ways. What makes this tricky is that the symptoms of bipolar and BPD8 are sometimes confused since they can seem similar on the surface.

Both conditions can include:

  • Very strong emotions
  • Problems with relationships
  • Risky behavior during tough times
  • Changes in how you feel about yourself

This is why getting a thorough evaluation from a mental health professional is so important. They can figure out if you’re dealing with one condition, both, or something else entirely. This helps make sure you get the right kind of help.

If you do have both conditions, they can be treated together. Your treatment team might combine approaches, like using medication to help with bipolar symptoms while doing therapy to build BPD coping skills. The key is having healthcare providers who communicate well with each other—and with you—about what’s working.

Safety Planning: Managing Crisis Moments

Life with bipolar disorder or BPD can have really tough moments, and both conditions are associated with suicidal behavior.9 Having a plan for these times is just as important as regular treatment.

A safety plan is like a roadmap for hard days. It includes:

  • Activities that help you feel better
  • People you can call when you’re struggling
  • Ways to make your environment safer
  • Professional support contacts
  • Reasons to keep going

It’s a good idea to create this plan with your therapist or doctor when you’re feeling okay, so it’s ready when you need it.

If you’re contemplating self-harm or having suicidal thoughts, or if you need immediate support, 24/7 help is always available:

  • Call or text 988 to reach the Suicide and Crisis Lifeline
  • Text HOME to 741741 to reach the Crisis Text Line
  • Call 911 if you’re in immediate danger

You can also visit the National Education Alliance for Borderline Personality Disorder (NEABPD) website for a comprehensive list of BPD support resources.10

Recovery From Bipolar and BPD: Building a Life Beyond Symptoms

Living with bipolar disorder or BPD can be challenging, but with the right support and treatment, many people with these conditions live fulfilling lives and achieve their goals. Everyone’s path looks different, and that’s okay.

Success often comes from:

  • Finding healthcare providers you trust and feel comfortable with
  • Building a support network of family, friends, and loved ones, as well as support groups
  • Learning what triggers your symptoms and how to manage them
  • Making small changes that add up to better stability over time
  • Being patient with yourself as you learn and grow

Recovery isn’t about being “perfect” or never having symptoms. It’s about learning to manage challenges and improve your quality of life over time. Some people find their symptoms get much better with treatment, while others learn to thrive even with ongoing symptoms.

If you’re just learning about these conditions, take it one step at a time. Focus first on finding a mental health provider who can provide an assessment and explain your treatment options. Every step forward, no matter how small, matters.

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Meg Kissinger’s 5+ Ways to Navigate Mental Illness in Your Family

The topic of mental illness has long been shrouded in silence, a hushed secret passed down through generations. Yet, as awareness grows and conversations open up, more and more individuals are realizing the profound impact mental health struggles have had on their families. Meg Kissinger, a Pulitzer Prize finalist reporter and author, offers a powerfully unique perspective on this often-taboo subject. Drawing from her own lived experience growing up in a family profoundly affected by mental illness, including the loss of two siblings to suicide, Kissinger provides invaluable insights into breaking the cycle of shame and fostering healing.

“There’s no shame in having mental illness of any kind, depression, anxiety, whatever it is. There’s no shame in that. It’s how you’re made and just that you would not be ashamed of cancer or diabetes. This is how we’re made and this is who we are and, and that’s okay. And it’s just a little piece of who we are,” emphasizes Kissinger, setting the tone for a candid and compassionate discussion about embracing vulnerability and seeking understanding.

1. Reframe Stigma as Discrimination: A Call for Dignity and Humanity

For too long, the term “stigma” has been used to describe the societal prejudice against individuals with mental illness. However, Kissinger, borrowing from the insights of Thomas Insel, former director of the National Institute of Mental Health, advocates for a crucial reframe: stigma is discrimination. This shift in terminology is not merely semantic; it fundamentally alters the focus from an internal failing to an external injustice.

“What stigma, you know, comes from the word stigmata… which literally means the markings of Christ. So marks on your hands and feet and head. And the suggestion is very subtle, but the suggestion is: people living with mental illness are marked,” Kissinger explains. “But I think where you, where you can kind of really get people to change the way they think about those folks is when you calibrate that view into discrimination. And so which ways do we deny people their full dignity and their, their full humanity? And then that really focuses, that shifts the spotlight then on the people who are doing that injustice.”

When we view the issue through the lens of discrimination, it becomes clear that the burden lies not with the individual experiencing mental illness, but with a society that denies them equal rights, opportunities, and compassion. This denial manifests in systemic ways, from inadequate housing and employment opportunities to the insistence that individuals “prove their worth” to receive care and support. By recognizing mental illness as an illness, rather than a character flaw or moral failing, we can begin to dismantle discriminatory practices and advocate for a more equitable and supportive system. This reframe empowers us to challenge the status quo and demand better treatment for those who are suffering.

2. Acknowledge and Address Generational Silence

Growing up in a large Irish Catholic family in an era where mental health was rarely, if ever, discussed, Kissinger experienced firsthand the pervasive silence surrounding mental illness. Her mother struggled with undiagnosed depression and anxiety, and her father with what is now recognized as bipolar disorder. These conditions, along with others, affected many of her eight siblings, leading to a profound impact on the family, including two suicides.

“My mother struggled with depression and anxiety. Of course, we didn’t know those were words that were never spoken in our house,” Kissinger recalls. “And we were never like sat down and told that. It’s just what we observed. So it took a long time to kind of sis out like what, or you know, what’s going on. And why is it when I come bounding down the stairs, you know, when I’m six years old looking for cream of wheat, it’s my grandmother at the stove and not my mother because she is mysteriously gone and they won’t tell me where she is or why. Then your, of course, your imagination runs wild and you think, what did I do to make my mother go away?”

This unspoken reality created an environment where confusion and self-blame often thrived. The lack of open communication and readily available information meant that the Kissinger children had no framework for understanding what was happening within their own home. This is a common experience for many families where mental illness is an unacknowledged presence. The absence of labels and conversations can lead to profound isolation and a distorted perception of “normal.”

To break this cycle, it’s crucial to acknowledge the impact of generational silence. Understanding that past generations may not have had the language, resources, or societal acceptance to discuss mental illness openly is an important first step. For families navigating similar legacies, initiating conversations, even if difficult, can be profoundly healing. This doesn’t necessarily mean public declarations, but rather creating a safe space within the family for honest dialogue and shared understanding.

3. The Power of Storytelling: Finding Healing in Narrative

Kissinger’s journey to understanding and healing involved writing a book that unflinchingly explored her family’s experiences with mental illness. This was not an easy undertaking, especially given the entrenched family silence. Yet, her siblings not only supported her endeavor but also provided access to personal records and insights, a testament to the transformative power of shared storytelling.

“It was imperative to me that I have their buy-in,” Kissinger states, highlighting the importance of family collaboration in her narrative. “It was important for me to have their approval. At the same time, this wasn’t gonna be a memoir by committee… It had to have the narrative arc and the My voice… But God bless my brothers and sisters and they, I am so grateful to them for being my fact checkers… they were very, very encouraging and. It was to me, nothing short of heroic for them to have the trust in me that I was gonna tell this story the way it needed to be told.”

The act of telling her family’s story, with their collective support, became a vehicle for processing trauma, finding perspective, and ultimately, healing. This illustrates that while not everyone needs to write a book, finding ways to articulate and share one’s experiences can be incredibly cathartic. This could involve:

  • Journaling: A private space to explore thoughts and emotions.
  • Support Groups: Connecting with others who have similar experiences can validate feelings and reduce isolation.
  • Therapy: A trained professional can provide a safe and confidential environment to process complex emotions and develop coping mechanisms.
  • Creative Expression: Art, music, or other creative outlets can offer a non-verbal means of expressing difficult experiences.

The goal is not necessarily public disclosure, but rather finding a healthy outlet to process and integrate one’s experiences with mental illness, both personally and within the family context. When we bravely share our narratives, we not only heal ourselves but also create pathways for others to feel less alone in their struggles.

4. Navigating Grief, Guilt, and Unexpected Relief After Suicide Loss

The death of a loved one by suicide brings a unique and often overwhelming constellation of emotions, including profound sadness, anger, shame, and guilt. Kissinger speaks candidly about the experience of losing two siblings to suicide, and in doing so, sheds light on a rarely acknowledged aspect of suicide grief: relief.

When her sister Nancy died by suicide after years of severe mental illness and multiple attempts, Kissinger and her family experienced a complicated mix of emotions. “When she finally did die, in June of 1978. It was a shock, but not a surprise,” she recounts. “And that night my dad gathered us all into the living room and, you know, looked at us sternly and said, if anybody asks, this was an accident. Which of course is a scary thing to hear. And the takeaway is that this is something to be ashamed of.”

Despite the profound sorrow and the societal pressure to conceal the truth, Kissinger admits to feeling a sense of relief alongside her grief. “There can be relief. Yeah. People need to hear that. Oh, absolutely,” she states. “And you know, I think that’s true of a lot of deaths, especially deaths where that, where the illness has gone on and on and on… it was a terrible sorrow. Of course. But it was also a great relief. I felt guilty that I felt such relief. But no, and you know, looking back on it so many years later. It’s a completely normal response and, um, why wouldn’t I, you know, she was out of her misery and we were out of ours. There’s a big sense of relief that came with that.”

This raw honesty is crucial for suicide loss survivors who may experience similar feelings but feel immense shame or guilt for them. It’s important to understand that feeling relief does not diminish the love for the person lost or the depth of grief. Instead, it can be a natural response to the cessation of intense suffering—both the individual’s and the family’s prolonged vigil.

For those coping with suicide loss, it’s vital to:

  • Allow all emotions: There is no “right” way to grieve. Grief is a complex process, and feelings like anger, guilt, and even relief are valid.
  • Seek support: Connecting with other suicide loss survivors can provide a sense of understanding and reduce isolation. Organizations like the American Foundation for Suicide Prevention (AFSP) offer resources and support groups specifically for those bereaved by suicide.
  • Challenge self-blame: Suicide is a complex issue with many contributing factors, and it is rarely the fault of family members.
  • Remember the person beyond their illness: While the illness was a part of their life, it did not define their entire being. Cherish memories of their good qualities and the joy they brought.

5. Cultivating Self-Love and Asking for Help

For individuals living with mental illness, and for those who support them, cultivating self-love and the courage to ask for help are paramount. Kissinger emphasizes that mental illness, particularly serious conditions like bipolar disorder or schizophrenia, can be a “lifetime saddle,” but it does not preclude a joyful and successful life.

“People with mental illness can have very good lives. And they can have joy and they can be loved and they can be successful. They can find success,” Kissinger asserts, challenging the notion that a diagnosis is a “death sentence.” She highlights her brother Jake, who lives in a group home for individuals with serious mental illness and “never apologizes for that. And he never flinches from talking about the struggles that he’s up against.” His openness and acceptance of himself serve as a powerful example.

For those struggling internally, Kissinger offers a simple yet profound piece of advice: acknowledge that mental illness is nothing to be ashamed of. Once this foundational acceptance is in place, the path to healing becomes clearer.

“I think just to be, just to know yourself and to, it starts with really just acknowledging that mental illness is nothing to be ashamed of. And once we get away from the shame of that and just accept who we are,” she advises. This internal shift can pave the way for seeking external support.

Learning to ask for help is a critical step. “People have such a hard time asking for help,” Kissinger notes, urging individuals to embrace humility and courage. Whether it’s confiding in a trusted friend, seeking professional therapy, or engaging with support groups, reaching out is a sign of strength, not weakness.

6. Supporting Loved Ones: Empathy, Boundaries, and Understanding

Supporting someone with a mental illness requires a delicate balance of empathy, understanding, and self-preservation. It’s not always easy to distinguish between a “stubborn personality” and the symptoms of an illness, as Kissinger points out. However, starting with the assumption that the person is hurting can guide compassionate responses.

Kissinger shares a poignant personal anecdote about her brother Danny, who confided in her that he “didn’t feel like being alive anymore.” Her initial, regrettable response was to punch him in the arm and tell him to “shut up.” This raw admission underscores the difficulty of navigating such conversations, especially when one is overwhelmed.

“I’m so sorry. And that’s, it’s understandable and that’s, it’s normal. A lot of people feel that way. I’m sorry. You’re going through that. You can get, you can come out on the other side. You’re, you’re gonna feel better. I’m here for you,” Kissinger reflects on what she would say now. This response prioritizes validation, hope, and support, recognizing the immense pain the individual is experiencing.

Furthermore, setting healthy boundaries is crucial to avoid burnout for caregivers. Kissinger quotes her brother Billy, who advises, “Acknowledge when it’s too much. Just learn that you have to sometimes walk away.” This doesn’t mean abandoning a loved one, but rather taking necessary breaks to recharge and maintain one’s own well-being. The love remains, but the ability to offer effective support depends on personal resilience.

Here are key takeaways for supporting a loved one with mental illness:

  • Educate yourself: Learn about the specific mental illness affecting your loved one. Understanding the symptoms and challenges can foster empathy and inform your approach.
  • Listen without judgment: Offer a compassionate ear and validate their feelings, even if you don’t fully understand them.
  • Encourage professional help: Gently suggest seeking therapy, medication, or other appropriate interventions. Offer to help them find resources or make appointments.
  • Practice self-care: Supporting a loved one can be emotionally draining. Prioritize your own mental and physical health to avoid burnout. This might involve setting boundaries, seeking your own therapy, or engaging in stress-reducing activities.
  • Remember it’s an illness, not a choice: Separate the person from their illness. Understand that their behaviors or moods may be symptoms, not intentional acts to hurt you.
  • Offer practical support: Depending on the situation, this could involve helping with daily tasks, transportation to appointments, or simply being a consistent, reliable presence.

Ultimately, navigating mental illness within families requires a commitment to open communication, empathy, and a willingness to challenge long-held societal norms. By reframing stigma as discrimination, acknowledging generational silence, embracing the power of storytelling, and cultivating both self-love and supportive relationships, families can move towards a future where mental health is discussed openly, understood deeply, and met with compassion and care.

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Gabbie Egan’s Journey Through Bipolar Disorder and Alcohol and Marijuana Addiction Recovery

Gabbie Egan’s story is a powerful and candid exploration of the interconnectedness of mental health and substance use. Her journey, marked by early exposure to drugs and alcohol, a teenage pregnancy, and an eventual diagnosis of bipolar I disorder, offers a deeply personal insight into the complexities of recovery. Gabbie’s unflinching honesty about her struggles and triumphs serves as a beacon of hope, demonstrating that even through multiple setbacks, sustained effort can lead to profound healing and self-acceptance.

The Early Seeds of Struggle: Childhood and Adolescent Experiences

Gabbie’s introduction to substance use began at a remarkably young age, rooted in a combination of environmental factors and personal vulnerabilities. Growing up in a part of North Carolina with limited recreational outlets, drug and alcohol use became a prevalent coping mechanism among her peers. “I’m from a part of North Carolina where it’s like there’s nothing to do,” Gabbie recounts, “And so the only thing that people are really doing to keep themselves occupied is like getting messed up.”

Her home environment, while loving, also contributed to a sense of unmonitored freedom. With parents deeply engrossed in their careers, Gabbie, an only child, was often left to her “own devices.” This lack of direct parental supervision, combined with a pre-existing sadness, created fertile ground for experimentation. She began with cough medicine in sixth grade, quickly escalating to marijuana and prescription pills like Vicodin by the age of 11 or 12. This early exposure to various substances at such a formative age significantly shaped her developing brain and laid the groundwork for future struggles.

Beyond the external influences, Gabbie also grappled with internal battles. She describes herself as “a very sad kid” who experienced bullying and felt she never truly fit in. Her expulsion from Christian school in sixth grade after piercing her belly button further isolated her and plunged her into an environment where she was “in a pretty low place ever since I was a child.” Her mother, a loving but misguided figure, dismissed her emotional struggles, attributing them to a lack of gratitude or a “made-up” mental illness. This invalidation of her feelings compounded Gabbie’s internal turmoil and prevented her from seeking the help she desperately needed. As Gabbie poignantly shares, “My mom doesn’t believe in mental illness. And so that’s tough because then, yeah.”

The Unveiling of Bipolar Disorder: A Diagnosis and a Family Legacy

The first hint of Gabbie’s underlying mental health condition emerged at 16, following a severe alcohol-related incident. After blacking out and requiring a stomach pump, she was court-ordered to see a mental health specialist. It was during this session that a therapist suggested she might have bipolar I disorder. The therapist explained that bipolar I is characterized by “high highs of extreme mania and then extremely low lows that last and extended like a certain amount of time.” This explanation deeply resonated with Gabbie, as it accurately described her volatile emotional landscape. “I’m either extremely low, like, you know, on the verge of like wanting to literally end my life or, um, you know, extremely high thinking, I am Jesus, you know?” she candidly admits.

Despite this crucial insight, her mother’s continued denial of mental illness led Gabbie to dismiss the diagnosis at the time. “My mom’s like, this is just how they get you in the system. They’re trying to medicate you,” Gabbie recalls. This dismissal, coupled with a lack of proper follow-up, meant that Gabbie continued to navigate her life unmedicated and without professional support for her burgeoning mental health challenges.

Years later, a more definitive diagnosis of bipolar I disorder would come after another significant incident in Las Vegas. During what she believes was a manic episode, Gabbie experienced a blackout and woke up in jail in a straightjacket, unable to recall the events that led her there. This terrifying experience, combined with the intense public scrutiny and hate she received online, propelled her to seek help on her own terms. It was through this process that she received an official diagnosis and began to truly understand the nature of her condition.

This second, undeniable encounter with her diagnosis allowed her to confront the reality of her mental health, a reality her grandmother had hinted at, revealing a family history of untreated mental illness. “I had went to my grandmother, who I’m really close with, and I had told her and she said, I think that that’s what my mom had,” Gabbie shares, adding, “My grandmother’s mom actually ended up jumping off of a bridge or off of a building in France when she was growing up and committed suicide because she had so many untreated mental health conditions.” This generational understanding provided a crucial piece of the puzzle, helping Gabbie contextualize her own struggles and recognize that her experiences were not merely “crazy” but rooted in a legitimate medical condition.

Explore bipolar disorder treatment options.

The Intertwined Paths of Substance Use and Mental Health

Gabbie’s narrative vividly illustrates the intricate relationship between substance use and mental health. Her early experimentation with drugs and alcohol served as a form of self-medication for her untreated depression and the chaotic emotional swings of undiagnosed bipolar disorder. The substances provided a temporary escape from the pain, isolation, and overwhelming feelings she couldn’t articulate or understand.

Her pregnancy at 13, giving birth just before turning 14, further intensified her struggles. As a teen mom, Gabbie faced immense pressure and isolation. She juggled high school, childcare, and the emotional burden of being an outcast among her peers. While she excelled as a mother to her son, other aspects of her life crumbled. “Everything else in my life would be completely falling apart. And every aspect. I was a horrible friend. I was a horrible partner. I was a horrible daughter to my parents. Just ’cause I was just like so just like in the trenches, but I was a great mom to my son,” she reflects.

During periods when her son was with his grandparents, Gabbie would resort to heavy drinking, often to the point of blacking out. These episodes were a desperate attempt to cope with the immense emotional distress and the deep void she felt. The incident at 16, where she was found unconscious and her stomach pumped, was a direct consequence of this self-destructive pattern.

Even joining the military at 17, an attempt to “fix” herself, didn’t provide the escape she hoped for. “Substance abuse just followed me into the military,” she admits. Her ability to function, even at the height of her addiction, is a testament to the high-functioning nature often seen in individuals with underlying mental health conditions. She graduated high school a year early, maintaining her academic responsibilities while engaging in significant substance abuse. “People don’t think that you can be functioning, but you can, you can do everything that you’re supposed to be doing and you can show up in every single way,” Gabbie emphasizes, recounting how she would complete school papers while “tripping balls” on acid. This period underscores the dangerous dance between her mental health challenges and her substance use, where each exacerbated the other, creating a vicious cycle.

Navigating Mania and Depression: The Bipolar Experience

Gabbie’s account of living with bipolar I disorder provides a raw and honest glimpse into the extremes of the condition. She describes her manic episodes as periods of intense energy and productivity, often accompanied by a feeling of invincibility. “I have all these ideas and I’m just like, I can stay up for days straight working on a project, a new project, a new business idea, a new something,” she explains. However, these highs are often accompanied by erratic and risky behaviors, including her two arrests, which she believes occurred during manic states. “The things that I have gotten myself into when I feel like I’m the hottest shit. I mean, I’ve gone to jail two times and I, I do believe that both of the times that I went to jail, I was like in a manic episode,” she reveals. During these manic phases, sleep becomes minimal or nonexistent, and she often reaches a state of “blackout” where she has no recollection of her actions.

The crash that follows these manic highs is equally debilitating. Gabbie describes it as a complete physical and emotional collapse, leaving her “completely debilitated.” The overwhelming feeling of paralysis, the inability to move forward with the projects started during mania, is a common experience for individuals with bipolar disorder. “It’s like now I’m halfway through all these projects and I have no energy for anything anymore, and I can’t do anything. And I just feel stuck,” she articulates, likening it to ADHD paralysis where the sheer volume of tasks leads to an inability to start any of them.

Gabbie’s journey with medication also highlights the complexities of treatment for bipolar disorder. While acknowledging that medication is beneficial for many, she shares her personal struggles with various prescriptions like Seroquel and Abilify. These medications, while addressing some symptoms, often left her feeling “like I wasn’t even human anymore,” turning her into a “zombie” or making her feel “boring.” This experience underscores the importance of individualized treatment plans and the ongoing search for the right balance between managing symptoms and maintaining a sense of self.

The Path to Recovery: Resilience, Acceptance, and Self-Worth

Despite the numerous setbacks and deep troughs of despair, Gabbie’s story is ultimately one of remarkable resilience and a profound journey toward self-acceptance. Her early and repeated failures in attempts at sobriety ultimately paved the way for a lasting recovery. “It doesn’t matter how many times you’re trying to recover, as long as you’re putting in the effort one day, it will stick if you really want it,” she advises, a testament to her own experience. She has learned to reframe failures not as endpoints, but as integral parts of her process, emphasizing that “you can fail a million times and still try again.”

Gabbie’s recovery extends beyond sobriety; it encompasses a deeper understanding and management of her bipolar disorder. She has learned to recognize the onset of her manic and depressive episodes, developing coping mechanisms to navigate them. This self-awareness allows her to mitigate the impact of the extreme highs and lows, recognizing when she needs to slow down or when she needs to push through the paralysis of depression by taking small, actionable steps.

Crucially, Gabbie has learned to distinguish between understanding her diagnosis and using it as an excuse for harmful behavior. While acknowledging that bipolar disorder explains certain aspects of her actions, she asserts, “it doesn’t excuse all my actions.” This mature perspective allows her to take accountability for her behavior while still working to manage her condition. She recognizes that the goal is not to eliminate the “crazy” but to “learn to manage that rather than make excuses for that.”

Today, Gabbie is a recovery advocate who openly shares her story, creating a space for others to find solace and understanding. She is a testament to the power of authentic vulnerability, demonstrating that healing is not about becoming a perfect version of oneself, but about embracing all facets of one’s experience. Her journey of “coming undone and rebuild[ing], to tell the truth out loud, and to never let go of your own becoming” serves as a powerful inspiration for anyone navigating the complexities of mental health and addiction recovery. Her story emphasizes that true recovery is a continuous process of learning, adapting, and ultimately, loving the person you are becoming, flaws and all.

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Bipolar 1 vs. Bipolar 2: Crucial Differences You Need to Know

Not everyone with bipolar will have the same symptoms. The differences are drastic enough for bipolar to have two distinct clinical categories: types 1 and 2. 

Both versions of bipolar include ‘polar’ opposite moods—noticeable highs and lows. Just how noticeable depends on what type of bipolar you have. Shorter periods of low-level mania (called hypomania) are unique to bipolar 2, while bipolar 1 has pronounced episodes of mania that may require hospitalization. 

With such distinct differences between symptoms, treatment and management for these sister conditions requires a personalized touch.

Characteristics of Bipolar Disorders

Bipolar disorder is a biological mental illness1, meaning parts of your brain aren’t working exactly how they should. Unlike depression, which can be the product of an unpleasant situation, bipolar exists independently of what you’re experiencing. Life events can certainly trigger a mood swing, but they aren’t what causes bipolar to exist in the first place. 

A combination of genetics, your brain’s ability to send and receive signals, your natural temperament2, and more produces bipolar disorders. Malfunctioning connection points in the brain mean you can get skewed amounts of neurotransmitters like dopamine and serotonin, leading to extreme mood swings, irritability, depression, and mania2. 

Mood Stabilizers vs. Antidepressants

Mood stabilizers, the go-to medication for bipolar, work by improving and stabilizing2 those ineffective connection points in your brain. This means neurotransmitters can flow as designed, leveling out mood swings and reducing mania. Highs won’t feel as high, and lows not so low—basically, the healthy baseline between depression and mania. 

Antidepressants produce more of certain mood-boosting neurotransmitters or help your brain receive more of them. While mood stabilizers help neurotransmitters flow correctly, antidepressants affect the amount of neurotransmitters created and/or received. 

Often, both a mood stabilizer and an antidepressant are used to treat bipolar disorders.

Signs and Symptoms of Bipolar I

Bipolar 1 mania often has a strong presentation, including out-of-character behavior that patients typically fear or regret. Manic episodes last at least 7 days1, including symptoms like

  • Extreme irritability
  • Extreme elation; high mood
  • Fun-seeking behaviors, including sexual promiscuity
  • Lacking sound judgment when it comes to purchases, activities, and priorities
  • Talking quickly and bouncing between ideas, sometimes so fast others can’t keep up or understand
  • Needing less sleep
  • Highly productive
  • Feeling especially important or special

And, sometimes,

  • Psychosis
  • Delusions
  • Hallucinations

The symptoms of mania may require hospitalization to manage the person’s safety and well-being, and to prescribe the correct mood stabilizers and bring them out of acute mania. Mood stabilizers like lithium can address acute mania and manage symptoms long-term, though prescription trends show more doctors leaning away from lithium3 and into other medications. These can have fewer side effects and easier tolerability. Atypical antipsychotics have proved helpful for bipolar 1 and 2.

Along with high moods and mania, people with bipolar 1 also experience extreme periods of depression. Episodes of depression typically last 1-2 weeks with bipolar 11, but can last longer. With this depression can come symptoms like

  • Thoughts or plans of suicide
  • Self-harm
  • Decreased energy and motivation
  • Loss of interest or pleasure in once-enjoyable activities
  • Feeling hopeless
  • Low mood and fatigue

Mood stabilizers and atypical antipsychotics can help manage depression, too. Interestingly, for bipolar depression, clinicians don’t recommend antidepressants as a sole medication. They can actually trigger a manic episode if not combined with a mood stabilizer1 or atypical antipsychotic.

It’s not a choice, it’s a condition. I have bipolar disorder, but it doesn’t define me.

Carrie Fisher

Research suggests that there are complex links between diabetes and mental health conditions, such as depression, bipolar disorder or schizophrenia — connections that are not fully understood.

National Alliance on Mental Illness

Signs and Symptoms of Bipolar 2

Bipolar 2 mimics bipolar 1, but with a crucial difference in manic symptoms. Someone with bipolar 2 experiences hypomania4, which means their periods of mania are much less intense and less debilitating, often not affecting their safety, relationships, and work responsibilities nearly as much as mania. You can remember “hypo” means low or less, so low-mania.

Sometimes, people with bipolar 2 actually enjoy their hypomanic states. They often feel more energized, but not out of control, and happier, but not over energized. Perceiving hypomania as a “good mood”, especially following a depressive episode, can keep those with bipolar 2 from seeking treatment or realizing something’s amiss. 

Hypomania occurs more frequently than mania5 and can have negative consequences even if people perceive them as positive. Many people with bipolar 2 don’t feel comfortable with their actions and behaviors during a hypomanic episode, either. Symptoms of hypomania5 include

  • Increased energy
  • Less need for sleep
  • Urge to socialize and talk about anything and everything
  • Risky and promiscuous sexual behaviors
  • Extreme irritability
  • Intense anxiety

Notably, hypomania doesn’t cause psychosis, delusions, or hallucinations. People in a hypomanic state may not even notice it’s happened, whereas mania has much more pronounced signs and effects. Loved ones may notice hypomania, and they will certainly notice mania.

Bipolar 2 also includes periods of depression, often more so than bipolar 16. Periods of depression can last months or years, while hypomania often lasts several days. 

Those with bipolar 2 face the highest likelihood of an incorrect diagnosis6. Since symptoms of mania are much less pronounced than bipolar 1, providers may misdiagnose patients with major depression, dysthymia (constant low-level depression), or borderline personality disorder (BPD). Hypomania can even present as extreme anxiety and irritability, which could be misdiagnosed as general anxiety disorder. Though these conditions can co-occur with bipolar 2, mistaking them for the primary diagnosis delays proper treatment.

Recognizing the cyclic nature of low/high moods can help patients and their providers arrive at an accurate diagnosis. Getting the right diagnosis means getting the most effective medications and therapy, which can be especially vital in treating bipolar disorders.

Key Differences

Key, overarching differences between bipolar 1 and 2 include

  1. Mania vs. hypomania
  2. Less vs. more frequent depressive episodes

Other differences vary person-to-person. Everyone will experience bipolar 1 or 2 differently. Doctors will often take a deep-dive to determine if you have bipolar 1 or 2, or an entirely different diagnosis.

Treatments for Bipolar 1 and 2

Medications

It’s true mood stabilizers like lithium can be life-changing medications for those with bipolar, especially bipolar 1. Mood stabilizers can manage mania (acute and long-term) and prevent mood cycling. 

Certain mood stabilizers and atypical antipsychotics center on reducing depression and suicidality, not mania. Those with bipolar 2 often benefit from these types of mood stabilizers, plus an antidepressant. 

Therapy

Therapy can help people manage and understand their symptoms. Cognitive behavioral therapy (CBT) focuses on changing thoughts and behaviors to positively alter mood, which can help in a depressive episode. Dialectical behavioral therapy (DBT) teaches practical strategies for managing distress, surviving crisis urges (like suicidal ideation), and interpersonal communication.

Those with bipolar often remain in therapy throughout their lifetime, as regular sessions can help manage stressors and other life events that could trigger a mood swing. Patients can learn personalized strategies for managing their symptoms and receive ongoing emotional support by working with a therapist.

Mood Tracking

Tracking mood serves as a vital tool for people with bipolar disorders. You can download apps designed exactly for this, or track it in a notebook. Keeping track of your mood and what’s happening in your life can clue you into the unique aspects of your mood cycles, helping you proactively manage highs and lows. This can help you feel more in control, not like your moods are happening to you.

Finding Your Cornerstone: Bipolar Maintenance

Figuring out your unique symptoms and expression of bipolar 1 or 2 can take time, but with accurate diagnoses, medications, therapy, and acceptance, you can learn to manage your bipolar as confidently as you might manage your diet or sleep. 

Regular appointments with therapists and psychiatrists can be key to long-term recovery. Let your loved ones know of your condition too, so they can offer their support when needed. And keep an open, non-judgemental mind as you navigate your symptoms—you’ve got this, and you’re in good company on the journey.

Use Recovery.com to find recovery centers offering bipolar treatment, with pictures, insurance information, reviews, and much more to help you find the best fit for you.

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Advancing Hope, Advocacy, and Recovery with Andrea Mora

Hey you! I’m Andrea Mora, your friendly neighborhood expert in lived experience with mental illness and substance abuse, and I’d love to share some of my recovery story with you. 

Content Warning: This article includes details of a mental health crisis and self-harm.

Beginning The Journey Toward a Diagnosis

My story starts before my diagnosis, as my first mental health crisis was in 2012. In October of that year, I was hospitalized due to a severe manic episode. We didn’t know what was happening at the time, and just chalked it up to “Andreaness”. What I mean by that is, I had always been a little wild in my adult life. I loved singing karaoke, and of course that was accompanied by lots of alcohol and erratic behavior. That night, however, was a whole different ball of wax.

Essentially, I became so inebriated I couldn’t see straight. I even ordered pizza, with the most random and awful topping combinations, according to my husband. It was all fun and games and lots of “Andreaness”, until it was time for bed. I didn’t want to go to bed, as I felt on top of the world, but also very anxious. Naturally, I took 5 or 6 benzodiazepines, which ooh golly, not a good idea. In addition to all of my erratic behavior, I also experienced psychosis during this manic episode, so much so that I even licked my washing machine. Say WHAT!? I can laugh about it now, but it was truly awful to recollect at the time. 

During this mental health event, I cut my wrists, flatlined on my bathroom floor and when I was resuscitated, I ran outside completely nude, around my yard. All of this happening with my kids sleeping upstairs. My next memory is waking up in the ER with a police officer sitting in my room, never taking his eyes off me. Ultimately, my husband was given two choices: jail or the mental hospital. He chose the mental hospital as I wasn’t a criminal….yet.  

Gaining a Diagnosis, But Grappling with Mismanaged Care

I spent the weekend at the hospital, but was never assessed by a provider. I was released the following Monday afternoon, and it was never spoken of again. That is, until the next manic episode happened in 2013. In between these timeframes, I was still binge drinking, essentially self-medicating as my moods were all over the place. During this time, I was irrational, elated, euphoric, irritable and hyper-sexual, with incredibly poor decisions made with feelings like I was untouchable. It was during that extended manic episode that I received my diagnosis. It didn’t come soon enough though, as I committed a financial crime during my mania as well, which is ultimately what led me on a path to recovery.

It took over four years of being mis-medicated and mistreated by a psychiatric provider before the time would come that my life felt saved. For many, finding a provider takes too much time, and to finally get an appointment takes even longer. I was so incredibly fortunate to find a new psychiatric provider within 2 weeks of deciding I needed a second opinion for management of my illness, and that is where everything started to turn around for me. This was at the end of 2017. 

During those four terrible years after diagnosis, my drinking was out of control, I couldn’t get a good job due to my convictions, and the crappy jobs I could get I was unable to hold on to thanks to my uncontrolled Bipolar Disorder, and I had gained 90 pounds, partially due to the meds I was on and the other part due to me using food and substances to try and cope with my issues. 

Finding Hope and True Healing Through Compassionate, Personal Care

Enter the psychiatric provider that saved my life in so many ways. She was a prior ER nurse who changed career paths to psychiatry, and she was everything I needed and more. I realized I had spent five years of my life living in a way I didn’t need to, miserable, a full-blown alcoholic, still having major episodes of mania and depression and destroying my family during that time. All those years, gone. Gone from happiness, from stability, from recovery. Those golden words, recovery. It is what we all strive for when living with adversity and illness, and finally, I was on my way.

We found the right cocktail of meds, the right therapy modalities and I got sober on April 17th, 2018. Side note: There is such a stigma about taking meds, and I will shout it from the rooftops that it is essential and acceptable and I would not be here without them. And by cocktail, I mean a juicy one. I currently still take most of those same meds, which totals 7. I have no shame or embarrassment about this. If it kept me stable, I would take 100. Sure, they come with some side effects, but nothing compares to what my mania or depression would look like without them. There’s my little PSA about meds. #endthestigma 

My medication regimen, my sobriety and intensive therapy, especially EMDR, was the trifecta I needed to get my mental illness in a controlled state, which allowed me to move into a place of recovery. This was a new journey for me, so different from the journey I had been on the six years prior. I was able to finally breathe again. To enjoy things again. 

Singing was such an important part of my life growing up and through my adulthood, and from 2014 to 2018, I shut music out of my life. Songs would come on that instantly triggered me into a panic attack. I felt all the shame and guilt come back to me when I would sing, as for so many years singing meant drinking which meant horrible behaviors and decisions. Even in the car, the radio would be off. I just couldn’t bring myself to feel that joy. But the joy was back. 

In addition to my journey of sobriety and mental stability, I started on a weight loss journey as well. Remember the 90 pounds I had gained? Lost ‘em! I lost 105 pounds between 2019 and 2020, so not only was I sober, stable and healthy, I was a SNACK! 

Living in The Moment, Celebrating Recovery, and Proving The Possibility of Recovery

There have been unexpected episodes with my mental illness during these last 6 years, and I used to be riddled with anxiety waiting for the other shoe to drop, every day. Therapy helped me realize I can’t live that way. I can’t focus on the past and I can’t control the future, all I can do is live in the now and tackle whatever comes, whenever it comes. 

My family is still on this wacky ride with me, they never gave up on me, and that brings tears to my eyes as I write this. My husband, Michael, and I are celebrating our 24th wedding anniversary on Halloween, I have my 3 beautiful girls by my side, and I am absolutely blessed to the core to have two new loves, my grandbabies. I have been through hell and back in my 42 years, but I am proof that recovery is possible. No matter what you’re struggling with, you have it within you to cope, to thrive, to heal. And always remember, you are not alone on your journey.

Author Bio:

A little about me, I am currently Board President of my local NAMI (National Alliance on Mental Illness) affiliate and Co-Chair of the Alliance for Mental Wellness Employee Resource Group at Renaissance Learning. I chose passion in all things, and one of those passions is mental health support, education and advocacy. My personal mission lines up with the NAMI mission, which is proving to be the perfect blending. I was diagnosed with Bipolar Disorder Type I in 2013, and boy has it been a wild ride. I am also a wife, mom and grandma and without a doubt, laughing is my most favorite thing to do.

Disclaimer: The views and opinions expressed in these contributions are those of the individual author and do not necessarily reflect the views of Recovery.com.

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Bipolar Disorder I vs. II: Understanding the Difference

Bipolar disorder is a mental health condition characterized by extreme mood swings that impact your energy levels and activity patterns. There are 2 primary subtypes: bipolar I and bipolar II, each with its distinct characteristics. Understanding the differences between bipolar I vs. bipolar II is crucial for effectively diagnosing and managing this disorder so you can find a path to stability and emotional well-being. 

Let’s look at the differences between these 2 subtypes: their symptoms, effects on daily life, and treatment options. 

Types of Bipolar Disorder

Bipolar disorder is a complex mental health condition characterized by extreme shifts in mood, energy, and activity levels. While there are several types of bipolar disorder, each shares the common feature of these mood swings. 

Here’s a general overview of the most common types:

Bipolar I Disorder

Bipolar I disorder entails manic episodes,1 which are periods of heightened energy, intense euphoria, and impulsive behavior. These episodes of mania often alternate with depressive episodes, which are marked by overwhelming sadness, fatigue, and a loss of interest in activities your normally enjoy. People with bipolar I disorder may experience severe manic episodes that can lead to psychosis, during which they lose touch with reality. 

The swings between manic and depressive states can be dramatic and disruptive to daily life. If you’re concerned that you might have bipolar, it’s important to get an accurate diagnosis so you can start to treat it effectively. 

Bipolar II Disorder

Bipolar II disorder differs from bipolar I in the severity and duration of manic episodes. In bipolar II, people experience hypomanic episodes,2 which are less extreme than full-blown manic episodes. While hypomania may include increased energy and creativity, it’s typically less disruptive and intense than mania. People with bipolar II tend to be depressed more often, which can cause emotional distress and impair your ability to function. Accurate diagnosis and treatment are essential for managing the cycle between hypomania and periods of depression. Untreated bipolar II can significantly impact your day-to-day life.

Cyclothymic Disorder

Cyclothymic disorder is a milder form of bipolar disorder3 marked by chronic mood disturbances. Unlike bipolar I and II, cyclothymia involves less severe mood swings. But it is chronic, and usually lasts for at least 2 years in adults. People with cyclothymia cycle through recurrent periods of hypomania and depressive symptoms. And while the mood swings in cyclothymia aren’t as extreme as in other forms of bipolar, they can still disrupt your daily life and relationships. It’s important to note that cyclothymic disorder can progress into bipolar I or II if left untreated,4 making early intervention and treatment vital for long-term well-being.

Is Bipolar Disorder I More Severe Than Bipolar Disorder II?

One of the common questions people have about bipolar disorder I vs. II is which type is more severe. 

The distinction between these 2 disorders has to do with the intensity of manic episodes. People with bipolar disorder I experience full-blown manic episodes,5 which can be more extreme, disruptive, and potentially lead to psychosis, making it crucial to receive timely treatment. While bipolar disorder II is sometimes considered a milder form of bipolar, it can still significantly impact your life due to the frequency of major depressive episodes. The severity of either disorder depends on a number of factors, including your specific experiences and the degree to which your symptoms interfere with your daily functioning.

Both bipolar I and II can cause significant challenges in managing emotions, relationships, and daily life. What matters most is that you receive the right treatment to address your specific needs—whether it’s mood stabilization, therapy, medication, or a combination of approaches. With quality care and support, people with any type of bipolar disorder can achieve stability, manage their symptoms, and lead fulfilling lives.

What Is the Difference Between Bipolar I and Bipolar II?

Bipolar I and bipolar II are distinct subtypes of bipolar disorder. While they share similarities, they differ in critical ways. 

Mania vs. Hypomania

One of the primary distinctions is the nature of manic and hypomanic episodes. In bipolar 1 disorder, people experience manic episodes of intense euphoria, impulsivity, and heightened energy. These episodes are often severe, disruptive, and can even lead to psychosis in some cases, which requires hospitalization. 

Bipolar II disorder features hypomanic episodes, which are milder and shorter than mania. While hypomania also involves increased energy, it’s generally less intense and disruptive to daily life. Hospitalization due to hypomania is rare. In fact, according to the DSM-5 criteria for hypomanic episodes,6

“The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic symptoms, the episode is, by definition, manic.”

Impact on Daily Life

The impact on daily life also varies between these 2 subtypes. Bipolar I tends to have a more significant impact because of the severity of manic episodes, which can lead to reckless behavior and seriously impair functioning. The depressive episodes that follow can be equally debilitating. 

In bipolar II, the impact on daily life stems from more prevalent and longer-lasting depressive episodes. Although people with hypomania may behave impulsively, it’s typically less disruptive than full mania. 

Differences in Bipolar Disorder Symptoms: I vs. II

Bipolar disorders I have some symptoms in common, like depressive episodes. But their main distinction is the severity and nature of manic or hypomanic symptoms. In bipolar I disorder, people experience full-blown manic episodes which are often followed by profound depressive episodes. Bipolar II disorder features hypomanic episodes and more frequent depressive episodes.

The main distinction between bipolar disorder I vs. II is the presence of either mania or hypomania:7 

Mania Symptoms

  • Elevated or irritable mood
  • Racing thoughts
  • Less need for sleep
  • Heightened energy and restlessness
  • Impulsivity and poor judgment
  • Grandiosity or inflated self-esteem
  • Engaging in risky behaviors (e.g. excessive spending or substance abuse)
  • Talkativeness and rapid speech
  • Difficulty focusing
  • Agitation and irritability
  • Hallucinations or delusions (in severe cases)
  • Disorganized thinking and behavior

Hypomania Symptoms

  • Elevated mood or increased happiness
  • Increased creativity and productivity
  • Enhanced energy and motivation
  • Reduced need for sleep without feeling fatigued
  • Increased talkativeness and sociability
  • Heightened self-confidence and self-esteem
  • Mild impulsivity (usually without severe consequences)
  • Improved focus and attention
  • A sense of optimism and positivity
  • Increased goal-directed activity
  • More engagement in pleasurable activities
  • Generally less severe and disruptive than full manic symptoms

Bipolar I vs. II Treatment

While bipolar disorder 1 and 2 share certain treatment approaches, they also have different considerations based on the nature of manic or hypomanic episodes. Both subtypes of the disorder usually involve a combination of medication and talk therapy8 to manage symptoms and promote stability.

Medication

In general, treatment for both bipolar I and II includes mood stabilizers, such as lithium, anticonvulsants, or atypical antipsychotic medications, to help regulate mood swings. Bipolar I may require more intensive medication management and monitoring due to the severity of manic episodes and the potential for psychosis. 

Talk Therapy 

Psychotherapy plays a crucial role in teaching people living with bipolar disorder coping skills, how to recognize triggers, and strategies to manage mood episodes. Mental health professionals often use approaches like cognitive behavioral therapy (CBT) and psychoeducation with this disorder.

Lifestyle Changes

Changes to daily routines, like maintaining a regular sleep schedule, reducing stress, and avoiding alcohol and drug use, are also essential to recovery.

While treatment approaches for both bipolar type 1 and 2 have similarities, it’s essential that your provider tailors your care to your specific symptoms and needs. Accurate diagnosis and an individualized treatment for bipolar disorder plan can help you effectively manage your bipolar disorder—and, ultimately, help you enjoy life.

Find Bipolar Disorder Treatment Centers

Living with bipolar disorder is challenging, but a comprehensive treatment program and ongoing support can help you do so in the best way possible. Finding the right provider is the first step towards a better life: search for bipolar disorder treatment centers that match your criteria, including location, insurance accepted, and more. 

Frequently Asked Questions About Bipolar Disorder I vs. II

What are the common types of bipolar disorder?

Bipolar disorder includes several types, with bipolar I and bipolar II being the most common. Bipolar I features full manic and depressive episodes, while bipolar II involves less severe hypomanic episodes and depressive episodes. There’s also cyclothymic disorder, which is milder but chronic.

What are the key differences in symptoms between bipolar disorder I and bipolar disorder II?

The main difference lies in the nature of manic or hypomanic symptoms. Bipolar I involves full-blown mania with severe symptoms, while bipolar II features hypomania, which is less intense. Depressive episodes are also more frequent in bipolar II. Both subtypes usually require mood stabilization medication and psychotherapy.

How is bipolar disorder I vs. bipolar disorder II treated?

Treatment for both bipolar I and bipolar II often includes mood-stabilizing medication and talk therapy. Working with a treatment team to get an accurate diagnosis and create an individualized treatment plan is crucial for managing bipolar so you can live a healthy fulfilling life.

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Demystifying Transcranial Magnetic Stimulation (TMS)

Traditional therapy and medications aren’t always effective for treating mental health disorders. If this is the case for you, transcranial magnetic stimulation (TMS) could be a viable alternative. This non-invasive treatment works by stimulating different parts of your brain to alleviate symptoms of mental health conditions like depression and PTSD.

Your primary care physician, mental health treatment provider, or rehab treatment team can help you determine if TMS is right for you.

Health Conditions TMS Can Treat

TMS can be used to treat1 several conditions:

About 20-30% of patients with MDD continue to experience depressive symptoms2 despite therapy and medication. For those patients, looking for alternatives to traditional treatment approaches is often a logical next step. TMS shows significant potential to improve depressive symptoms among people with treatment-resistant depression and PTSD. It may take several weeks to see results, so it’s imperative for patients to consistently attend the number of sessions prescribed by their doctor.

Repetitive TMS, or rTMS, has also been shown to be successful for anxiety and bipolar disorders,3 although it’s more effective in treating depression than manic episodes. It may also speed up recovery after a stroke, and help alleviate symptoms that arise after the event. In addition, low-frequency rTMS can help control the symptoms of Tourette syndrome and OCD. High-frequency rTMS helps people quit smoking by reducing cravings. rTMS can even reduce cocaine use and cravings4 in people struggling with addiction.

What Exactly Is TMS?

TMS is a non-invasive procedure that stimulates brain tissue5 by producing a high- or low-intensity magnetic field through a copper wire. There are 3 main methods of TMS used today:

  • Single-pulse TMS (spTMS) stimulates the motor cortex while a machine measures and records electrical activity.
  • Paired-pulse TMS (ppTMS) delivers 2 pulses through the same coil, with long or short intervals in between.
  • Repetitive TMS (rTMS) is a popular variation of TMS that applies repeating pulses to a specific area of the brain. This method treats the symptoms that come from mental health disorders. Deep TMS (dTMS)6 is a newer type of rTMS that stimulates deep brain areas because their larger helmet allows for more surface area. All Points North Lodge is one rehab center that offers dTMS treatment.

Typically, spTMS and ppTMS evaluate brain functioning, while rTMS actually creates changes in the brain. If you’re treated for a mental health condition, you’ll most likely undergo rTMS. There are several different coils available for use in TMS treatment. The specialists who deliver your treatment will determine the best one for your needs.

You can either complete TMS sessions at an inpatient rehab center (Inspire Malibu, for example, offers this in partnership with a physician’s office) or at a private clinic as an outpatient. In the latter option, you’d stay at home and commute to your sessions each day.

What Happens During a TMS Session?

Before you undergo any TMS procedures,7 you’ll take a physical and mental health screening to confirm your candidacy. This includes discussions of symptoms, conditions, and any medications you take with your treatment team, who will then guide you through the process.

During your session, you’ll sit in a reclining chair with earplugs (or some sort of hearing protection) with an electromagnetic coil attached to your head. The Dawn Rehab in Thailand even lets you listen to music so you feel as comfortable as possible. During rTMS (the most common type of TMS procedure), the operating physician will turn the coil on and off repeatedly to deliver pulses to your brain. During this process, you’ll feel a tapping sensation, called “mapping.” The professional administering rTMS will slowly increase the dose of magnetic energy to determine the right amount for you.

Most people don’t find TMS painful,8 but some people may feel slight discomfort. The Dawn Rehab describes their TMS sessions:

“A TMS-trained nurse will place an electromagnetic coil against your head which will painlessly deliver brief magnetic pulses – the same as those used in MRI (Magnetic Resonance Imaging) machines – to the region of the brain involved in mood control and depression.”

After your session, you can continue your regular daily routine as usual.

How Long Are TMS Sessions?

Duration can vary from person to person, and will also depend on your diagnosis. Standard rTMS treatment for major depressive disorder,9 for example, averages around 20-30 daily sessions for around 4-6 weeks. However, research recommends a minimum of 6 weeks. One study found that 38.4% of MDD patients responded well to just 4 weeks of treatment, but then surveyed patients who didn’t respond well to the initial 4 weeks after an additional 12 weeks of biweekly sessions. 61% of those patients responded well to the longer treatment phase.

Some studies have explored another, faster form of rTMS called “accelerated rTMS” or arTMS. During rTMS, people undergo multiple sessions in one day. Some studies suggest promising outcomes from this procedure, but more research will determine if this is actually a more viable option. Theta burst stimulation (TBS) is another, newer form of rTMS that can produce quicker results.10 Some studies found that, after only 5 days, patients enrolled in TBS arTMS trials reported success rates of 90%.

Some people may continue to attend “maintenance sessions” after their first set of TMS sessions. This involves slowly reducing the number of sessions per week from 3 to 1, which is eventually reduced to 1 session every 2 weeks. However, some people stop rTMS altogether, and go back to therapy and medications after completing their sessions. Unfortunately, rTMS maintenance isn’t well studied, and needs more research before making any determinations.

Should You Try TMS Therapy? Consider the Cons

While TMS has relatively few drawbacks, they do exist. Side effects are possible, but are usually minimal. And, TMS can be expensive and time-consuming. However, it may still be worth it for you, since lifting your depression to any degree can greatly impact your quality of life. Here are some factors to consider before trying TMS:

Possible Side Effects

Although TMS is non-invasive and seldom produces side effects,11 it can cause seizures in rare cases, and doctors do not recommend it for patients with epilepsy. While the risk of a seizure is small (less than 0.01% if you don’t have epilepsy, and less than 3% if you do), it’s still a possibility. If any of the following apply to you, you may be more likely to experience seizures:

  • Pre-existing neurological conditions
  • Adolescent
  • Changes in medication
  • Active substance use

You should talk to your doctor if you have any metal or electronic implants that will be near the TMS coil. This includes cochlear implants. These may cause problems with the therapy, and can be dangerous.

You may feel some slight discomfort in your scalp or neck during the procedure or pain afterward. You might also become more sensitive to sounds or experience ringing in your ears—which is why treatment providers should always provide ear protection. Some people report feeling fatigued afterward. However, it’s unlikely that you’ll encounter any of these side effects, and if you do, they will most likely be mild and short-lived.

Cost

rTMS is expensive,12 ranging from $200-300 USD per visit in a private clinic. If you complete the full course recommended by your doctor, you may end up paying $5,000-10,000 USD. Of course, this can differ depending on the duration and number of sessions you attend. Check with rehabs you’re considering to see if TMS is included in the cost of your program, or how much additional costs are.

Could TMS Provide the Relief You’ve Been Looking For?

Being unresponsive to treatment is incredibly frustrating when you’re living with depression or other mental health issues. But the good news is, you still have options. Alternative treatments like TMS just might do the trick for you, and the simple act of being open to trying something new can empower you to move forward in your recovery journey.

To learn more about residential treatment programs that offer this and other alternative therapies, browse our collection of rehabs and connect with centers directly.

Frequently Asked Questions About Transcranial Magnetic Stimulation for Addiction Treatment

How does Transcranial Magnetic Stimulation (TMS) work for addiction treatment?

Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate specific areas of the brain. It works by delivering targeted magnetic pulses to activate or inhibit brain cells, which can help regulate mood and alleviate symptoms of mental health conditions.

Is Transcranial Magnetic Stimulation safe for treating depression and anxiety?

Yes, Transcranial Magnetic Stimulation is considered a safe procedure for treating conditions like depression and anxiety. It has been extensively studied and approved by regulatory authorities. Common side effects may include mild headache or scalp discomfort during or after the session, but these are generally well-tolerated.

What are the potential benefits and risks of Transcranial Magnetic Stimulation?

Transcranial Magnetic Stimulation offers several potential benefits, including its non-invasiveness, minimal side effects, and efficacy in treating certain mental health conditions. However, it may not be suitable for everyone, and some individuals may experience rare side effects such as seizures. It’s essential to consult with a qualified healthcare provider to determine if TMS is a suitable treatment option.

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Inpatient Treatment for Mental Health Conditions

Mental illness is highly treatable. But if you’re struggling, it can be hard to know where to start. Just remember that you are not alone, and that it’s ok to ask for help from the experts. Sometimes, the best way to begin healing is by attending an inpatient treatment program.

Residential rehab isn’t just for substance use disorders. These programs can also help patients heal from mental health conditions, manage chronic symptoms, and process trauma. They may be a good fit for those who need intensive treatment in order to kickstart the healing process.

Inpatient treatment won’t “cure” you. Most mental illnesses are lifelong conditions. However, you’ll likely leave the program with new knowledge and skills that will help you build a sustainable life. Different facilities treat a variety of mental health concerns, including but not limited to the following diagnoses:

Anxiety Disorders

The term “anxiety disorder” may refer to a number of specific diagnoses. Some of the major types of anxiety disorders1 are:

  • Generalized anxiety disorder (GAD) is characterized by chronic feelings of anxiety, regardless of life circumstances.
  • Social anxiety disorder causes excessive self-consciousness or anxiety in social situations. Symptoms may occur in specific situations, such as large parties or formal events, or may be present in all social interactions.
  • Panic disorder is a condition in which patients have repeated and unexpected panic attacks, including both emotional and physical symptoms, such as intense fear and an elevated heart rate.

Other more complex conditions, such as obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are sometimes also categorized as anxiety disorders.

Although anxiety disorders are the “most common mental illness in the U.S.,”2 only 36.9% of people with these diagnoses receive treatment. These patients are six times more likely than others to be hospitalized for psychiatric disorders.

Treatment Options for Anxiety Disorders

Anxiety disorders can be treated3 with medication, talk therapy, or both. Commonly prescribed anxiety medications4 include SSRIs (like Prozac), SNRIs (like Cymbalta) or benzodiazepines (like Xanax).

Whether or not they take medication, people with these conditions often benefit from various types of talk therapy. Cognitive behavioral therapy (CBT)5 can be especially helpful. In this modality, patients learn specific skills to help them to interrupt anxious thought patterns and navigate triggering situations.

Inpatient treatment is rarely necessary for patients with minor or intermittent anxiety. However, untreated anxiety disorders may lead to severe symptoms, including suicidal ideation. These patients may benefit from residential programs, in which they can learn new coping mechanisms in a safe, protected environment.

Bipolar Disorder

This condition, once called manic-depressive disorder, is characterized by cycling periods of depression and mania. Some patients also experience hypomania, which is a less severe symptom, and may just present as increased energy and productivity. There are three clearly defined types of bipolar disorder:6

  • Bipolar I disorder includes manic episodes that last at least 7 days, or are so severe that they require hospitalization, and depressive episodes that typically last 2 weeks. This is considered to be the most severe type of the condition.
  • Bipolar II disorder has similar depressive episodes, but includes less severe symptoms of mania than Bipolar I. Instead, patients usually exhibit signs of hypomania.
  • Cyclothymic disorder (cyclothymia) presents with similar symptoms, including some combination of depression, mania, and/or hypomania. However, patients with this condition do not meet the exact criteria for either Bipolar I or Bipolar II.

These chronic illnesses may be caused by a combination of genetics, adverse life events, and neurochemical imbalances. Because of this, treatment protocols may be complex and highly individualized to each patient.

Treatment Options for Bipolar Disorder

People with bipolar may require hospitalization7 more frequently than those with other diagnoses, possibly because of the unpredictable nature of this disorder. Severe symptoms may appear suddenly and frequently, especially if the patient does not have an adequate plan for long-term care.

This condition is most often treated with a combination of medication and talk therapy. Pharmaceutical treatment of bipolar8 may include mood stabilizers (such as lithium and lamotrigine) and antidepressants. Studies also show that certain types of psychotherapy—including CBT, family-focused talk therapy, and interpersonal and social rhythm therapy— are particularly effective.

Because bipolar disorder may be genetic and/or neurochemical, even inpatient treatment will not completely alleviate symptoms. However, temporary residential care may help patients determine which methods will be most helpful for long-term maintenance.

Borderline Personality Disorder

Borderline personality disorder (BPD) is a serious mood disorder. It’s often misdiagnosed as bipolar disorder, and to the untrained eye, symptoms may appear extremely similar. However, BPD is more closely related to PTSD and C-PTSD, as traumatic life events can cause symptoms to appear or worsen. These experiences may interfere with a person’s ability to develop a stable sense of self, regulate their emotions, and maintain healthy relationships. Patients exhibit at least 5 of the 9 official diagnostic criteria for BPD, as defined by the DSM-5. Quoted directly from an article on diagnosing borderline personality disorder9 published by the National Center for Biotechnology Information, these criteria are as follows:

  • Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  • Identity disturbance: markedly and persistently unstable self-image or sense of self.
  • Impulsivity in at least 2 areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
  • Recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour.
  • Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
  • Chronic feelings of emptiness.
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  • Transient, stress-related paranoid ideation or severe dissociative symptoms.

Although borderline personality disorder may have a neurochemical component, it is primarily a behavioral disorder. Because of this, it’s absolutely possible for these patients to improve and even go into remission from BPD.10

Treatment Options for Borderline Personality Disorder

BPD is usually treated with dialectical behavioral therapy (DBT). This type of therapy combines group sessions with 1-on-1 talk therapy. The group therapy component resembles a class, as patients go through lessons from a textbook and even complete homework assignments. Groups normally meet several times a week, while 1-on-1 sessions take place at least once a week. Unlike most other forms of therapy, patients may be invited to contact their providers by phone in between sessions.

While DBT can be effective in an outpatient setting, residential treatment allows patients to focus on healing with fewer distractions. Research suggests that inpatient DBT may be more effective at treating borderline personality disorder11 than other modalities. Talk therapy of any kind is often combined with prescription medications, such as mood stabilizers, antidepressants, or anti-anxiety medications.

Depression

Depression, or major depressive disorder,12 is an extremely common diagnosis. As of 2019, an estimated 7.8% of all adults in the U.S. had major depression. This condition is characterized by a period of at least two weeks in which the patient “experienced a depressed mood or loss of interest or pleasure in daily activities, and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.”

It is important to differentiate between depression and sadness or grief.13 Depression is a mental health condition, and not a proportionate response to current life events. It is also known to damage a person’s self-esteem, and may cause feelings of worthlessness or hopelessness. Sadness and grief, on the other hand, are generally caused by specific circumstances. These emotions can be overwhelming, but they do not necessarily damage a person’s sense of self.

Depression may be caused by genetics,14 biochemistry, or environmental factors. Those with low self-esteem may also be at risk for developing this condition. Fortunately, most cases of depression are highly treatable.

Treatment Options for Depression

Perhaps because of its high prevalence, there are many different treatments available for major depressive disorder.15 Most patients benefit from some combination of medication, talk therapy, and brain stimulation therapies.

Antidepressants, including SSRIs (like Prozac) and SNRIs (like Cymbalta), are commonly used to treat major depression. Patients normally begin to see results 2-4 weeks after they begin taking a new prescription. Severe cases are usually treated with talk therapy at the same time, and mild cases may be treated with talk therapy alone. “The length and severity of the symptoms and episodes of depression often determine the type of therapy.”16

If a patient has treatment-resistant depression, they may be advised to try alternative modalities, such as brain stimulation therapies.17 Specifically, depression can be treated with electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS). These therapies are intended to have a direct effect on brain or nervous system function, alleviating the most extreme symptoms of depression.

Because it may lead to suicidal ideation, some patients may be hospitalized for depression on an urgent basis. If possible, it’s best to get help before your symptoms become so severe. There’s no need to wait for an emergency before attending a residential program.

Eating Disorders

Eating disorders affect at least 9% of the global population.18 These conditions can affect anyone, regardless of gender, body type, ability, occupation, age, race, ethnicity, or sexual orientation. However, certain demographics may be at a higher risk for developing certain diagnoses. Following are some of the most common types of eating disorders:19

  • Anorexia nervosa is characterized by the severe restriction of caloric intake. Patients with this condition may exhibit dramatic weight loss, a preoccupation with food and dieting, or adherence to an overly strict or taxing exercise routine.
  • Bulimia nervosa follows a binge-purge cycle. Patients with bulimia tend to binge eat, and then induce vomiting. Some also present with dental problems, weight loss, and excessive time spent in the bathroom after meals.
  • Binge eating disorder involves episodes of binge eating. Unlike bulimia, these episodes are not followed by purging. People with this condition may feel or express guilt and shame, hide food in strange places, and create lifestyle schedules that make time for binging behaviors.
  • Other specified feeding and eating disorders (OSFED) is a term that refers to eating disorders that do not fit neatly into any of the above categories. Patients with OSFED may exhibit weight loss or gain, and their self-esteem may be overly tied to body image.

Eating disorders are defined by a person’s behavior and emotional state, and not their body size. For example, it’s possible for someone to have anorexia and not appear clinically underweight. Eating disorders can be serious, and even life-threatening, no matter whether the patient’s weight is perceived to be healthy.

Treatment Options for Eating Disorders

Many people with eating disorders develop physical complications due to malnutrition. Because of this, hospitalization or inpatient treatment may be an important first step toward healing. This is not necessary for all patients, as it depends on the severity of their symptoms.

Some patients may benefit from residential treatment even if they don’t present with physical complications. This is an opportunity for them to begin intensive psychotherapy, work with a nutrition counselor, and be closely monitored for disordered behavior around food.

Medication alone is not usually used to treat eating disorders.20 In some cases, antidepressants or antianxiety medications may be prescribed in addition to therapy and behavioral health strategies. These patients may benefit from a number of different types of psychotherapy,21 including but not limited to acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and interpersonal psychotherapy (IPT).

PTSD and C-PTSD

Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) are very similar mental health diagnoses, and are both caused by adverse life experiences. It’s important to differentiate between PTSD and C-PTSD22 in order to design an appropriate treatment plan.

PTSD is normally caused by specific, time-bound traumatic occurrences. On the other hand, C-PTSD is caused by complex trauma,23 which is the prolonged exposure to extreme circumstances such as “domestic violence, childhood sexual or physical abuse, torture, genocide campaigns, slavery etc. along with the victim’s inability to escape.” It’s important to note that C-PTSD is not yet considered an official diagnosis.24 Despite this, it is an area of interest for researchers, and some have proposed that it be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The shared symptoms of PTSD and C-PTSD25 include the following:

  • Flashbacks to and nightmares of the inciting traumatic event
  • Avoidance of thoughts, people, places, and activities that may bring up painful memories
  • Hypervigilance due to a constant or persistent sense of threat/danger
  • An exaggerated startle response

C-PTSD may also involve personality and mood changes, difficulty with emotion regulation, a sense of worthlessness, the risk of self harm, paranoia, and/or dissociation.

“Most people with PTSD—about 80%—have one or more additional mental health diagnoses. They are also at risk for functional impairments, reduced quality of life, and relationship problems. PTSD and trauma26 are linked to physical health problems as well.” People with a history of trauma may benefit from intensive therapy for these co-occurring disorders, which may include a period of residential treatment.

Treatment Options for PTSD and C-PTSD

It’s important for people with these diagnoses to seek out trauma-informed care. This approach to treatment takes their unique symptoms and experiences into account, and fosters a more productive environment for healing.

The primary treatment for PTSD27 and C-PTSD is psychotherapy. Clinicians strongly recommend cognitive behavioral therapy (CBT) and prolonged exposure therapy, although other styles of therapy may also be helpful. These two modalities invite patients to face the original traumatic events head-on, developing skills that will help them navigate flashbacks and triggers in the future.

Patients may be prescribed medication in addition to—but not instead of—therapeutic interventions. Most often, PTSD is treated with SSRIs.28

Schizophrenia

Schizophrenia is a chronic brain disorder29 characterized by difficulty distinguishing between the real and the unreal. Symptoms generally fall into one of 3 categories:

  • Positive symptoms: The abnormal presence of visual or aural hallucinations, paranoia, distorted perceptions of the world
  • Negative symptoms: An abnormal loss of or decrease in the ability to make and carry out commitments, speak, express or feel emotion
  • Disorganized symptoms: Confused speech and/or thinking, disconnected logic, and abnormal behavior or movements

Experts believe schizophrenia may be caused by a combination of genetic and environmental factors. However, the disease’s exact etiology is unknown. There may be a link between schizophrenia and substance misuse,30 especially among teens. Specifically, research suggests that “taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk.” Continued substance use—and especially the use of psychedelics like LSD or psilocybin—can make it difficult to diagnose schizophrenia, because the effects of these drugs can mimic its symptoms.

Treatment Options for Schizophrenia

It’s extremely important to treat schizophrenia using both pharmaceutical and behavioral modalities. These patients are commonly prescribed antipsychotic medications,31 such as Abilify or Seroquel.

Talk therapy not only helps people to manage the symptoms of schizophrenia;32 it can also “ensure that patients remain adherent to their medications.” This makes every aspect of treatment more effective in the long term. In particular, beneficial talk therapies for schizophrenic patients33 include cognitive behavioral therapy (CBT), supportive psychotherapy, and cognitive enhancement therapy (CET).

If a person’s symptoms are severe enough to require immediate medical attention, they are likely to require admission to a hospital or residential treatment program. According to the CDC, approximately half of all emergency room visits related to schizophrenia34 “led to either a hospital admission (32.7%) or a transfer to a psychiatric hospital (16.7%).” These patients, as well as patients who are not in crisis, may find relief through longer-term residential treatment.

Suicidal Ideation

If you or someone you know is experiencing suicidal ideation, get immediate help by calling the National Suicide Prevention Lifeline at 800-273-8255.

Suicidal tendencies may be symptomatic of another diagnosis, or may appear independently. Regardless of the circumstances, suicidal ideation is an extremely serious symptom, and should be urgently treated.

Patients with this symptom may experience thoughts or fantasies of suicide, or may be actively planning to engage in self-harm. The warning signs of suicide35 include, but are not limited to the following:

  • Talking about wanting to die or to kill themselves
  • Looking for a way to kill themselves, like searching online or buying a gun
  • Talking about feeling hopeless, trapped, or in unbearable pain
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing reckless behavior, such as substance misuse
  • Withdrawing or isolating themselves, losing interest in activities they once enjoyed
  • A sudden and unexplained lift in mood, expression of a feeling of peace or tranquility
  • Sudden and extreme generosity, giving away money or treasured keepsakes

Not all instances of suicidal ideation are followed by suicide attempts. In some cases, this symptom is an expression of major depression, PTSD, or another co-occurring disorder. While emergency action may or may not be necessary, it’s important to get help as soon as this symptom appears. That may mean going to therapy, starting or changing a medication, or seeking inpatient care.

Treatment Options for Suicidal Ideation

Severe symptoms of suicidal ideation require immediate care. It may be appropriate to call an ambulance, or even call the police to request an in-person wellness check. Depending on your specific location, it may be possible to have the patient temporarily hospitalized with or without their consent. During this time, they may be closely supervised by healthcare providers to ensure they do not attempt self harm.

After the immediate threat of suicide has passed, it’s important to continue with an ongoing plan of care. Patients should begin by obtaining an official diagnosis, which will help their providers design a long-term plan. Because suicidal ideation is a symptom, and not officially a mental health condition, treatments vary widely.

Remember that you deserve care. Remember: a mental health diagnosis means nothing about your willpower or your character, and healing is absolutely possible. To learn more about treatment options, search our collection of inpatient mental health treatment centers and reach out to a specialist today.

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Finding Treatment for Bipolar Disorder

Bipolar disorder is a serious diagnosis. Without proper treatment, it can be extremely destabilizing—both for the person who has the condition, and for those around them. If you have this diagnosis, it’s vital to get the care you need. For some clients, inpatient rehab is a helpful place to start.

About 2.8% of the population has been diagnosed with bipolar disorder1 (once called manic-depressive disorder). And 83% of those cases are classified as severe. However, these numbers do not account for cases that go undiagnosed. It’s also frequently misdiagnosed as schizophrenia or borderline personality disorder (BPD). Without a proper understanding of your condition, it’s unlikely for clients to get appropriate treatment for their mental health.

If you think this diagnosis may fit your experience, it’s important to learn more about it. Make sure you talk to a mental health professional before you pursue a particular plan of care.

Understanding Bipolar Disorder

This condition is characterized by “intense emotional states that typically occur during distinct periods of days to weeks, called mood episodes,”2 according to the American Psychiatric Association. “These mood episodes are categorized as manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). People with bipolar disorder generally have periods of neutral mood as well.”

While its exact etiology is unknown, experts believe this condition can be caused by a combination of factors. You may have a genetic predisposition to bipolar disorder,3 even if previous generations of your family were never diagnosed. It may also be related to a neurochemical imbalance. Some experts believe it can be caused or exacerbated by adverse life experiences.

The term “bipolar” may lead casual observers to believe that the associated mood swings are simple. That’s far from the truth. Mania4 isn’t just happiness; it can include sleeplessness, anxiety, irritability, and disproportionate anger. It can also cause impulsivity, which may lead to excessive spending, promiscuity, or substance misuse. Similarly, depressive episodes aren’t simply bouts of sadness. Symptoms mimic those of major depression, and may include fatigue, oversleeping, trouble concentrating, over- or undereating, and suicidal ideation, in addition to sadness.

Clients with bipolar disorder are also prone to a third emotional state, called hypomania. Hypomania is often characterized as a less severe version of classic mania. Clients still present with energy, impulsivity, and other signs of mania; however, their symptoms are less overwhelming. And unlike mania, “hypomania5 does not cause a major deficit in social or occupational functioning.” By definition, it lasts for at least four days, whereas mania lasts for at least a week.

Based on the frequency and severity of the client’s mania, hypomania, and depression, bipolar disorder may be classified in one of three ways.

Bipolar Disorder I

According to experts at Creative Care Calabasas, “bipolar I is the most severe form of the mental health condition.” To qualify for this diagnosis, clients must experience mania for at least one week. Their behavior “must represent a change from the person’s usual behavior and be clear to friends and family. Symptoms must be severe enough to cause dysfunction in work, family, or social activities and responsibilities.” Clients with this type of bipolar disorder also experience depressive episodes that may last for weeks at a time. In severe cases, hospitalization can be necessary.

Bipolar Disorder II

Bipolar II is more often associated with depressive episodes. Clients with this condition experience similar swings, but their mania is both less severe and less frequent. Some experience depressive episodes interspersed with hypomanic episodes, without ever showing symptoms of mania.

Cyclothymic Disorder

Clients with cyclothymic disorder also cycle between depression and hypomania. This condition includes less severe symptoms than other forms of bipolar. It can also take much longer to get an accurate diagnosis. Clients must experience mood swings for at least two years, without ever meeting the exact criteria for bipolar I or bipolar II.

Living With Bipolar Disorder

It’s important to remember that bipolar disorder is a medical diagnosis, and not a reflection of a person’s character. Like any other diagnosis—from diabetes to depression—it can have a huge impact on the rest of your life. Conversely, the events of your life may make your symptoms more or less severe. Clients may have difficulty navigating regular activities as a result of this condition.

Important Life Events

Trauma is linked to the development of many psychiatric conditions, including depression, anxiety, and a number of mood disorders. Bipolar is no exception. Experts agree that “​​childhood trauma6 in all its subcomponents appears to be highly associated” with this condition.

And after developing bipolar disorder, various life events may bring on severe mood swings. Both traumatic events and extremely positive experiences may be risk factors.7 Research has found that “bipolar patients are highly sensitive to reward, and excessive goal pursuit after goal-attainment events may be one pathway to mania. Negative life events predict depressive symptoms, as do levels of familial expressed emotion.”

Career

When even positive events can trigger your symptoms, it may be difficult to maintain an upward trajectory. For that reason, bipolar disorder interferes with some clients’ ability to work.

One study found that “Occupational disability is one of the most problematic impairments for individuals with bipolar disorder due to high rates of unemployment and work impairments. Current evidence indicates that social stressors at work8—such as social isolation, conflict with others, and stigmas—are common experiences for employed individuals with bipolar disorder.”

These social stressors can make or break a clients’ success in the workplace. And for people with bipolar, even more than for other clients, social support is hugely impactful throughout the healing process.

Community Building

Strong relationships are uniquely important for people with this condition. Data suggests that social support9 may be directly linked to the severity and frequency of clients’ symptoms.

Some rehab programs have a unique focus on the social aspect of healing. Gould Farm, for instance, is a therapeutic community that treats clients with bipolar disorder. Residents receive clinical care from a team of healthcare providers, and also participate in community efforts. This treatment model is designed to help clients “learn new skills, and others re-discover their strengths, building confidence and self-esteem.”

According to experts, “empathy and understanding from another person can make it easier to cope with bipolar disorder.10 Social interaction can also provide opportunities to challenge negative ruminative thoughts and prevent the onset of a major mood episode.” A loss of social support, on the other hand, can trigger either mania or depression.

When your diagnosis has such a great impact on so many aspects of life, it can be hard to disentangle your symptoms from your healthy emotional reactions. And remember, not all healthy reactions are positive. For example, it’s perfectly healthy to experience anxiety if you have to switch jobs. Clients with bipolar disorder may struggle to stay present with that anxiety, instead of tipping into a manic episode. This difficulty can lead to unhealthy coping mechanisms, such as substance misuse.

Bipolar and Substance Use Disorders

There is a high prevalence of substance use disorders among people with bipolar disorder.11 This may be an attempt to self-medicate by regulating unstable moods, and/or response to symptomatic impulsivity.12

Also, experts believe there may be “a shared neurobiology between bipolar disorder and addictions.”13 If this is true, it would mean that people with a diagnosis of bipolar are neurologically predisposed to substance use disorders. Much more research is needed on this subject, however.

Because bipolar disorder may be related to neurochemical imbalances,14 substance use of any kind may have a direct impact on your symptoms. That’s true of both substance misuse and appropriate use of prescription medications. For this reason, it’s absolutely vital for clients to receive care from clinicians who have experience with this diagnosis.

If you have both bipolar disorder and a substance use disorder, you may benefit from rehab for co-occurring disorders. These programs address each client as a whole person, rather than treating each symptom individually. And, they may have a higher success rate. According to the experts at Skyland Trail, “research indicates that people who address multiple psychiatric diagnoses simultaneously experience better long-term outcomes than those who try to address each diagnosis separately.”

Healing From Bipolar Disorder

Bipolar disorder is a chronic condition. Once you receive this diagnosis, it will probably continue to apply for the rest of your life. That being said, bipolar can absolutely go into remission, and some clients go for long periods of time between manic, hypomanic, or depressive episodes. With appropriate care and management, you can significantly improve your quality of life.

While there are a number of ways to treat bipolar disorder, most clients benefit from a combination of therapy and medication.15 During treatment, you’ll work closely with your providers to decide which options are best for you. Certain modalities have been found to be extremely effective.

Psychotherapy

Talk therapy is a powerful way to begin healing from almost any mental health diagnosis. With this approach, you’ll develop a one-on-one relationship with a provider. Therapy sessions will take place more often during inpatient treatment—sometimes even daily. Outside of rehab, it’s quite common for clients to meet with their therapists once a week. However, your specific clinician may suggest you see each other either more or less often.

This modality allows clients to work through difficult feelings in a safe context. Therapy can work as a release valve, in which you can express extreme feelings without jeopardizing other relationships. It’s your therapist’s job to hold space for you, no matter what you think or how you feel. You can safely and ethically set aside any concern that they’ll judge you negatively for having mood swings.

Research has demonstrated that therapy is extremely important for people with this condition. Experts write that “psychotherapy, when added to medication for the treatment of bipolar disorder, consistently shows advantages over medication alone as a treatment for bipolar disorder.16 There are many different types of psychotherapy. If you attend an inpatient program, the team at your facility will help you choose which modality best suits your needs.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) teaches clients how to change their own thought patterns using practical, repeatable strategies. For example, you might learn to recognize when your own thoughts are distorted or divorced from reality. In those moments, CBT skills can help you ground yourself in the present moment, and respond from a calmer place.

Data suggests that this type of therapy is especially helpful for clients with certain conditions. Specifically, it “has a positive impact on patients with bipolar disorder17 in terms of reducing depression levels, improving mania severity, decreasing relapse rates and increasing psychosocial functioning.”

Psychiatry and Medication

Medication can be hugely beneficial for people with this diagnosis. Specifically, psychiatrists often prescribe lithium, lamotrigine, or antidepressants such as Prozac. Because bipolar disorder is thought to be a neurochemical imbalance, these treatments may be necessary even if talk therapy proves helpful.

However, it’s also important to consider the relationship between bipolar and substance use disorders. Even with a prescription in hand, some clients may be tempted to fall back into unhealthy patterns. In order to avoid this, it’s absolutely vital that you stay in close communication with your mental health team about your medication use. For some clients, having access to a prescription of any kind may be a trigger. If that’s the case for you, be sure to ask your therapist about substance-free alternatives.

Finding Balance With Bipolar Disorder

With extreme emotions, introspection can be difficult. Some clients with bipolar disorder struggle to find clarity, or even to ask for help. If these symptoms resonate with your experience, know that you have the right to reach out. It’s important to get the care you need.

Because bipolar disorder touches on so many aspects of life, it can be difficult to imagine what healing would look like. Remember that, no matter how severe your symptoms may be, no emotion lasts forever. You can and will feel differently. And, with the right support, you can even feel consistently better. It is absolutely possible for clients with bipolar to live rich and meaningful lives.

To learn more about inpatient treatment for this condition, you can browse our list of rehabs specializing in bipolar disorder.

Frequently Asked Questions About Rehab for Bipolar Disorder

What are the common treatment options for bipolar disorder?

Treatment for bipolar disorder often includes a combination of medication, psychotherapy, and lifestyle adjustments. Medications like mood stabilizers are commonly prescribed, and therapies such as cognitive-behavioral therapy (CBT) and family therapy help with managing symptoms and improving overall well-being. Some people start treatment at an inpatient rehab.

How long does rehab for bipolar disorder typically last?

The duration of treatment for bipolar disorder varies depending on individual needs and response to interventions. It typically involves long-term management to stabilize mood and prevent relapse. Treatment may span several months to years, with regular follow-up appointments and adjustments to the treatment plan as necessary.

Can therapy alone be effective in treating bipolar disorder?

While therapy alone may not be sufficient for managing bipolar disorder, it plays a crucial role in the overall treatment plan. Therapy, such as cognitive behavioral therapy, helps individuals develop coping skills, improve self-awareness, and enhance relationships. Combined with medication and other interventions, therapy contributes to a comprehensive approach for bipolar disorder treatment.