It’s Okay to not be Okay: Bipolar Disorder and Treatment

It’s normal to feel a broad range of emotions as we go through different situations. Getting a raise would make anyone jump for joy. A loss of a close friend would be painful for anyone. These are situations that elicit ‘socially’ acceptable negative emotions. Mood swings are normal, even if they cycle throughout the same day. 

What happens you feel extreme levels of excitement, only to feel waves of crippling depression afterward? Or if you feel numb or dissociated from the world regularly? Perhaps you’ve convinced yourself that feeling sad all the time is just a base-level state at this point. Or maybe you have sudden bursts of energy that lead you to do something random and out of character. While some see it as spontaneity, these symptoms may be signs of Bipolar Disorder. 

It’s okay not to be okay. If you feel you may have Bipolar Disorder, reach out to a licensed therapist. BetterHelp has thousands of certified therapists ready to help you take control of your life.

What is Bipolar Disorder?

According to the DSM-5, Bipolar disorder is a group of brain disorders that cause extreme fluctuations between mood, energy, and ability to function. Bipolar disorder falls under three categories, but they’re all known for manic and depressive episodes. 

Manic episodes are moments of extreme happiness, heightened energy levels, and a lack of inhibitions that often lead to reckless or uncharacteristic actions. In contrast, depressive episodes are moments of crippling sadness, lack of interest or appetite, and excess of sleep. 

Also, read about Confronting Trauma with Therapy

Bipolar Disorder is categorized by manic and depressive episodes’ intensity and duration. Based on how long each manic episode lasts, bipolar disorder can fall into one of three categories:

Bipolar 1 Disorder

Bipolar 1 is categorized by having a manic episode that lasts more than seven days. Patients with Bipolar 1 can experience highly elevated emotions and restlessness. They may have an overabundance of energy and may not sleep for several days at a time. Bipolar 1 is the most dangerous of the manic states since it’s the most severe and long-lasting. 

Bipolar 2 Disorder

Bipolar 2 also has manic episodes but less severe than Bipolar 1. Typically, manic episodes last four days and are followed by depressive episodes. Patients who have Bipolar 2 may feel deep remorse from their manic episodes that trigger depressive episodes. 

Cyclothymic Disorder

Cyclothymic Disorder is categorized with brief moments of manic and depressive states. These highs and lows aren’t as extreme as the other Bipolar types and can often go undiagnosed due to their mild symptoms. 

These episodes aren’t necessarily sequential. Many people with Bipolar disorder can have a manic episode, then come back to a normal state, followed by a depressive or another manic episode. 

What are some signs of Bipolar Disorder?

Bipolar Disorder consists of many symptoms. The DSM-5 states that a person must show at least 3 of the following symptoms for manic episodes.

  • Feelings of grandeur inflated self-esteem
  • Lack of sleep or decreased need for sleep
  • Racing thoughts
  • Jump from activity to activity without finishing, lack of focus
  • Increased talkativeness
  • Easily distracted
  • Attempting uncharacteristic actions or destructive behavior

For the depressive states, the criteria are slightly higher. A person must show at least 5 of the following symptoms to be diagnosed with a major depressive state.

  • Feeling depressed most of the day, low self-esteem
  • Low energy level, fatigue
  • Loss of interest in activities
  • Increase or decrease in appetite
  • Major weight loss 
  • Feeling worthless or guilty
  • Indecisiveness
  • Suicidal thoughts or attempts

What treatment options are available for Bipolar Disorder?

Treatment for Bipolar disorder is available, though it is still under research for more effective treatments. 

Manic Episodes

Unfortunately, therapy does not help someone during a manic state. Usually, patients in this state may cause harm to themselves or others. If your family and a loved one have a manic episode, the best thing to do is keep them safe and take their car keys or credit cards if they want to go on a shopping binge. 

The most common treatment for manic episodes is medication. Lithium Salts are the most common treatment and most effective. Lithium salts are mood stabilizers that dampen the extremities of a manic episode. The one drawback of lithium salts is that they may trigger a person into a depressive episode because they’re mood stabilizers. Also, lithium salts can dehydrate users and cause problems in the thyroid and kidneys.

Depressive Episodes

Patients going through a depressive episode are usually given antidepressants. Selective Serotonin Reuptake Inhibitors or SSRIs are often used for depressive episodes. As stated previously, its side effect may trigger a manic episode. For this reason, patients must be carefully monitored by a licensed psychiatrist whenever undergoing a medication plan. 


While talk therapy may not be effective during manic states, it can improve a patient’s life if administered after or before manic states occur. Therapists can use cognitive behavioral therapy techniques to address a patient’s actions and behaviors during a manic state and make a plan to minimize potential damage, whether physical, financial, or otherwise.

Coincidentally, family therapy seems to have the most significant positive effect for patients with Bipolar disorder. In Family therapy, every family member gains the tools to help patients through their episodes. Therapists can teach families to respect boundaries and recognize signs of oncoming episodes. Families can learn to reduce stress levels and coordinate together, preventing a triggered episode. 

Final Thoughts

Bipolar Disorder can be crippling for an individual and heartbreaking for families who don’t understand its implications. If you feel you have Bipolar disorder, help is available. Reach out to a licensed therapist specializing in CBT, Family Therapy, or works with patients with Bipolar Disorder.

Marie Miguel Biography

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

About Carson Derrow

My name is Carson Derrow I'm an entrepreneur, professional blogger, and marketer from Arkansas. I've been writing for startups and small businesses since 2012. I share the latest business news, tools, resources, and marketing tips to help startups and small businesses to grow their business.