Bipolar Disorder Treatment That Helps You Build a More Stable Future

Though symptoms can differ based on the type of episode and vary person to person, below are some of the most common:

Manic episode symptoms

• An elevated, expansive, or unusually irritable mood lasting most of the day
• Markedly reduced need for sleep without feeling fatigued
• Racing thoughts and rapid, pressured speech
• Inflated self-esteem or grandiosity
• Engaging in high-risk or impulsive behavior such as overspending, sexual indiscretion, reckless driving, unwarranted business risks
• In severe cases, psychosis including delusions or hallucinations

Hypomanic episode symptoms:

• Similar to mania but less intense and severe, shorter in duration, and without psychosis
• Increased energy, productivity, and reduced need for sleep
• Improved mood and confidence 
• May feel positive but can escalate into a severe depressive episode or precede a full-blown manic episode

Depressive episode symptoms:

• A persistent depressed mood or emptiness
• Lack of interest or enjoyment in activities
• Substantial fatigue, changes in sleep, changes in appetite
• Trouble concentrating or making decisions
• Excessive feelings of worthlessness, hopelessness, or guilt
• Frequent thoughts of death or suicide
• Self-harm behaviors in some presentations

Bipolar disorder has a very strong biological basis. While there is no one single cause, the following factors all play a role:

• Genetic — Genetics play a role in bipolar disorder, with research suggesting that genetic factors account for about 60% to 80% of the risk; having a first-degree relative with bipolar disorder increases the likelihood of developing it.[4]
• Neurobiological factors— Differences in the structure and function of brain regions involved in mood regulation, reward, and executive function are consistently observed; dysregulation of neurotransmitter systems involving dopamine, serotonin, and norepinephrine also contribute.[5]
• Environmental triggers — Significant life stressors, disruptions in sleep, substance use, and major life changes may provoke mood episodes in individuals with underlying biological vulnerability; they do not cause bipolar disorder but can precipitate or worsen episodes of depression and mania.[6]

Bipolar disorder is a chronic illness that does not resolve on its own and worsens over time without proper psychiatric management.

Seeking treatment is necessary when:

• Manic or hypomanic episodes have resulted in serious behavioral consequences or safety risks
• Depression is causing difficulty performing daily activities, interacting socially, or producing suicidal thoughts
• Mood cycles are happening with increasing frequency or severity
• A substance abuse problem has developed alongside bipolar disorder
• A loved one has expressed concern about behaviors exhibited during manic or hypomanic episodes
• Prior treatments have been inadequate or unsuccessful, especially if antidepressants were given without a mood stabilizer, which can induce or worsen mania [7]

Research consistently shows that there is an exceptionally high rate of substance use among those diagnosed with bipolar disorder, with some estimates suggesting that up to 50% of people with Bipolar I have a co-occurring substance use disorder.[8] 

There are several reasons for this high correlation.

Impulsivity associated with manic episodes increases the likelihood of using substances due to lowered inhibitions and increased risk-taking behavior. The hopelessness and depression associated with depressive episodes may lead some to self-medicate with drugs or alcohol. The neurochemical dysfunction seen in bipolar disorder may also contribute to a predisposition to addiction through dysfunctional dopamine pathways.[9]

Having a substance use disorder on top of bipolar disorder can create a very complex clinical picture. Substances trigger manic or depressive episodes, destabilize mood even if medicine is being taken, and mask symptoms in ways that complicate diagnosis. Treating bipolar disorder and addiction separately results in poorer outcomes. To adequately treat one condition, it is necessary to address the other at the same time. At Agape, we use a comprehensive dual-diagnosis treatment model that integrates both diagnoses into each patient’s treatment plan.

At Agape, bipolar disorder treatment starts with a complete evaluation that takes into account the nature and severity of the client’s bipolar disorder, their previous treatment experiences, any possible co-occurring disorders, and whether there are any immediate safety issues that need to be addressed. 

From this assessment, an individual treatment plan is developed, designed to meet all of the client’s specific needs and goals. Personalization is important because Bipolar I and Bipolar II patients are two distinct populations requiring different approaches to treatment. Each patient also has unique needs based on any potential co-occurring disorders, which necessitates a tailored approach to meet those needs.