Of Two Extremes: Bipolar Related Disorders

Bipolar and its related disorders are mood disorders affecting 2.6% of Americans or over 5.7 million American adults over 18. It is characterized by https://www.nimh.nih.gov/health/topics/bipolar-disorder unusual and unpredictable shifts in mood, activity levels, energy, and concentration to the extent that they interrupt a person’s ability to function ‘normally’.

Bipolar is usually diagnosed in a person’s mid-20s, but people can show symptoms as early as their teens or as late as their 50s. It is an indiscriminate disorder that equally affects men and women of different ethnic groups, ages, and social classes. However, bipolar is a difficult disorder to diagnose and is often difficult to treat, even though many treatments are effective.

Of Two Extremes: Bipolar Related Disorders


Because there are two sides to bipolar, mania and depression, there are several varied symptoms. During a ‘low’ or depressive episode, a person may experience:

  • Extreme sadness, despair, or hopelessness
  • Trouble falling or staying asleep
  • Insomnia or hypersomnia
  • Rapid weight gain or loss
  • Slow and distracted speech
  • Trouble concentrating or focusing on a task
  • Little interest in any or all activities
  • Decreased self-care and hygiene
  • Thoughts about or attempts at self-harm or suicide

During a ‘high’, manic, or hypomanic episode, a person may experience:

  • Feeling elated, ‘high’, invincible, or irritable
  • An increase in energy, agitation, or feeling ‘wired’
  • A decreased need for sleep
  • Fast and varied thoughts and speech
  • Racing thoughts
  • Impulsivity and risky behavior
  • Poor judgment and decision making
  • An elevated sense of importance, power, and talent

Mania and Hypomania

It is important to note the difference between mania and hypomania: severity. Both have the same symptoms, but mania can be so intense that the person has a psychotic episode. Psychosis is not a feature of hypomania.


There are several types of bipolar disorder, each with its own distinctive characteristics. It’s important to note that not everyone experiences the same symptoms in the same way, and so there are different types. These types are defined less by symptoms and more by when and how these symptoms display themselves.

Bipolar I Disorder

A person has at least one manic episode. This follows or precedes a hypomanic or depressive period.

Bipolar II Disorder

A person has at least one major depressive episode. This follows at least one hypomanic period. A person with Bipolar II Disorder has not experienced a manic episode.

Cyclothymic Disorder

A person has had several instances of hypomanic and depression episodes for at least two years.

Mixed Episodes

A person experiences symptoms of both depression and mania or hypomania at the same time.

Comorbid disorders

Because the symptoms of bipolar are so varied, those with bipolar often have other disorders. These include:

  • Anxiety
  • Attention-Deficit Hyperactivity Disorder (ADHD)
  • Drug or alcohol abuse
  • Eating disorders
  • Psychosis


Treatment for bipolar disorder involves therapy, medications, and other procedures.


Several medications are effective in treating this disorder, but often a combination of two or more medications. These medications are mood stabilizers, antidepressants, and atypical antipsychotics, and also include other medications to treat symptoms like anxiety and insomnia.


The purpose of psychotherapy is to help a person identify and cope with problematic thoughts, feelings, and actions. It also helps educate and guide a person and their families.

Other Treatments

Other treatment options include brain stimulating procedures like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).

How we can help

At Pandora’s House, we work with you to discuss your symptoms and to help you find solutions. For more information about our services or to make an appointment, please contact us today or call (972) 784-3064. Read our blog for more information about mental health and wellness.