Bipolar Disorder: What You Need to Know

When Are Mood Swings Not Normal? Ups and downs are common. But bipolar disorder is a serious mental health condition that requires treatment

Life is full of emotional highs and lows. The guy you like likes you—high; you got a D on an algebra test—low; you’re going to the football game with friends—high; you had a fight with your mom—low. If your day feels like an endless cascade of ups and downs, that’s usually normal.

Sometimes, though, it’s not normal. Bipolar disorder is a condition characterized by severe mood swings ranging from manic (high) to depressed (low). In these states, a person can feel emotionally hypersensitive to everyday events, even when nothing that dramatic is going on. Though the average age-of-onset for bipolar disorder is 25, symptoms can start in the teen years, according to the National Alliance on Mental Illness.

If you are prone to feeling moody, you might wonder whether it’s related to this disorder. Here are a few ways you can tell the difference between normal mood swings and the clinical condition:


What is bipolar disorder?

Bipolar disorder causes mood swings between depression and elation or mania. During depression, you may have a loss of energy, disinterest in activities, drop in grades, loss of appetite, and a desire to sleep all the time. Many people feel sad and worthless.


During the mania or hypomania period you may feel elated and energetic. You could also have racing thoughts, a decreased need for sleep, excessive irritability, show reckless behavior, make rash or risky decisions, and have problems concentrating.


Having one or two of these symptoms does not mean you have the disorder: Most people are familiar with at least a few of these feelings from time to time. With bipolar disorder, however, these symptoms happen more days than not, impairing your ability to function, explains Paula Panzer, M.D., chief clinical and medical officer of the Jewish Board of Children and Family Services and a community psychiatrist in New York City.


What’s more, the moodiness you feel is often not something you can find a direct cause for, like a fight with your boyfriend or parents for instance. This type of mood instability can come on quickly, cycling between mania and depression in hours or days. But it can also appear slowly—taking weeks or even months to shift from one phase to the other.


How do you get bipolar disorder and could I have it?

Although no one is completely certain, experts believe that bipolar disorder is related to an imbalance of chemicals in the brain. The condition often runs in families, meaning if your parent or grandparent had it, you are more likely to get it, too. Figuring out whether your mood swings are a normal part of being a teen or if they could be connected to this clinical condition isn’t easy. Sharing your worries with a parent, teacher, rabbi, school counselor, sports coach, or another trusted adult is a good place to start.


“Adolescence is a time of massive amounts of change, and it can be hard to pin down what’s going on because of the moving target,” says Tim O’Connor, psychiatric nurse practitioner and member of the psychiatric leadership team at the Jewish Board. “There are so many changes in your life right now, and that makes it tricky to identify bipolar disorder.”


Here are some differences between normal teen behavior and bipolar disorder symptoms:


Normal: You may feel a lack of focus.

Not normal: You are too distracted to function in daily life.


Normal: You may have low self-esteem.

Not normal: You feel hopeless about your life.


Normal: You may think about doing something drastic.

Not normal: You engage in drastic, risky behavior.


Normal: You may be impulsive.

Not normal: You make bad choices using impaired judgment.


Normal: You may sleep in on the weekend

Not normal: You sleep all day—for weeks.


Normal: You may stay up late.

Not normal: You stay up all night five or more nights in a row.


Normal: You feel irritable.

Not normal: You act hostile.


Normal: You may talk a lot with friends.

Not normal: You experience increased talkativeness and rapid speech that you can’t control.


Normal: You may be a deep thinker.

Not normal: You have racing thoughts you can’t turn off.


Of course, you may have experienced a few or even all of these thoughts at some point in your life. That does not necessarily mean you have bipolar disorder. These are just some of the symptoms doctors look for, in addition to how long these thoughts last for and whether they occur together or in patterns.


Other signs of bipolar include feeling paranoid, thinking things that others tell you are not true, hearing voices or seeing things that are not there, or hearing voices telling you to harm yourself. These are serious symptoms that require immediate help. “These symptoms can be part of mania and can get worse pretty quickly,” says Dr. Panzer. “The best thing to do is reach out for immediate help. Thoughts of harming yourself are always treatable.”


With so many possible signs of the disorder, it’s understandable that you might be confused whether or not you really have it. Here’s the thing: When you are feeling down or like you’re not in control, having an official bipolar diagnosis is far less important than getting help so you can feel good again. Reach out for support first; worry about what to call it later.


How do you treat bipolar disorder?

Treatment for bipolar disorder usually includes medication and psychotherapy. There are several different kinds of therapy, as well as group and family counseling. Finding the one that works for you is key to feeling better.


In therapy, you’ll learn how to recognize symptoms of bipolar so you can successfully manage them. You’ll learn how to let others know when your mood feels out of whack so they can help you in times when you’re not using good judgement. You’ll discover mental exercises that can help you get through low patches when you feel hopeless or irrational highs when you might think about risky behavior. And you’ll hear about other helpful tools to overcome mood swings, including your faith, meditation, eating well, and exercising.


As you come to terms with your disorder, you may want to share your experience to help educate your peers or destigmatize the mental health issue. Whatever you do, don’t isolate yourself. “We all need a human connection,” says Panzer. “Our mental health gets worse with persistent isolation.” Opening up to friends is a giant step toward accepting your situation and moving on with your life. Remember: Bipolar disorder is completely treatable. You just have to ask for help.

Special thanks to:

Paula Panzer, MD, Chief Clinical and Medical Officer of the Jewish Board of Family and Children’s Services, community psychiatrist with an expertise in trauma, leader and administrator in New York City.

Tim O’Connor, Psychiatric Nurse Practitioner, member of the Psychiatry Leadership Team at the Jewish Board of Family and Children’s Services in New York City.

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