Manic depression, now more commonly known as bipolar disorder, is a serious mental health condition that causes extreme shifts in mood, energy, and behavior. These shifts include manic episodes (high or irritable mood) and depressive episodes (low or depressed mood).
Living with manic depressive illness can be overwhelming, especially for those also dealing with substance abuse or substance use disorders. If you or someone you love is experiencing mood episodes, it’s essential to know that you are not alone—and that effective treatment is available.
This article will explore what manic depression is, how to recognize it, and where to find treatment and support to manage it.
Understanding Manic Depression
Once called manic depressive illness, bipolar disorder is a category of psychiatric disorders that affects 37 million people worldwide. It involves recurring manic and depressive episodes, which can vary in severity and duration. These episodes aren’t just mood swings—they are extreme enough to interfere with daily life, relationships, and overall functioning.
There are several types of bipolar and related disorder classifications, each with distinct characteristics. Understanding these types can help people recognize the signs and seek the right help.
Types of Bipolar Disorder
Bipolar disorder is not just one condition. There are several forms of this disorder. Understanding the symptoms of each and the differences between them can help you make informed decisions about your treatment and long-term care.
Here is an overview of different forms of bipolar disorder.
Bipolar I Disorder
Bipolar I disorder is diagnosed when someone has experienced at least one full manic episode that lasts at least seven days or requires hospitalization. These severe manic episodes may include psychotic symptoms, such as hallucinations or delusions, especially if left untreated. Often, a major depressive episode also occurs, though it is not required for a bipolar I diagnosis.
Bipolar II Disorder
Bipolar II disorder involves patterns of hypomanic episodes (a milder form of mania) and major depressive episodes. People with bipolar II do not experience full-blown mania, but their depressive symptoms tend to be long-lasting and deeply painful. Despite being “less severe” than bipolar I, bipolar II disorder can be just as disabling.
Cyclothymic Disorder
Also known as cyclothymia, this type involves chronic fluctuations between hypomanic symptoms and depressive symptoms that do not meet the full criteria for either a manic or major depressive episode. This form often goes undiagnosed for years but can still significantly affect a person’s life.
Other Types
Some individuals experience unspecified bipolar or rapid cycling bipolar disorder, where bipolar episodes occur four or more times a year. Others may suffer mixed episodes, where manic and depressive symptoms co-occur.
Symptoms of Bipolar Disorder
Recognizing the symptoms of bipolar disorder is key to early intervention. These symptoms are divided into manic, hypomanic, and depressive categories.
Manic symptoms include:
- Elevated or irritable mood
- Inflated self-esteem
- Decreased need for sleep
- Racing thoughts
- Distractibility
- Impulsive or risky behavior (spending sprees, unsafe sex, drug use)
Hypomania symptoms are similar to manic symptoms but are less intense and don’t cause significant impairment. However, they can still be harmful, especially when accompanied by drug and alcohol misuse.
Depressive symptoms include:
- Persistent depressed mood
- Fatigue or loss of energy
- Feelings of hopelessness or guilt
- Changes in appetite or weight gain
- Thoughts of death or suicidal thoughts
- Difficulty concentrating or making decisions
These mood symptoms can last for days, weeks, or even longer. Major depression in bipolar disorder is often more intense and more challenging to treat than in other mental disorders.
Substance Abuse and Bipolar Disorder
People with bipolar disorder are at a higher risk of substance use disorders. The relationship between mental illness and substance abuse is complex. Sometimes substances are used to cope with manic or depressive episodes, while other times, they can trigger or worsen bipolar symptoms.
Using drugs or alcohol to manage worsening symptoms often leads to a dangerous cycle that makes bipolar disorder symptoms more difficult to treat. It can also increase the likelihood of psychotic symptoms, risky behavior, and hospitalization.
That’s why integrated treatment is essential. Addressing both bipolar disorder and substance abuse simultaneously leads to better long-term outcomes.
Diagnosing Bipolar Disorder
To diagnose bipolar disorder, a mental health provider will assess your mental health history, current symptoms, and behavior over time.
This process may involve:
- A psychiatric evaluation
- A review of family history
- Mood tracking over time
- Ruling out other mental health conditions or psychiatric disorders
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the standard tool used by mental health professionals for identifying bipolar disorder and other mood disorder types.
Proper diagnosis is vital—many people are misdiagnosed with borderline personality disorder, major depression, or anxiety before receiving a correct bipolar disorder diagnosis.
Treating Bipolar Disorder
If you or someone you care about is living with bipolar disorder, know that treatment can help restore stability and hope. While there is no way to prevent bipolar disorder completely, managing the symptoms is very possible with the right treatment plan.
Here is an overview of bipolar disorder treatment plans.
Medication
Mood stabilizers like lithium are commonly used to manage manic and depressive symptoms. Antidepressants, antipsychotics, and anti-anxiety medications may also be part of treatment, depending on the individual’s needs. A mental health specialist should always supervise medication management.
Talk Therapy
Psychotherapy, or talk therapy, can help individuals understand their condition, develop coping strategies, and process trauma. Common forms include Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy, and Family-Focused Therapy.
Lifestyle Adjustments
Healthy habits can make a meaningful difference. These include:
- Getting regular sleep
- Avoiding alcohol and drugs
- Building strong support systems
- Keeping a regular daily routine
Alongside medication and therapy, these lifestyle changes can help people manage their symptoms more effectively and improve their overall wellness.
Dual Diagnosis Treatment
When substance abuse is involved, a specialized dual diagnosis program can provide care for both conditions. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends integrated care that addresses the whole person—not just isolated symptoms.
Why Bipolar Disorder Often Goes Undetected
One reason bipolar disorder often remains untreated is that the manic or hypomanic episodes may feel good. Some people report feeling productive, euphoric, or empowered. This can cause people to deny there’s a problem until a depressive episode or severe manic episode results in consequences like job loss, broken relationships, or hospitalization.
Furthermore, individuals struggling with drug and alcohol misuse may confuse bipolar disorder symptoms with the highs and lows of addiction. This makes it even more crucial to work with mental health professionals trained in co-occurring disorders.
Final Thoughts
Manic depression—now understood as bipolar disorder—is a complex but treatable mental illness. For those also facing substance abuse, the road may feel even steeper. But there is hope.
With proper diagnosis, a personalized treatment plan, and compassionate care from trained professionals, healing is within reach. If you or a loved one is struggling, reach out to the specialists at First Step Behavioral Health for guidance. Learn about our comprehensive treatment programs, find trustworthy mental health resources, or schedule an intake appointment by contacting us today.
Frequently Asked Questions (FAQ)
1. Can bipolar disorder be mistaken for substance-induced mood swings?
Yes. Substance use—particularly stimulants, alcohol, or opioids—can cause mood changes that mimic manic or depressive episodes. This overlap often complicates diagnosis. A qualified mental health professional will evaluate your mood symptoms during periods of sobriety to accurately distinguish between bipolar disorder and substance-induced conditions.
2. Is there a genetic link to developing bipolar disorder?
Yes, bipolar disorder tends to run in families. Individuals with a close relative—such as a parent or sibling—with the condition are at higher risk of developing it themselves. However, genetics alone don’t determine the outcome. Environmental factors, trauma, and substance use also influence whether someone develops bipolar symptoms.
3. What’s the difference between hypomania and mania?
Both involve elevated or irritable mood, but hypomania is less intense and doesn’t typically cause significant disruptions in daily life or include psychotic symptoms. Mania, on the other hand, can be severe, often requires hospitalization, and may impair judgment or lead to dangerous behaviors.
4. Does bipolar disorder change over time?
Yes. The pattern and severity of mood episodes can evolve. Some people experience more frequent bipolar episodes as they age, or shift from depressive episodes being more prominent to experiencing more manic symptoms. In some cases, rapid cycling may develop later. Ongoing treatment helps manage these changes.
5. Are alternative therapies helpful in managing bipolar disorder?
While not a substitute for medication and therapy, some individuals find benefits in complementary approaches like mindfulness, meditation, yoga, or structured exercise routines. These can help stabilize mood, reduce anxiety, and support recovery—especially when combined with a medical treatment plan.
6. How does stress impact people with bipolar disorder?
Stress is a known trigger for manic and depressive symptoms. High-stress situations, including relationship issues, financial strain, or lack of sleep, can contribute to mood episodes. Learning stress management skills and maintaining a consistent daily routine are key components of long-term stability.
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