Bipolar disorder, previously called manic depression, is a condition where drastic mood shifts occur. One extreme is mania–a feeling of heightened excitement, self-esteem, and confidence; the other is profound depression–deep despair and loss of interest and joy.
Symptoms can also fluctuate and combine; some may experience psychosis, such as delusions and hallucinations. These psychoses tend to match the mood, for example, believing they have “superpowers” and are famous during manic episodes or financially ruined during depressive episodes.
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The complex disorder may also affect sleep and eating patterns, with both extremes disruptive and challenging for the individual and their family to manage. Episodes can be as short as a day or last for many months. The average duration is around 13 weeks.
For those living with bipolar disorder–often initially misdiagnosed and treated as depression – life can be unpredictable and confusing. These extreme switches in emotion and energy can negatively impact relationships, goals, school, careers, health, and economic well-being. The disorder is also associated with social alienation and isolation.
Bipolar Disorder Prevalence in the United States
In the United States, approximately 2.8% of the population, or seven million adults, experience the condition yearly. The condition is heritable, with around 4.4% predicted to experience it at some stage. It is the sixth leading mental health disorder globally. Bipolar is considered severe and disabling, affecting females and males equally and presenting as young as 13.
Many with the condition in the United States do seek treatment. However, among a sizable proportion, therapy is limited to primary health care rather than the specialist mental health and mood stabilization required. It’s suggested that globally, up to half of bipolar disorder cases may go untreated.
What Is Bipolar Disorder?
Three bipolar types are recognized – bipolar I, bipolar II, and cyclothymia. While each type shares similar symptoms, they differ in level of severity.
- Bipolar I: Manic episodes last at least seven days, or manic symptoms require urgent medical care. Depressive episodes are also present, usually of a minimum two-week duration. “Rapid cycling” refers to four or more episodes annually.
- Bipolar II: A pattern of hypomanic (less severe symptoms) and depressive episodes.
- Cyclothymic disorder (cyclothymia) presents as recurring but less intense and shorter duration depressive and hypomanic symptoms.
Many also experience eating disorders, attention deficit hyperactivity disorder (ADHD), anxiety, and other mood disorders. The condition is likely to co-occur with other health challenges, such as substance abuse, with up to half of those living with bipolar experiencing comorbidity. There is also a pronounced risk of developing diabetes, stroke, or cardiovascular disease, with over a third living with obesity.
While researchers are still studying probable causes of bipolar, it’s clear that numerous factors contribute to the development of the condition.
- Genetics: The disorder is likely inheritable due to specific multiple genes predisposing individuals and families to the condition.
- Brain structure: Studies indicate that the brain structure and functioning of those with bipolar differ from those without the condition. For example, in those with the disorder, the part of the brain regulating emotion – the amygdala – may be smaller.
- Life events: Stressful events and environments may trigger bipolar symptoms in genetically predisposed people.
While research continues, current diagnosis relies on a patient’s history and symptoms rather than brain imaging.
How Is Bipolar Disorder Diagnosed?
Typically, your medical health professional takes your history and conducts a physical examination, including blood tests. This evaluation helps to exclude physical causes of your symptoms, such as multiple sclerosis or hypothyroidism. If your doctor finds no physical cause, they will perform a psychological evaluation.
This assessment consists of a discussion where your medical professional will ask about your or a family history of anxiety, depression, or bipolar disorders. They will discuss symptoms, onset, duration, intensity, and previous treatments.
They will also ask about suicidal thoughts, substance use, and other risky behaviors. To understand how symptoms impact your daily tasks and quality of life, your doctor may request that you complete a self-assessment questionnaire and daily diary of moods, sleep, and eating patterns. If required, with your permission, they may also speak to your relatives and friends to get a complete picture.
If your doctor diagnoses bipolar, they will give you feedback and discuss your diagnosis, outlook, and best treatment options.
How Is Bipolar Disorder Treated?
Leading treatments are directed at symptom management. They include medication, education, and psychological counseling, such as psychotherapy and support groups. Treatment is ideally recommended and guided by mental health specialists such as psychiatrists supported by psychiatric nurses and social workers to address mental, physical, and social elements.
- Medication: Mood-stabilizing pharmaceuticals such as lithium can have an immediate effect. The drug’s success rates range from 40% to 85%, with almost all users reporting positive results (90%). Your doctor may also prescribe antidepressants and antipsychotics to help manage all the symptoms.
- Counseling: Ongoing psychotherapy and other talk therapy programs can provide support during and after the initial diagnosis to help control symptoms.
- Substance abuse treatment: Comorbidities such as drug or alcohol abuse require concurrent treatment, as they can exacerbate symptoms and complicate treatment.
People with bipolar can behave recklessly, become detached from reality, or feel suicidal while experiencing mood extremes. In this case, your medical professional may recommend hospitalization to keep you safe and comfortable as your mood stabilizes.
Importantly, treatment for bipolar disorder must be lifelong. Medical interventions must be continued, even when people with bipolar are feeling well. Missing medication doses and therapy sessions can cause a relapse and reappearance of symptoms, making getting back on track exceedingly difficult.
The Impact of Psychotherapy
Psychotherapy approaches include psychoeducation, psychoanalysis, family-focused therapy, interpersonal social rhythm therapy (IPSRT), and cognitive behavioral therapy (CBT).
Evidence-based psychoanalytic therapy explores and helps to resolve underlying or unconscious drivers through talking, relating, interpreting, experiencing, and centering. Psychotherapy such as IPSRT is proven to help bipolar disorder patients manage their symptoms within their biological and social rhythms. Often combined with individual approaches, family-focused psychoeducation is another modality known to help therapists and patients understand and address family dynamics in a safe environment.
Cognitive behavioral therapy (CBT) is the most widely used modality combined with medication. It has proven positive results, helping to reduce depressive symptoms by up to 7% and the risk of relapse by 60%. CBT can be beneficial in managing intense emotions, changing behavior, and preventing relapse.
CBT is a talk-based therapy focusing on identifying and replacing unhealthy thoughts and behaviors with more helpful options. It does this by helping people with bipolar gain insight into symptoms and thoughts, teaching them improved coping skills and strategies using evidence-based techniques. Four distinct benefits include:
- Recognition and prevention of symptoms.
- Easing symptom severity and duration.
- Comorbidity treatment.
- Medical protocol compliance.
CBT approaches may differ across individual cases but typically include an assessment, psychoeducation, cognitive and behavioral interventions, and relapse prevention. Therapy can be one-on-one, in groups, or both. Participating in peer support groups has been shown to increase treatment adherence by 86%.
At the same time, seeking treatment can be difficult for many. For those in a depressive phase, low energy and sadness may make the thought of getting up and traveling somewhere overwhelming. In addition, people with mobility issues, social anxiety, and those living remotely, with limited budgets for travel or language barriers, may also face obstacles. According to Doctor on Demand, one in every five adults with mental health concerns cannot get treatment.
The Benefits of Online Therapy for Bipolar Disorder
Conveniently, for people with bipolar disorder who are unable to attend sessions physically, online bipolar disorder therapy is available. Studies have confirmed the effectiveness of online and Internet cognitive behavioral therapy (ICBT), reporting its efficacy across various primary disorders and comorbidities.
An American Psychological Association review of 15 articles concluded that online therapy can help educate, manage symptoms, develop and implement treatment plans, and encourage a positive, hopeful outlook. Virtual therapy may also help patients manage their time and help prioritize mental health care. Online treatment means avoiding travel and waiting rooms, and sessions and feedback can be conducted in real-time–wherever you are, whenever suits you – and asynchronously.
Beyond being accessible for anyone with online resources, therapist overhead expenses are reduced and processes streamlined. Online therapy for bipolar disorder is more affordable than traditional on-premises counseling. Moreover, online therapy is entirely confidential and secure for those with privacy concerns. In addition, beyond sharing billing and contact details, you can choose to remain anonymous.
How Does Online Therapy for Bipolar Disorder Work?
Online therapy platforms such as BetterHelp match you with a licensed therapist, where you can benefit from professional counseling from home. Interaction is available through in-person voice calls, video calls, or in-app messaging.
BetterHelp has found that rapport with your professional helps you reach your goals. So, the first thing they do after signup is to match you to an available therapist. This professional will offer a focus and approach aligned with your unique issues, objectives, and preferences. The matching process may take a few hours or days, and you can request a new match if the combination isn’t ideal.
Your therapy will occur live via appointment-based phone and video calls. In addition, you and your therapist will be assigned a virtual “therapy room.” This space is dedicated, private, and secure for confidential communication, including journaling, questions, and discussion. You will receive an email notification when your therapist has read and responded to your messages. You can refer to all your professional’s advice and messages anytime.
So, if you are one of the millions of Americans with bipolar disorder, why not contact a licensed online therapist through BetterHelp? Please note that online options preclude diagnoses, medication prescriptions, and court-ordered therapy and may not be appropriate in every case.
Why Choose BetterHelp for Online Therapy?
BetterHelp is the world’s largest 100% online therapy platform. Their specialist care is accessible anywhere and anytime, affordable, and international.
BetterHelp’s extensive network of independent, experienced providers is affiliated with but not employed by them. This structure means the platform provides a service supporting direct, efficient, effective, tailored therapy and communication. Associated therapists are trained, licensed, accredited psychologists, professional counselors, relationship therapists, and clinical social workers. All have a minimum of three years and 1,000 hours of clinical practice.
Subscription fees are billed monthly and range from $60 to $90. Cost depends on preferences, location, and therapist availability. You, your therapist, and your progress toward goals drive the length of your subscription, and you can cancel at any time. While BetterHelp services are not covered by health insurance, Medicaid, or Medicare, their affordable fees are comparable to most insurance plan co-pays.
By relying on BetterHelp online therapy for bipolar disorder, you’re not alone, even if you cannot leave your home. Go online and get started today.