Bipolar disorder is a mental health condition characterized by extreme shifts in mood and energy levels. Bipolar disorder can range from mild to severe, with severe bipolar disorder featuring more extreme highs (mania) and lows (depression). Severe bipolar disorder can significantly impact a person’s functioning and quality of life if left untreated. In this article, we will explore what severe bipolar disorder looks like, including common symptoms, triggers, and treatment options. Understanding the signs and symptoms of severe bipolar can help those struggling get the help they need.
What are the main symptoms of severe bipolar disorder?
Some key symptoms and signs of severe bipolar disorder include:
- Extreme manic episodes – Mania in severe cases may involve psychosis, risky behavior, and hospitalization.
- Extreme depressive episodes – Depression with suicidal thoughts, inability to function, and psychotic features.
- Mixed episodes – Experiencing mania and depression simultaneously.
- Rapid cycling – Frequent mood episodes shifting between mania and depression.
- Lengthy mood episodes – Mania/depression lasting for months if untreated.
- Impaired functioning – Severely limited ability to carry out daily activities.
- Psychotic symptoms – Detachment from reality, delusions, hallucinations.
- Cognitive distortions – Impaired judgment, racing thoughts, disjointed thinking.
The main distinction between mild and severe bipolar disorder is the intensity and duration of mood episodes. In severe cases, mania and depression are more extreme, episodes change more rapidly, and symptoms significantly disrupt the ability to function.
What are some specific examples of severe mania symptoms?
Severe manic episodes may involve:
- Feeling euphoric, on top of the world, or having superhuman abilities.
- Talking very rapidly, jumping between topics.
- Having racing thoughts, distractibility, inability to focus.
- Needing very little sleep but feeling energized.
- Impulsiveness, poor judgment, and risk taking.
- Irritability, aggression, or violence.
- Impaired social functioning and self-care.
- Psychosis – hallucinations, delusions, detachment from reality.
- Requiring hospitalization due to poor functioning and risk of harm.
A severe manic episode is a psychiatric emergency needing urgent treatment. It can be a traumatic, disorienting experience leading to relationship conflict, financial issues, and health risks.
What are some examples of severe depression symptoms?
Severe bipolar depression may involve:
- Feeling extremely sad, hopeless, worthless, or guilty.
- Having very low energy levels, feeling fatigued.
- Sleeping too much or inability to sleep.
- Withdrawing socially, isolating oneself.
- Loss of interest in activities previously enjoyed.
- Appetite changes – eating too much or too little.
- Cognitive impairment – inability to concentrate, indecisiveness.
- Psychomotor changes – agitation or moving slowly.
- Suicidal thoughts – making plans or attempting suicide.
- Needing hospitalization to manage risk of self-harm.
Severe depression can make it extremely difficult for someone to function in daily life without significant support.
What triggers severe bipolar episodes?
There are certain triggers that can set off severe mood episodes in people with bipolar disorder:
- Stopping medication or missing doses of mood stabilizers.
- Use of drugs/alcohol, sleep deprivation, or stress.
- Major life changes – starting a new job, relationships ending.
- Seasonal changes or lack of sunlight in winter.
- Hormonal changes like postpartum period or perimenopause.
- Physical illness or chronic medical conditions.
- Use of antidepressants or steroids without a mood stabilizer.
Avoiding and managing these triggers through treatment adherence, self-care, and lifestyle changes can help minimize mood episodes. But episodes can still occur periodically even with proper management.
How is severe bipolar disorder treated?
Treatment for severe bipolar disorder often requires:
- Medication – Mood stabilizers (lithium, anticonvulsants) and atypical antipsychotics to manage symptoms long-term. Anti-anxiety meds or sleep aids may also help.
- Psychotherapy – Cognitive behavioral therapy, family therapy, psychoeducation to develop coping strategies.
- Hospitalization – Inpatient care during acute manic or depressive episodes to stabilize condition.
- Lifestyle changes – Maintaining regular sleep/wake cycles, reducing stress, limiting alcohol, identifying triggers.
- Social rhythm therapy – Developing daily routines and social interactions to maintain mood stability.
Treatment is often lifelong as severe bipolar disorder is a chronic illness. Long-term adherence to medication and psychotherapy is crucial for managing symptoms. Support from family and treatment team helps maintain stability.
Conclusion
In summary, severe bipolar disorder is characterized by extreme, debilitating mood swings between mania and depression. Manic episodes may involve psychosis and risky behavior requiring hospitalization. Depressive episodes can be life-threatening due to suicidal thoughts and inability to function. Triggers like drug use, stress, and sleep changes can provoke severe episodes. Effective treatment includes medication, psychotherapy, hospitalization when needed, and major lifestyle changes. While challenging to manage, severe bipolar disorder can be stabilized with diligent long-term treatment, social support, and self-care practices. Increased understanding of severe bipolar symptoms, triggers and treatment helps sufferers and their loved ones support recovery.
| Mild Bipolar Disorder | Severe Bipolar Disorder |
|---|---|
| Hypomania may not cause much impairment | Mania causes severe impairment in functioning |
| Depressive episodes are less intense | Depressive episodes can include psychosis, catatonia |
| Mood episodes last days to weeks | Mood episodes last weeks to months untreated |
| Symptoms cause modest social/work disruption | Symptoms prevent ability to work, destroy relationships |
| Usually no violence, hospitalization, or suicide attempts | Higher risk of violence, hospitalization, and suicide |
| Less impairment with proper treatment | More residual symptoms even with treatment |
Risk Factors for Developing Severe Bipolar Disorder
- Early age of onset – diagnosed in childhood or teen years
- First-degree relative with bipolar disorder
- Presence of psychotic symptoms
- Rapid cycling between mood episodes
- Substance abuse or addiction issues
- Significant stress or childhood trauma
- Initial misdiagnosis or inadequate treatment
When to Seek Emergency Care for Bipolar Symptoms
Seek immediate medical help if experiencing:
- Thoughts of hurting oneself or suicidal behavior
- Symptoms of psychosis – delusions, hallucinations
- Manic behavior that involves high risk activities
- Extreme inability to carry out basic self-care
- Catatonia – lack of speech, movement or response
- Debilitating depression with unrelenting despair
Don’t wait to see if worrisome symptoms resolve on their own. Call emergency services, go to the ER, or contact a mental health crisis line. Prompt treatment can help stabilize an episode.
Coping with Severe Bipolar Disorder
In addition to professional treatment, the following self-care strategies can help manage severe bipolar:
- Learn to recognize personal triggers and early warning signs of episodes.
- Have an emergency action plan for accessing help when symptoms escalate.
- Take medications exactly as prescribed and avoid discontinuing without doctor approval.
- Follow a regular sleep, activity, and eating schedule – avoid irregular cycles.
- Reduce stress through relaxation techniques, support groups, therapy.
- Avoid drugs and alcohol which destabilize moods.
- Join a peer support group to share coping strategies.
- Express feelings creatively through art, music, writing, poetry.
- Let friends/family know how they can be most supportive.
While living with severe bipolar disorder can be very difficult, the condition is treatable and stability is possible between episodes. Close adherence to professional treatment paired with self-care provides the best chance of managing this challenging mental illness. There are many resources and support systems available to help individuals and families cope with severe bipolar disorder.