Why It’s Hard to Diagnose Bipolar Disorder

How to Support a Loved One with Bipolar Disorder Supporting a loved one with bipolar disorder can be incredibly challenging, but it also offers an opportunity to make a profound difference in their life. It’s an emotional experience that can include moments of intense highs and lows – which can take a toll on everyone. By educating yourself about the condition, you can become a better ally to your friend or family member throughout their journey. Ways to show your support include offering understanding, compassion, and action, which we’ll dive into below. {MiniWidget:Anxiety} Educating yourself on bipolar disorder Understanding the condition is the first step in preparing to support someone with bipolar disorder. Bipolar disorder is a complex mental health condition characterized by extreme fluctuations in mood that come in episodes, which can have an outsized impact on a person's daily activities, energy levels, thought process, and overall well-being. What is bipolar disorder? Individuals with bipolar disorder experience intense emotional shifts that can continue for several days, weeks, or even months. Unlike your typical mood swings, those with bipolar disorder often find their swings greatly impair varying aspects of their everyday life.  It’s important to know that bipolar disorder is a medical condition for which continuing care and professional support is recommended by qualified medical professionals. Having bipolar disorder is not a choice, but taking steps to best manage it for your lifestyle is. Types of bipolar disorder With advancements in research, it’s now known that bipolar disorder exists in different forms – some overlapping challenges and each coming with their own set of unique difficulties. Some examples are listed below: Bipolar I disorder: A severe condition characterized by at least one episode of mania that may be extreme and dangerous. Patients may or may not also experience depression. Bipolar II disorder: A severe condition that includes depressive episodes and at least one period of hypomania. Cyclothymic disorder. A milder subtype of bipolar disorder that is usually less severe than bipolar l and bipolar ll. Mood episodes do not meet the full criteria for bipolar I, bipolar II, or major depressive disorders. Cyclothymic disorder may later develop into bipolar I or bipolar II.  Understanding the specific type of bipolar disorder your loved one has can help you tailor your support accordingly. As always, consulting qualified medical professionals is a strong start to set a solid path for supportive engagement.  Recognizing symptoms and triggers Learning the triggers and signs of mania and depression may help you support someone with bipolar disorder. People suffering from bipolar conditions may not even realize they're experiencing a mood shift, or they may feel too overwhelmed to seek help. Symptoms of mania During a manic episode, your loved one may seem unusually happy, energetic, or even irritable. Be on the lookout for: Racing thoughts Exaggerated self-confidence or grandiosity Reduced need for sleep Impulsive or risky behaviors, like excessive spending or dangerous decisions, without regard to considering or realizing possible negative consequences or impacts Rapid speech, such as speaking so quickly they are difficult to follow While mania can sometimes feel euphoric, it can also lead to poor judgment, strained relationships, and potentially harmful situations. Symptoms of depression On the other side of the spectrum, depressive episodes can be equally debilitating. Watch for: Persistent sadness or hopelessness Fatigue and lack of energy Changes in appetite or sleep patterns Difficulty concentrating Loss of interest in activities they once enjoyed Thoughts of suicide or self-harm During a depressive phase, your loved one may withdraw, stop engaging with the world, and isolate themselves. Recognizing these patterns can help you reach out and provide support when they may not have the strength to ask for it themselves. Common triggers Triggers can vary from person to person. Some common ones include: Stress: Significant life changes, work pressures, or personal conflicts can intensify symptoms. Sleep disruption: Irregular sleep patterns can signal both manic and depressive episodes. Substance use: Drugs and alcohol may negatively interact with medications and worsen symptoms. Seasonal changes: Some individuals with bipolar disorder experience more mood episodes during specific times of the year, like winter or spring. When you understand these triggers, you can intervene and offer assistance in the hopes of preventing escalation. Ask how you can support them Since individuals with bipolar disorder may experience its effects differently, one of the things you can do to help a loved one is simply asking them how they'd like to be supported. Do they prefer you check in regularly? Do they want space when they're feeling overwhelmed? Get the conversation going so you can understand how you can best be there for them. Let them know when you notice concerning symptoms Sometimes during a manic or depressive episode, a person might not be fully aware of their own symptoms. Gently pointing out when you've noticed a change in their behavior can support awareness and action. Take care to approach them with empathy and without judgment. A simple "I've noticed you seem more stressed than usual – do you want to talk about it?" can go a long way. Encourage them to stay in treatment Bipolar disorder often requires ongoing treatment, including medication and therapy. Sometimes people with the condition have varying views about treatment, so be prepared for the possibility. The medications aren't working: Encourage them to talk to their doctor rather than stopping treatment abruptly. They don't like the side effects: Suggest they talk to their doctor about alternative options. They forget to take their medications: Offer to set up reminders or help them create a routine to ensure they take their medication consistently. They don't think they need treatment: Gently remind them of previous episodes and how treatment has helped them maintain stability. Have a crisis plan prepared Bipolar disorder can sometimes lead to crises, such as suicidal thoughts or actions. Be ready with a crisis plan that can guide you during an emergency. This plan might include: Contact information for doctors and therapists Emergency contact numbers Steps to take during an episode, like removing access to harmful objects or substances Instructions for when to seek professional help or hospitalization Take care of yourself Be careful not to let your support for your loved one negatively impact your own mental health. It's good to be there for them, but important to also look out for yourself. There are ways to prioritize your mental health which include: Talk therapy Talking to a therapist may be helpful for you. Therapy can give you tools to manage stress and emotional exhaustion. Try a support group You're not alone in supporting a loved one with bipolar disorder. Seek out others going through the same thing and connect with them either in person or online. They may be able to share insights on how to take care of yourself, or give you the encouragement to keep going. Prioritize self-care Decide what you need to feel relaxed and recharged. For some it could mean taking a beach day, and for others, unwinding by playing video games. These acts of self-care could keep you from feeling burnt out. Know your limits There is only so much you can do. Recognize when you need to step back and take a break. Consider whether it's time for you to see a therapist for help in getting to a better place. Accept your loved one's limits Your loved one may have limitations, especially during an episode. Being patient and showing compassion may be good for your relationship, but it may not be enough. It’s important to understand and accept their limits just as you work to understand and accept your own. Start your wellness journey with Cerebral Consider joining Cerebral to connect with a compassionate, credentialed therapist who can provide the support you deserve. We’re here to help you create a personalized treatment plan and provide the tools and care needed to prioritize your mental health while continuing to be there for your friend or loved one.  Image by Helena Lopes on Pexels.

Understanding the differences between bipolar disorder and borderline personality disorder (BPD) can be challenging. Both conditions affect mood and behavior but have distinct characteristics and may respond to different treatment approaches. In this informative guide, we'll explore what sets these two disorders apart, how they're similar, how they're diagnosed, and how you can get affordable, convenient mental healthcare. {MiniWidget:Bipolar} What is bipolar disorder? Bipolar disorder is a mental health condition characterized by extreme mood changes that include emotional highs (mania or hypomania) and lows (depression). These mood changes can affect sleep, energy, behavior, and the ability to think clearly, ultimately impacting daily life overall. Types of bipolar disorder There are 3 types of bipolar disorder that are differentiated by the nature and intensity of the mood episodes experienced, including the duration and pattern of manic, hypomanic, and depressive episodes. Those types of bipolar disorder are: Bipolar I disorder: This type involves severe mood episodes from mania to depression. Mania is a state of heightened mood, activity, or energy levels that last for at least 7 days or requires hospitalization. Bipolar II disorder: In this type, individuals experience depressive episodes and hypomanic episodes, which are less severe than full-blown manic episodes. Cyclothymic disorder: This is a milder form of bipolar disorder, with periods of hypomanic symptoms and depressive symptoms lasting for at least 2 years in adults (1 year in children and adolescents), but the symptoms do not meet the diagnostic criteria for a hypomanic episode and a depressive episode. It's important to consult with a mental health professional if you or someone you know is experiencing symptoms that align with any of these types of bipolar disorder.  Symptoms of bipolar disorder Symptoms can vary widely between individuals and can range from mild to severe.  Symptoms of mania include: Increased energy, activity, and restlessness Excessively euphoric mood Extreme irritability Rapid speech and racing thoughts  Poor concentration Little need for sleep Unrealistic beliefs in one's abilities and powers Impulsiveness and risk-taking behaviors Symptoms of depression include: Lasting sad, anxious, or empty mood Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Loss of interest in activities once enjoyed Decreased energy or fatigue Difficulty concentrating, remembering, or making decisions Restlessness or irritability Sleeping too much or inability to sleep Appetite or weight changes Chronic pain or other persistent physical symptoms not caused by illness or injury Thoughts of suicide or death, or suicide attempts Understanding these symptoms can help in identifying the condition early and seeking timely intervention. Bipolar disorder treatment options  When it comes to managing bipolar disorder, a multi-faceted approach is often recommended. Treatment typically involves a combination of medications and psychotherapy, tailored to meet the specific needs of the individual.  Medication: Common medications include mood stabilizers and antipsychotic medications. Therapy: Psychotherapy, such as cognitive behavioral therapy (CBT), can help manage symptoms by addressing negative thought patterns and behaviors. Seeing a therapist who specializes in interpersonal and social rhythm therapy (IPSRT), family therapy, or psychoeducation can also be beneficial for those affected by bipolar disorder and their loved ones. Early diagnosis and adherence to a treatment plan can help stabilize mood and reduce the risk of relapse. Each person's experience with bipolar disorder is unique, and understanding the various treatment options can empower individuals to manage their mental health. What is borderline personality disorder? Borderline personality disorder (BPD) is a mental health disorder characterized by intense emotional instability, impulsive behaviors, and difficulties in maintaining interpersonal relationships. This instability often disrupts family, work, and/or daily life, long-term planning, and the individual’s sense of self-identity.  Symptoms of BPD BPD symptoms often manifest in ways that significantly impact an individual’s daily life and relationships. The signs include: Intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection. A pattern of unstable, intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel. Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all. Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours. Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating, or drug abuse. Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection. Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame, or anxiety. Ongoing feelings of emptiness, being emotionally numb, disconnected, or incomplete, leading to constant seeking of external validation or stimulation to fill this void.  Inappropriate, intense anger, such as frequently losing your temper, being bitter, or having physical fights. Seek professional help if you or someone you know is exhibiting signs of this condition. BPD requires careful diagnosis and tailored treatment plans. Treatment options for BPD Treating BPD involves a comprehensive and individualized approach aimed at addressing the diverse range of symptoms associated with the condition. Given the complexity and intensity of BPD, a combination of therapeutic methods is often necessary to achieve the best outcomes.  Medication: Antidepressants, antipsychotics, or mood stabilizers may help with symptoms of BPD, but they generally aren’t used as the primary way to treat the condition. Therapy: Dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), schema-focused therapy, and mentalization-based therapy are effective forms of psychotherapy for BPD. DBT, in particular, is designed specifically for people with BPD and focuses on teaching skills to cope with stress, regulate emotions, and improve relationships with others. Understanding the available treatment options can provide those affected with tools and support to manage their symptoms and lead more balanced lives.  Key differences between bipolar and BPD While bipolar disorder and BPD share some overlapping symptoms, they are distinct in several ways. When impulsive behaviors occur In bipolar disorder, impulsive behaviors usually occur during manic or hypomanic episodes. In contrast, individuals with BPD may exhibit impulsive behavior more consistently, at any time, and the behaviors are often triggered by fear of abandonment or rejection. Sleep People with bipolar disorder often experience changes in sleep patterns, with manic episodes usually involving a decreased need for sleep, while depressive episodes may involve excessive sleeping. Those with BPD may also have sleep disturbances, but these are usually related to stress or emotional turmoil rather than distinct episodes. Length of episodes Bipolar disorder is characterized by distinct periods of mania or hypomania and depression that can last for days, weeks, or even months. BPD mood swings are often shorter, more rapid, and can fluctuate within a single day. Relationships Those with bipolar disorder may experience relationship difficulties during mood episodes but not necessarily at other times. Conversely, people with BPD often have intense and unstable relationships that are marked by idealization and devaluation.  Triggers Bipolar mood shifts often don’t have a clear trigger and can occur spontaneously. For individuals with BPD, mood swings are usually triggered by interpersonal stressors and perceived abandonment. Self-harm While self-harming behaviors can also occur in bipolar disorder, it's typically linked to severe depressive episodes. These behaviors, however, are more common in BPD as a coping mechanism for emotional pain or as a way to express anger or frustration. Self-esteem Self-esteem can fluctuate with bipolar mood episodes, often inflated during manic phases and severely diminished during depressive phases. In contrast, Individuals with BPD often struggle with self-esteem, as it’s typically low and unstable due to it being heavily influenced by perceived rejection or failure. Diagnosing borderline personality vs. bipolar  Mental health professionals use a combination of clinical interviews, patient history, and symptom assessment to differentiate between BPD and bipolar disorder. Clinical interviews: These involve detailed conversations with the patient to understand their symptoms, duration, and impact on daily life. Patient history: Understanding the patient’s personal and family mental health history helps in identifying patterns and potential genetic factors. Symptom assessment: Standardized assessment tools and questionnaires can aid in evaluating the specific symptoms and their severity. Collaboration with mental healthcare providers will help you get a comprehensive assessment and personalized treatment options. How Cerebral can help Online mental health services like Cerebral can help in managing both bipolar disorder and BPD. Cerebral offers convenient access to therapy and medication management, making it easier for individuals to get the help they need without the barriers of traditional in-person visits. Some of the many benefits include:  Accessibility: Clients can access care from the comfort of their homes. Flexibility: Cerebral offers flexible scheduling, accommodating busy lifestyles and reducing the need for time off work or school. Continuity of care: Cerebral provides ongoing support and access to providers. Privacy: Virtual consultations offer a level of privacy that some patients may find more comfortable than visiting a physical location. While bipolar disorder and borderline personality disorder share some similarities, they are distinct conditions that require different treatment approaches. Understanding these differences can help in getting a diagnosis and personalized treatment. Cerebral can help you get just that. Sign up today. Images by freepik, master1305, and drobotdean on Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

One morning, you wake up feeling invincible, like you can conquer the world. Your mind races, and your energy seems to know no bounds for a period of time. Then, down the line, you find yourself unable to get out of bed, overwhelmed by a crushing sense of hopelessness. The dramatic shifts of bipolar episodes can be disorienting and draining. Bipolar disorder is a complex mental health condition that requires careful management and understanding. By identifying the triggers that set off mood episodes, you can take proactive steps to reduce their impact. This informational guide can help you understand the different types of bipolar disorder, recognize the symptoms, identify common triggers, and address these triggers with coping strategies. {MiniWidget:Bipolar} Types of bipolar disorder Bipolar disorder is a mental health condition characterized by noticeable shifts in mood, energy, and activity levels from the person’s usual baseline. These changes range from periods of highly elevated, irritable, or energetic behavior (manic or hypomanic episodes) to very low, sad, detached, or hopeless periods (depressive episodes). There are different types of bipolar disorder, each with its unique pattern of mood swings. Bipolar I disorder Bipolar I disorder involves manic episodes that last at least 7 days or are so severe that immediate hospital care is needed. Depressive episodes also occur, typically lasting at least 2 weeks. These episodes can be extremely intense and disruptive to daily life. Bipolar II disorder Bipolar II disorder is defined by a pattern of depressive episodes and hypomanic episodes, which are less severe than the manic episodes in bipolar I disorder. Hypomanic episodes can vary in how they impair your daily functioning, but the depressive episodes can be very challenging. Cyclothymic disorder Cyclothymic disorder involves periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode or a depressive episode. Symptoms of bipolar disorder Recognizing the symptoms of bipolar disorder can help you manage the condition. Varying widely, the symptoms could affect every aspect of your life. Signs of a manic episode Increased energy or activity levels Euphoric or irritable mood Racing thoughts or rapid speech Decreased need for sleep Unrealistic beliefs in one’s abilities Distractibility Impulsive behavior Symptoms of depression Feeling sad, empty, or hopeless persistently Loss of interest or pleasure in most activities Fatigue or loss of energy Feelings of worthlessness or excessive guilt Difficulty concentrating, remembering things, or making decisions Changes in appetite or weight Thoughts of suicide or death If you're thinking about acting on suicidal thoughts, reach out for help immediately.  Call 911 if you’re having a mental health emergency. Text HOME to 741-741 if you're emotionally distressed and need immediate support. Call 988 for the National Suicide Prevention Hotline Common triggers for bipolar episodes Understanding the potential contributors of bipolar episodes can help you avoid or manage triggers more effectively. Here are some common reasons an episode is triggered: Stress Stressful life events, whether positive or negative, can trigger mood episodes. This includes work-related stress, relationship problems, or significant life changes such as moving or changing jobs. Lack of sleep Sleep disturbances can trigger both manic and depressive episodes. It's crucial to establish a regular sleep routine and ensure you get enough restful sleep each night. Medications Certain medications, especially antidepressants, can trigger manic episodes in people with bipolar disorder. Always consult your doctor before starting or stopping any medication. Negative life events Traumatic events or significant losses, such as the death of a loved one or a divorce, can trigger depressive episodes. It's important to seek support during these times. Drug or alcohol use Substance abuse can exacerbate bipolar symptoms and trigger episodes. Avoiding drugs and limiting or stopping alcohol use can help you manage bipolar disorder more effectively. Explore more: Can I Drink Alcohol With Bipolar Disorder? Seasonal changes Changes in seasons, especially the transition to winter, can trigger depressive episodes. Light therapy or other interventions can help manage symptoms of seasonal affective disorder (SAD). Hormonal changes Hormonal fluctuations, such as those experienced during pregnancy or menopause, can affect mood stability. It's important to monitor these changes and seek medical advice if needed. Co-occurring medical conditions Other health conditions, such as thyroid disorders or chronic illnesses, can influence bipolar symptoms. Regular medical check-ups can help you manage these conditions. How to manage triggers Managing triggers to reduce or avoid bipolar mood episodes is a critical part of achieving a balanced life with bipolar disorder. Here are some strategies to help you manage these triggers and reduce the likelihood of episodes: Stay on your medications Adhering to your prescribed medication regimen is crucial for maintaining mood stability. Never stop taking your medications without consulting your healthcare provider. Stick to a healthy routine Maintaining a consistent routine, including regular meal times, exercise, and sleep schedules, can help stabilize one's mood. Get enough sleep Prioritize getting good rest every night. Create a relaxing bedtime routine and make your sleep environment comfortable. Manage stress Implement stress-reducing techniques such as mindfulness, yoga, or deep-breathing exercises. Learning how to manage stress effectively can prevent it from triggering mood episodes. Avoid drugs and alcohol Substance use can destabilize your mood and trigger episodes. It's important to stay away from drugs and alcohol and seek help if you struggle with substance abuse. Grow your support network Having solid support from friends, family, and support groups can provide emotional comfort and practical help. Don’t hesitate to reach out when you need someone. Talk to a therapist Regular therapy sessions can help you manage triggers and develop coping strategies. Cognitive behavioral therapy (CBT) and other therapeutic approaches can be particularly effective for people with bipolar disorder. Explore more: A Guide to Finding A Therapist For Bipolar Disorder The role of online mental health services By expanding access, online mental health services have become a valuable resource for managing bipolar disorder. Cerebral provides several benefits, including: Convenience: Access therapy and medication guidance from the comfort of your home. Flexibility: Schedule sessions at times that work best for you — days, nights, or weekends — without the need to travel. Accessibility: Connect with state-licensed therapists and mental health professionals from wherever you are in your state. Lower costs: Cerebral patients can save up to 80% on some  prescription medications, and the cost per therapy session is lower than traditional, in-person therapy on average. Cerebral offers online therapy and virtual medication management, making getting the help you need when you need it more accessible. Understanding and managing the triggers for bipolar episodes can help you maintain stability and improve your quality of life. By recognizing the common reasons mood episodes are triggered and implementing strategies to manage those triggers, you can reduce the frequency and severity of mood episodes. With the tools and support, you can lead a fulfilling life. Take the first step: Sign up to schedule your first session, where our mental health experts can better understand your current condition and collaborate with you on a personalized treatment plan. Images by freepik, Drazen Zigic, and ansiia on Freepik. *The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.