Why It’s Hard to Diagnose Bipolar Disorder

Finding the right bipolar disorder treatment path for you can be empowering. This guide can help you simplify the process of finding a therapist. In it, you’ll learn about the therapy types, the advantages of therapy for bipolar disorder treatment, how in-person and online therapy compare, and advice on how to select the best therapist for you.  The types of therapy used for bipolar disorder Often used in conjunction with medication, therapy can play a supporting role in the management of bipolar symptoms by helping individuals explore their experiences, thoughts, feelings, and behaviors under the guidance of a trained professional. Since the disorder affects each person differently, various therapeutic approaches allow for personalized care plans that address specific challenges, triggers, and symptoms. The goal of therapy is not only to manage bipolar symptoms but also to enhance overall quality of life, empower individuals with coping strategies, and support long-term stability. Cognitive behavioral therapy (CBT) CBT is a structured form of talk therapy that has been shown to be effective in helping individuals with bipolar disorder to better manage their symptoms by examining and changing thought patterns, emotions, and behaviors. It typically involves identifying negative thought processes and learning how to replace them with more positive ones. CBT may also involve developing coping strategies and stress management techniques. Free resource: CBT Thought Record Exercise Worksheet Dialectical behavioral therapy (DBT) Often used in conjunction with other therapies, DBT is a more focused offshoot of CBT that concentrates on managing the intense emotions and mood swings associated with bipolar disorder. It achieves this by combining standard cognitive-behavioral techniques with core concepts of distress tolerance, mindfulness, emotional regulation, and interpersonal effectiveness. Learn more: DBT Distress Tolerance Skills for Emotional Crisis Family-focused therapy (FFT) FFT is not just about the individual; it involves the whole family. It educates, supports, and teaches family members effective and constructive ways to interact with the individual with bipolar disorder to create a nurturing and empathetic environment. This type of therapy may also involve addressing family dynamics and communication patterns to improve relationships and promote healing. Interpersonal and social rhythm therapy (IPSRT) IPSRT is an evidence-based approach developed specifically for the treatment of bipolar disorder. Its focus is on balancing social routines and mood symptoms while also developing strategies to improve social skills and stabilize mood. ​​This therapy could be especially helpful for those seeking to consistently maintain daily routines and manage the disruptions in social relationships that can come with bipolar disorder. How therapy can help those with bipolar  Why should you choose therapy? Here's the rundown on some of its benefits: Symptom reduction: Therapies like CBT and DBT are shown to reduce the frequency, duration, and severity of bipolar symptoms. Beyond medication: While medication is a standard treatment for bipolar disorder, therapy offers an additional layer of support. Life skills: Therapy can provide individuals with the tools they need to manage their thoughts, emotions, and relationships, which are especially crucial for those with bipolar disorder. Prevention of relapse: Some types of therapy, like IPSRT, help individuals regulate their social rhythms, which can lead to a more stable life and, in turn, reduce the risk of relapse. Incorporating therapy could enhance your overall treatment plan for bipolar disorder. How therapy complements bipolar meds Medication is a fundamental component of bipolar disorder treatment, vital for stabilizing moods and controlling symptoms. However, medication alone may not address all the complexities of the condition. This is where therapy comes into play, serving as a complementary approach. By participating in therapy, individuals not only work toward managing their symptoms but also develop crucial life skills and coping strategies. These skills help address daily challenges and reduce the impact of stressors that could trigger episodes. Medication brings chemical imbalances under control, laying a foundation for emotional and psychological stability. Meanwhile, therapeutic interventions build on this stability, focusing on the behavioral, cognitive, and emotional aspects of bipolar disorder. This integrated approach can empower you to take control of the entirety of your experience with bipolar disorder, paving the way for a more balanced and fulfilling life. In-person vs. online therapy The traditional in-person therapy model has been a go-to for mental healthcare, but online therapy is quickly becoming very popular. Let’s compare the two. In-person therapy is a traditional approach that allows for improved body language reading and environment control but comes at the cost of being more expensive and less convenient. Online therapy offers accessibility and affordability while still implementing proven therapeutic modalities. Without all the overhead that comes with running an office, online mental health providers like Cerebral can pass along savings to clients. Online therapy can also save you time because there aren’t as many scheduling limitations — plus, there’s no need to commute!  How to find a therapist Selecting a therapist for your bipolar disorder care will take some research. Here are some avenues to explore: Online resources: Services like Psychology Today's directory or Cerebral’s network of online therapists can offer detailed profiles. Get a referral: Your primary care physician or psychiatrist can usually provide a list of recommended therapists. Friends and family: Reach out to friends and family who have positive experiences with therapy, especially if they have the same diagnosis. Check patient organizations: Organizations like the National Alliance on Mental Illness (NAMI) can be excellent resources for finding local support and therapy options. Community centers: Local mental health centers often have a network of resources and professionals. Exploring various options and communicating openly with potential therapists will help you establish a therapeutic relationship that feels like the right match for you. A good fit can make all the difference in your therapy experience and overall treatment success. Things to look for in a therapist Once you have a list of potential therapists, how do you narrow down your options? Look for the following: Affiliations: Is the therapist part of any recognized mental health organizations or networks? Specialties: A therapist with a specific focus on bipolar disorder will likely have more experience treating it. Reviews and ratings: While not definitive, online reviews can provide insights into others’ experiences. Initial consultation: Meeting a therapist for a session can give you a feel for how you might benefit from their approach. When searching for quality care from a credentialed therapist, prioritize experience with bipolar disorder, good communication skills, and a therapeutic practice that resonates with you. What to ask a potential therapist Being prepared with the right questions helps clarify the process. Be sure to ask: Are they accepting new patients?  Do they take your insurance?  Can they coordinate with your doctor or psychiatrist? What’s their background and training in bipolar disorder like? You’ll also want to know what a typical therapy session looks like and how they measure progress toward your goals and motivations for going to therapy. How to know if a therapist is a good fit for you It's important to recognize when you've found a good relationship with a therapist so you can keep building on the work you do together. Signs that you're on the right track include: They’re responsive to your needs. A good therapist will demonstrate having heard and understood you by responding to your concerns and listening to you.  They foster a sense of trust and safety. You’ll need to feel comfortable sharing many things with them, so you should feel that they’ve created a safe, judgment-free environment where you can be open and work through issues and concerns. You see progress. After an appropriate number of sessions, which varies from person to person, you should begin to notice improvement and benefits from your sessions, tailored to your personal timeline and needs. Identifying these positive signs can help you feel assured in your choice of therapist, fostering a rewarding and supportive therapeutic relationship. Why Cerebral might be a good fit for you If you’re looking for convenience, flexibility, and affordability while still getting access to top-rated licensed therapists, Cerebral could be the right choice for you. We’re committed to helping you find the best fit for you. With Cerebral, you’ll have access to a diverse group of mental health care professionals, and we take your preferences into account. Not only can we match you with a therapist who has experience with bipolar disorder, but preferences around an ethnic background, age range, LGBTQIA+ experience, and gender can also be factored in. Plus, you can switch therapists for any reason, at any time. We offer online therapy sessions at times that suit you best — during the day, at night, or over the weekend — allowing you to focus on your mental health without impacting your day-to-day responsibilities. When mood episodes can already cause interruptions in one’s daily life, this flexibility can be an advantage for bipolar individuals. The ability to join sessions from the privacy and comfort of your own home can also be a significant benefit. It’s not uncommon to feel unmotivated during depressive episodes, and the effort, stress, and time it takes to travel to a therapist’s office could be a barrier during those periods. With Cerebral, you can engage in meaningful therapy sessions wherever you are most comfortable. Being in a familiar private space could also help you feel freer to open up and discuss your feelings from the start. Additionally, we have a large network of top-tier licensed prescribers, allowing you to also manage your bipolar medication online from one central place under one affordable subscription with free expedited shipping. Want to give Cerebral a try? Schedule your first session today. Images by freepik and freepik 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.

People managing bipolar disorder may explore different options when seeking to achieve mental balance, including self-medication. With the rise in marijuana being used to treat other conditions, you may be curious and searching for answers about its effects on bipolar disorder. But here's the blunt truth: Research overwhelmingly points to negative outcomes that outweigh any temporary relief its use could potentially provide. Drawing on research, we’ll outline how smoking weed or taking edibles may affect symptoms, impact medication, and lead to other risks. How marijuana affects bipolar symptoms Bipolar disorder is characterized by significant mood swings, including manic highs and depressive lows. Introducing marijuana into this already unpredictable mix can make symptoms and episodes worse. Marijuana makes bipolar symptoms worse People with bipolar disorder may turn to marijuana in an attempt to relieve their symptoms, but it may have the opposite effect. Mania or hypomania During manic phases, dopamine levels are already high, contributing to heightened excitement and impulsivity. When THC (tetrahydrocannabinol) is introduced into your system, it can further increase dopamine levels, potentially intensifying these manic symptoms. This surge can lead to: An escalation in risk-taking behaviors Decreased need for sleep More pronounced mood swings Heightened manic symptoms can disrupt the balance needed to manage bipolar disorder. Depression While it’s often associated with feelings of calm and relaxation, marijuana can also induce feelings of depression in certain individuals. This unexpected outcome is believed to arise from THC's effects on the brain's endocannabinoid system, which is instrumental in regulating emotions and stress. THC's psychoactive properties can further imbalance critical mood-regulating neurotransmitters like serotonin and dopamine. Instead of alleviating the symptoms of bipolar depression, marijuana can intensify feelings of sadness, loneliness, and hopelessness, amplifying existing negative emotional states and thought patterns. Anxiety Marijuana can induce feelings of paranoia and anxiety in some individuals. For those with bipolar disorder, this can be particularly problematic as they often experience anxiety, too. Overall, research suggests that bipolar symptoms will intensify or last longer with marijuana use. One study published in the Journal of Affective Disorders observed that some patients with bipolar disorder reported longer periods of worsened symptoms after marijuana use. Early research also indicates that there’s no advantage in using THC therapeutics for depression or CBD treatments for mania. Why this is important: The unpredictability of marijuana's effects can make mood states more difficult to manage and predict, complicating treatment and recovery efforts. Cognitive effects of marijuana use One of the many concerning effects of marijuana use is its impact on cognitive functions like memory and attention, which can already be affected by bipolar disorder’s symptoms. Use can also influence coordination and reflexes. These cognitive effects can exacerbate the challenges that bipolar disorder’s shifts in thinking and daily functioning present, including: Declined memory: Research indicates that marijuana use, particularly long-term or heavy use, can impair both short- and long-term memory.  Reduced attention and concentration: Marijuana can also affect an individual’s ability to focus, pay attention, and process information efficiently.  The effects of marijuana also extend to psychomotor skills, impairing coordination and slowing reflexes. For someone with bipolar disorder, these effects could make managing medication schedules more difficult, present challenges with school or work tasks, and increase their risk of accidents and injuries. Marijuana interferes with medication Individuals with bipolar disorder often rely on mood stabilizers like lithium or antipsychotics, which are processed by liver enzymes. The active compounds in marijuana, THC and cannabidiol (CBD), can interfere with these enzymes, potentially causing medications to reach dangerously high levels or fluctuate unpredictably in the bloodstream. What this means: Elevated levels of mood stabilizers might lead to toxicity, while insufficient levels may fail to prevent mood swings. Additionally, marijuana use can intensify the sedative effects of bipolar medications, further impairing daily functioning. To help avoid safety issues and unpredictable outcomes, individuals with bipolar disorder should discuss any marijuana use with their healthcare provider. Marijuana use can lead to symptoms of psychosis Some bipolar individuals are already at risk of experiencing psychosis. THC, the active component in marijuana, could trigger psychotic symptoms by interacting with the brain's cannabinoid receptors, affecting mood, perception, and cognition. People with bipolar disorder have brain chemistry and mood regulation mechanisms that are already affected. Introducing THC can disrupt neural pathways further, increasing the risk of experiencing psychotic episodes for some. For those who experience psychosis, symptoms such as hallucinations, delusions, or disorganized thinking could worsen. The association between marijuana use and psychosis is particularly significant for those with a family history of psychotic disorders. Explore more: What You Should Know About Bipolar Psychosis It can increase the frequency of bipolar episodes Marijuana's impact on the brain can destabilize a person's mood, potentially triggering more frequent and intense episodes. THC can disturb the brain's natural mood regulation by affecting neurotransmitters like dopamine and serotonin. This disruption can lead to more frequent and severe mood swings, amplifying the underlying mood instability associated with bipolar disorder. By affecting the brain’s natural mood regulators, marijuana can lead individuals to cycle back and forth between mania and depression, which can make it challenging to manage bipolar disorder. The bottom line: Marijuana's effects can make it more difficult to maintain emotional stability. It may increase the risk of suicide Marijuana use could worsen the condition by increasing suicidal thoughts and behaviors. Bipolar disorder inherently raises the risk of suicide due to its severe mood fluctuations. When marijuana is used, it can intensify depressive symptoms, making the lows feel even more profound and unbearable. Why this is important: Major depressive episodes can be strongly linked to suicidal thoughts and behaviors. Reliance on the substance for relief could also potentially lead to a vicious cycle of dependency and heightened despair and hopelessness, thereby elevating the risk of suicide. Professional guidance is vital for managing the condition safely, and self-medication practices that could lead to more severe outcomes should be avoided. Other effects of marijuana use While marijuana can be regarded for its therapeutic properties, it's important to recognize that regular use has its own set of health risks, too. Specific examples of how marijuana can negatively impact someone's health include: Cardiovascular health: Marijuana use increases heart rate and blood pressure shortly after use, which can be particularly concerning for individuals with pre-existing heart conditions. Over time, this elevated strain on the cardiovascular system could increase the risk of heart-related issues. Respiratory problems: Smoking weed can harm the respiratory system, similar to how smoking cigarettes does. Regular marijuana smokers may experience chronic bronchitis, lung irritation, and an increased risk of respiratory infections. It's critical to consider the added burden of managing a physical health complication on top of a mental health condition. Can marijuana increase the chance of becoming bipolar? While marijuana use has not been definitively linked to causing bipolar disorder, it can potentially act as a trigger for bipolar episodes due to its impact on the developing brain. Studies show that using the drug can increase your chance of developing bipolar disorder as well as producing an earlier onset of the condition.  Research published in JAMA Psychiatry found that marijuana use raises the risk of developing bipolar disorder, and its use also increases the risk of bipolar psychosis even more.  A study in the Journal of Affective Disorders suggested that individuals who use marijuana may experience the onset of bipolar symptoms earlier than those who do not use the drug.  Research in the American Journal of Psychiatry indicates that individuals with certain genetic markers for bipolar disorder are more susceptible to the mood-altering effects of THC, suggesting a genetic basis for the adverse outcomes observed in some cases. Given the potential for the drug to interfere with bipolar disorder management, a careful and individualized approach to treatment and counseling is warranted. For individuals with a genetic predisposition to mental health conditions like bipolar, marijuana use should be approached with extreme caution. How bipolar disorder is treated Treating this disorder requires a multifaceted approach that typically involves a combination of medication, therapy, and lifestyle adjustments.  Medication Bipolar disorder treatment typically includes mood-stabilizing medication tailored to each patient's unique needs to manage the cycles of highs and lows. Lithium and other anticonvulsants are common in stabilizing moods. Antipsychotics may be prescribed for episodes. What works best can differ between people, but a licensed prescriber can help you develop a medication regimen that alleviates your bipolar symptoms.  Therapy In-person or online therapy can help you recognize triggers and develop coping mechanisms without relying on substances like marijuana. It also supports the development of a healthy daily routine, which is crucial for managing the mood swings common in bipolar disorder. Why this is important: Lowering the intensity of mood episodes could help reduce the desire to look to alternatives for symptom relief.  Lifestyle adjustments Equally important are lifestyle adjustments that promote health and balance while managing bipolar symptoms. This can include having a set daily routine, getting regular exercise, eating a balanced diet, and getting enough sleep. Since substance use can be a trigger, avoiding or limiting use may be vital to maintaining your mental and physical well-being. The goal of treatment is to manage symptoms, reduce the frequency and intensity of mood swings, and help you lead a more stable and fulfilling life. Learn more: Treatment Options for Bipolar Disorder The risks outweigh potential benefits Marijuana use complicates an already complex illness and treatment process. It can potentially lead to worse bipolar symptoms, medication issues, and an increased risk of suicide, psychosis, and other health problems. If you haven’t been diagnosed but are wondering about your mental health status, the use of marijuana could potentially act as a catalyst, increasing the chances of the disorder’s onset. People with bipolar are already at a higher risk of developing substance use disorder due to their brain's reward system's altered functioning. Adding marijuana into the mix can further increase the likelihood of developing this disorder. The most important action you can take is to seek professional advice and have an open, honest conversation about the risks of marijuana use. With that knowledge, you can make informed decisions that lead to long-term mental wellness and stability. If you’re managing bipolar disorder and weighing the effects of marijuana use, our care team — including licensed prescribers, online therapists, and care counselors — will work with you to address your mental health needs and substance use concerns. With Cerebral, you can get personalized therapy and work with a licensed professional to manage your medication all from the comfort and privacy of your home. Images by freepik, freepik, and freepik 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.

The Differences Between Bipolar Disorder and ADHD Understanding mental health conditions is crucial, especially when disorders can share similar symptoms yet require different approaches for management. Bipolar disorder and ADHD are two conditions that can look like one another. In this explanatory guide, we'll unravel the nuances of these conditions to help you distinguish between them. What is bipolar disorder? Bipolar disorder is a complex mental health condition characterized by extreme shifts in mood, energy levels, thinking, and the ability to function. Previously known as manic depression, bipolar disorder can vary from person to person in its severity and combination of symptoms. These shifts are called mood episodes and are distinctly different from the person's usual state. Types of bipolar disorder Bipolar disorder is divided into several subtypes, with the most common being bipolar I and bipolar II, along with cyclothymia, which is a milder form. Bipolar I disorder involves episodes of severe mania that last at least 1 week, sometimes requiring hospitalization. There may also be depressive episodes, typically lasting 2 weeks or more. Bipolar II disorder is characterized by a pattern of depressive episodes and hypomanic episodes, which are less severe than full-blown mania. Cyclothymia (also known as cyclothymic disorder) features numerous periods of hypomanic symptoms and depressive symptoms that last for at least 2 years, with no more than 2 months of stable moods in between. Bipolar symptoms  When a person is experiencing a manic episode, they may feel euphoric and full of energy. Symptoms of mania include:  Increased energy and activity levels, both physically and mentally Elevated mood or extreme irritability Racing thoughts and talking fast Trouble focusing, easily distracted, and prone to forgetting Little need for sleep Impulsiveness Poor judgment Depressive episodes, on the other hand, can lead to feelings of hopelessness, loss of energy, and thoughts of suicide. Symptoms of depression include:  Persistent feelings of sadness, anxiety, or emptiness A lack of interest in hobbies Fatigue or lack of energy physically and/or mentally Trouble concentrating or remaining motivated Poor memory Difficulty making decisions Changes in appetite Suicidal thoughts or behaviors Bipolar disorder treatment options Treatments for bipolar disorder focus on managing the intensity and duration of mood episodes. This may include a combination of medication and therapy. Mood stabilizers and antipsychotics are common for managing bipolar disorder's mood swings. Therapy, particularly cognitive behavioral therapy (CBT), can help individuals understand and manage their condition's social and psychological aspects. Explore more: Treatment Options for Bipolar Disorder What is ADHD? Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects the ability to pay attention and control impulsive behaviors. It can also cause hyperactivity, which can be challenging to manage. ADHD symptoms The symptoms of ADHD are typically grouped into two categories: inattention and hyperactivity-impulsivity. These symptoms are often present in childhood and can persist into adulthood. Manic symptoms can look like ADHD because they include: High physical and mental energy levels that manifest in ADHD-like restlessness Rapid speech and thought Racing ideas and constant activity Trouble concentrating and/or remembering plans, to-do’s, and commitments  Depressive symptoms can also mimic these symptoms of ADHD: Difficulties with focus and attention due to a depressed mood Lack of energy, leading to reduced activity both physically and mentally Low self-esteem that affects motivation and confidence ADHD treatment options ADHD treatment typically involves a multifaceted approach, including medication, lifestyle modifications, and counseling. When exploring medication options for ADHD, it's essential to engage in a thorough discussion with healthcare providers about the full spectrum of treatment possibilities that might suit your needs. One avenue in managing ADHD symptoms involves non-stimulant medication options. These alternatives work differently from stimulants, focusing on increasing levels of certain neurotransmitters in the brain. Behavior therapy, family therapy, and support groups can benefit someone diagnosed with ADHD and their family members. These therapies can help a person with ADHD implement organizational habits, develop social skills, and manage disruptive behaviors. Key differences between bipolar and ADHD While there are similarities between ADHD and bipolar disorder, there are distinct differences that can help distinguish one from the other, including: Age of onset: ADHD typically presents in childhood, with symptoms appearing before the age of 12. On the other hand, bipolar disorder often develops in late adolescence or early adulthood. Nature of symptoms: The symptoms of bipolar disorder are characterized by distinct cyclical periods of mania and depression that can last for weeks or longer. In contrast, ADHD symptoms tend to be more chronic and less episodic. However, they may fluctuate in intensity. Triggers: Environmental triggers are more commonly linked to mood episodes in bipolar disorder, whereas external situations don’t impact symptoms of ADHD. Diagnosing ADHD vs. bipolar disorder Proper diagnosis of either disorder helps select a course of action for managing symptoms. However, due to the complexity of symptoms and their potential overlap, making an ADHD or bipolar diagnosis can be challenging. It often involves: A comprehensive assessment of symptoms and family history The ruling out of other conditions that could be causing similar symptoms Psychological and cognitive testing to evaluate cognitive and behavioral patterns Can you have ADHD and bipolar disorder? Yes, ADHD and bipolar disorder can occur together, particularly in adults. This presents a unique diagnostic and treatment challenge, as both conditions may need to be addressed simultaneously. Management strategies include: Careful consideration of medication to avoid making symptoms worse Education and regular monitoring to manage symptoms  A collaborative approach between the patient and any medical and/or mental health professionals involved Seeking treatment for bipolar and/or ADHD If you suspect you have either or both conditions, seeking professional help is important, as early diagnosis and intervention can significantly improve outcomes. With Cerebral’s online therapy and medication management services, you can get personalized treatment from the comfort of your home. Our highly-rated mental health professionals will help you understand your condition, implement coping strategies, develop a treatment plan, and provide the support you deserve through all the phases of treatment. Images via DC Studio and pressfoto 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.