Bipolar vs. BPD: How To Tell The Difference

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.

Regardless of the mental health condition, it’s common for someone to wonder if their symptoms will worsen or change over time. Understanding how bipolar disorder, a condition that affects millions of people worldwide, emerges or evolves as one ages can be essential for effective management and treatment. Experiencing bipolar symptoms later in life, especially post-50, presents a unique set of characteristics. That makes it all the more important to understand this condition's trajectory across a lifetime. Here, we’ll explore how bipolar disorder impacts older adults, how symptoms and treatment needs might shift with age, and what you or loved ones could do to help manage these changes. {MiniWidget:Bipolar} Prevalence of bipolar disorder in older adults While bipolar disorder is often diagnosed in younger individuals, the prevalence of bipolar disorder among those in their later years has gained more attention. Studies indicate that about 5-10% of new bipolar disorder diagnoses are in adults over 50, sometimes referred to as ‘late-onset bipolar disorder.’ Why does this happen? It’s likely due to a variety of factors, including symptom overlap with other conditions and evolving views of the importance of mental health. Reasons for misdiagnosis Late-onset bipolar disorder can be challenging to diagnose due to its likelihood to exhibit symptoms differently, the complexity of symptoms, and the presence of other age-related health issues. Bipolar disorder in older adults can present predominantly with depressive episodes. Since these episodes can look very similar to clinical depression, it's not uncommon for the condition to be misdiagnosed as unipolar depression. Additionally, manic phases in those with bipolar disorder who are post-50 might not be as pronounced as in younger individuals. Sometimes, these manic episodes are less about traditional mania and more about irritability or less obvious changes in energy, which can be easily overlooked or misattributed. In some cases, there could be a misdiagnosis of dementia in patients who are actually experiencing bipolar disorder, or vice versa. The overlap in symptoms for both dementia and the depressive or manic phases of bipolar disorder can include: Memory loss Disorientation Impaired executive function  Both dementia and bipolar disorder can include behavioral disturbances, too. In the case of bipolar disorder, these might be part of a manic episode, whereas, in dementia, they could be due to cognitive decline, making the correct diagnosis challenging. Historical stigma and late diagnosis It’s no secret that mental health was heavily stigmatized and a taboo conversation topic in previous decades. Back then, this stigma often prevented individuals from seeking help or even acknowledging mental health issues. As societal understanding and acceptance of mental health issues have improved, more older adults could be seeking treatment for symptoms that may have been present but unaddressed for decades. This shift could explain an increase in diagnoses of late-onset bipolar disorder as well as re-evaluations of misdiagnoses. In short: Reasons for late diagnoses could be that people now in their 50s and beyond grew up during times when psychiatric treatment options weren’t as advanced or as socially accepted as they are today.  Late-onset bipolar disorder Typically diagnosed after the age of 50, late-onset bipolar disorder can present unique challenges and considerations. Unlike early-onset bipolar disorder, which generally appears in adolescence or early adulthood, late-onset bipolar disorder can be influenced by a range of factors.  Why bipolar disorder can develop in later years The development of bipolar disorder in adults age 50 and older can often be explained by the significant changes the brain and body undergo as part of the aging process. Some of the reasons why bipolar disorder might emerge late in life include: Increased biological vulnerability: Age-related physiological changes can make the brain more susceptible to bipolar disorder. Reduced resilience in brain function can lead to an inability to regulate mood effectively. Cumulative health issues: Older adults often have a higher burden of chronic illnesses, which can stress the body and brain, potentially triggering or unmasking psychiatric conditions, including bipolar disorder. Medication-induced: Sometimes, the treatments for other age-related health issues can have side effects that manifest as bipolar symptoms. Certain medications used to treat physical ailments could influence mood regulation or even directly trigger manic or depressive episodes. These triggers could complicate treatment plans, and, in some cases, a multidisciplinary approach to treatment will be needed. Other reasons for showing bipolar symptoms Neurological changes, other medical conditions, and hormonal imbalances can present symptoms that mimic those of bipolar disorder. Other explanations for those signs could include: Brain atrophy: As people age, there can be a general reduction in brain volume and mass. This atrophy can affect neurotransmitter systems, potentially triggering psychiatric symptoms, including those associated with bipolar disorder. Vascular changes: Microvascular disease can cause changes to the brain's small blood vessels, damaging brain tissue that contains nerve fibers and connects to other parts of the brain. This can produce bipolar-like symptoms. Neurodegenerative diseases: Conditions such as Alzheimer's disease or Parkinson's disease can exhibit symptoms that mimic bipolar disorder, such as mood swings and erratic behavior. Stroke and brain injuries: Strokes or traumatic brain injuries can lead to changes in personality and mood regulation, potentially initiating bipolar-like symptoms. Thyroid disorders: Thyroid dysfunctions, which are more common in older adults, can lead to significant mood swings and psychiatric manifestations that resemble bipolar disorder. Other endocrine changes: Changes in hormonal levels due to aging, such as decreases in estrogen or testosterone, can also impact mood and behavior. The complexity of diagnosing the issue could require careful psychological and medical evaluation. How does bipolar change as you age? As individuals step into their later years, the intensity and presentation of bipolar symptoms undergo significant transformations. Let’s explore how aging impacts bipolar disorder. How elderly bipolar symptoms differ Bipolar symptoms can shift with age. For instance, older adults might experience more depressive episodes and fewer manic episodes, or they may find that their episodes are more prolonged than when they were younger. Additionally, research suggests that while the frequency of manic episodes may decrease with age, depressive episodes can become more severe and last longer. This effect of aging on bipolar disorder can significantly impact an individual’s quality of life and requires tailored treatment. Symptoms also could blur into a mixed emotional state, making it challenging to differentiate between mania and depression.  Changes in the brain The impact of age on the brain further complicates the clinical picture. Aging affects brain structure and function, which can make symptoms harder to manage and predict. Studies have pointed to the possibility of accelerated brain aging in those with bipolar disorder, potentially influencing symptom severity and treatment responsiveness. Bipolar disorder and life expectancy Managing bipolar disorder is crucial to maintaining quality of life. People with bipolar disorder may have a shortened lifespan and may experience biological aging at a faster rate. The disorder’s associated behaviors and comorbid conditions such as cardiovascular disease can also impact life expectancy. Additionally, because one could experience more severe depressive episodes in their later years, thoughts of suicide could become more prevalent, increasing the risk of self-harm or suicide attempts. Remember: Seek immediate help if you're ever thinking about acting on suicidal thoughts, in a crisis, or experiencing extreme emotional distress.  Call or text 988 for the National Suicide Prevention Hotline. Call 911 if you’re having a mental health emergency. Text HOME to 741-741 if you're emotionally distressed and need immediate support. Regular monitoring and support for mental health alongside strategies to reduce these risks and maintain safety should be aspects of one’s treatment plan in their later years. It’s also vital for adults in their 50s and above to have routine health screenings and maintain a comprehensive care treatment plan that addresses both mental and physical health. Should treatments for bipolar change as you get older? The short answer: Most likely. As you age, both your body and your brain can undergo significant changes that can alter your symptoms and the way you respond to bipolar treatment options. Because of that, it can become important to make bipolar treatment adjustments in older age to account for these physiological and psychological developments. Let’s explore some of the common modifications people in their 50s and beyond may need to make. Medication for late-onset bipolar With age, the way drugs are processed can be affected in the following ways: Risk of adverse drug reactions: Older adults are more susceptible to side effects from medications due to changes in metabolism and increased sensitivity to drugs. Higher comorbidity rates: The presence of other health conditions often means that the interaction of various medications must be carefully managed to avoid issues. Considering some may experience cognitive decline in their later years, more straightforward medication routines may be needed to make it easier to stick to taking medications while aging with bipolar disorder. Therapy options for older adults with bipolar Therapy can be a cornerstone of treatment at any age. However, the focus might shift towards addressing specific life stage concerns, including retirement, loss of loved ones, and changes in independence. Cognitive behavioral therapy (CBT) and other forms of psychotherapy can be tailored to help cope with the transitions that aging naturally brings. Explore more: A Guide to Finding A Therapist For Bipolar Disorder The importance of complementary care Lifestyle adjustments and non-medical interventions can be a critical addition to finding balance while living with bipolar disorder, including: Seeing social connections and participating in support groups to combat isolation, which can exacerbate symptoms. Keeping a routine to maintain balance. Engaging in regular physical exercise to boost mood and preserve health. Using mindfulness and relaxation techniques, which can help manage stress and promote emotional stability. All of these strategies can enhance quality of life and support overall well-being.  Getting personalized mental health care While aging with bipolar disorder can present new challenges, understanding these changes can lead to better management strategies and a higher quality of life. It's important to consult licensed professionals who can tailor treatment plans with age-associated adjustments. After all, the aging process affects all of us differently. Some may feel and function just like they did in their younger years, while others may have developed health conditions that impact their mobility, ability to drive, or ability to perform daily tasks. Because retirement and aging can bring about many life transitions, you may want to consider online therapy and virtual medication management. Some of the benefits of choosing an online mental health service like Cerebral over traditional in-person visits include: Convenient access to care from the comfort of your home: This is especially helpful if you live in an area with few mental health resources, live in more than one home throughout the year, or have limited mobility.  Frequent monitoring and easier communication with licensed providers: This can be crucial in managing medication adjustments and addressing any emerging issues promptly. An integrated approach that includes both psychiatric medication management and psychotherapy: This holistic approach addresses both the biochemical and psychological aspects of the disorder in a coordinated manner under one simple, affordable monthly payment. Plus, Cerebral offers more flexible scheduling options than traditional in-person visits. This flexibility is particularly beneficial for individuals with bipolar disorder, whose symptoms can fluctuate unpredictably, requiring more frequent support or prompt interventions. Explore more: How Does Cerebral Work? 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.

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.  {MiniWidget:Bipolar} 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.