Bipolar Disorders

College-age young adults, between 18 and 25 years, have the highest prevalence of mental illness (22.1%) and are the least likely to receive mental health treatment - only about a third of those needing services receive it. On college campuses, roughly one-third of students report mental health problems.

Bipolar Disorder and the College Student: A Review and Implications for Universities — Read now

2021 ICD-10-CM Diagnosis Codes: F31- Learn more

Manic Episodes:

• Definition: a distinct period of abnormal and persistently elevated, expansive, or irritable mood AND abnormal and persistent increased goal-directed activity or energy.

• Must represent a noticeable change from normal behavior

• Lasting at least 1 week and present most of the day, nearly every day

• Causes significant impairment in functioning or necessitates hospitalization

• To constitute a manic episode, three or more of the following symptoms are present to a significant degree for at least 1 week, present for most of the day, every day:

  • Inflated self-esteem or grandiosity

  • Decreased need for sleep

  • More talkative than usual

  • Flight of ideas

  • Distractibility

  • Increased goal-directed activity or psychomotor agitation

  • Risky activities (e.g. gambling, risky sex, drug use)

Hypomanic Episodes:

• Definition: a period of abnormally and persistently elevated, expansive, or irritable mood AND persistently increased activity or energy

• Lasting at least 4 consecutive days

• Diagnosis requires at least three other symptoms similar to those in a manic episode BUT to a lesser degree than mania

• Episodes are not severe enough to cause significant impairment in functioning or to necessitate hospitalization

  • While an individual’s functioning is not required to be affected for a diagnosis, it can still affect social and/or occupational functioning.

• An estimated 25% percent of individuals diagnosed with bipolar disorder will attempt suicide at least once in their lives

• Suicide rate for people with bipolar disorder is 15 to 20 times that of the general population

• Greater risk of suicide when an individual has a history of suicide attempt(s) and/or the percent of days spent depressed in the past year

• Suicide or suicide attempt can occur during a manic or depressive episode

Cyclothymia is a diagnosis given to adults who experience at least 2 years (for children, a full year) of both hypomanic and depressive periods without ever fulfilling the criteria for an episode of mania, hypomania, or major depression.

For a diagnosis of Cyclothymia, an individual must experience:

1. Numerous periods with hypomanic symptoms

2. Numerous periods with depressive symptoms

3. Symptoms present for at least two years (one year for children)

4. Not without symptoms for more than two months at a time

5. The criteria for major depressive, manic, or hypomanic episode have never been met

2021 ICD-10-CM Diagnosis Code: F34.0 — Learn more

Medications:

*Drugs often take weeks to take effect.

• Selective Serotonin Reuptake Inhibitors (SSRI’s)

  • These are antidepressants — (caution: SSRI’s can trigger a manic episode)

  • Antidepressants in Bipolar Disorder — Read now

• Lithium

  • This is a mood stabilizer (the most common mood stabilizer for Bipolar disorder)

  • The Role of Lithium in the Treatment of Bipolar Disorder: Convergent Evidence for Neurotrophic Effects as a Unifying Hypothesis — Read now

• Abilify

  • This is an antipsychotic medication

  • The Treatment of Adult Bipolar Disorder with Aripiprazole: A Systematic Review — Read now

Psychotherapy:

• Cognitive-Behavioral Therapy (CBT)

  • Particularly used for depressive episodes.

  • Work on what is called “the negative/cognitive triad” — negative thoughts about the self, the world, and the future.

    • Bipolar Disorder Treatment - Cognitive Behavioral Therapy (CBT) — Read now

• Interpersonal Therapy

  • This is useful because relationships can be greatly affected by bipolar disorders.

  • Treating Bipolar Disorder: A Clinician’s Guide to Interpersonal and Social Rhythm Therapy — Read now

• Family and Marital Therapy

  • This is useful because an individual’s family and marriage can be greatly affected by bipolar disorders.

  • Family-Focused Therapy for Bipolar Disorder: Reflections on 30 Years of Research — Read now

Alternative Treatments:

• Electroconvulsive Therapy (ECT)

  • Electroconvulsive Therapy for Bipolar Disorder in Adults — Read now

• Transcranial Magnetic Stimulation (TMS)

  • Use of Transcranial Magnetic Stimulation in Bipolar Disorder — Read now

• Deep Brain Stimulation (DBS)

  • Deep Brain Stimulation for the Treatment of Refractory Bipolar Disorder — Read now

• Bright Light Therapy

  • Can Light Therapies Help with Bipolar Disorder? — Read now

• Relaxation techniques

  • Such as yoga, breathing, Progressive Muscle Relaxation (PMR), meditation, etc.

  • Meditation and Bipolar Disorder Can Help You Manage Bipolar Disorder — Read now

Relation to College Students:

Although bipolar disorders may not be as common with college students as  anxiety disorders or eating disorders, bipolar disorders are important to know about and understand. This is especially true in light of the fact that it is between the ages of 18-24 that people most often get diagnosed with a bipolar disorder. In addition, this is a category of disorders that is  wildly misunderstood. For those who do experience a bipolar disorder, some of whom may very well be your fellow college students, there are both energetic aspects, called mania, and depressive aspects, called depression, to the disorder. Typically, over the course of a bipolar disorder, an individual will have bouts of increased energy (mania) that can lead them to engage in risky behaviors and, eventually, they will also experience bouts of depression. Typically, there are one or two cycles per year. This can make it difficult for individuals to interact with life in similar ways to those of individuals without bipolar disorder. Since this disorder usually starts to manifest as a young adult, many individuals will be in college when they start to experience the symptoms. This means that, on top of all the stressors that college already brings, an individual that begins to experience symptoms of a bipolar disorder would also have to learn how to navigate this new and foreign thing that, at the time, they might not even know what is happening. Thankfully, bipolar disorders are manageable and, with the right support, medication, and therapy, individuals with bipolar disorders can live a fulfilling life.