Bipolar Disorder

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Balancing the extremes

Understanding Bipolar

Bipolar disorder is a chronic condition marked by alternating episodes of elevated mood (mania or hypomania) and depression. These shifts are more extreme than ordinary ups and downs and can impair work, relationships, and daily functioning. The distinction between Bipolar I and II lies in the presence of full mania versus hypomania, not in the seriousness of the condition. Both forms are disabling and require treatment.

Bipolar disorder is one of the most misunderstood mental health conditions. It is frequently misdiagnosed — often as depression, anxiety or personality disorder — because the depressive episodes are often more prominent and the elevated mood states are not always recognized as symptoms. Many people live with bipolar disorder for years before receiving an accurate diagnosis.

Overview

■ Bipolar I: at least one full manic episode (7+ days or hospitalization), often with depression

■ Bipolar II: at least one hypomanic episode (≥4 days) plus major depressive episodes, no full mania

■ Cyclothymia: chronic mood fluctuations with hypomanic and depressive symptoms that do not meet full criteria for episodes, lasting ≥2 years in adults

Causes

The disorder has a strong genetic basis, with heritability among the highest of psychiatric conditions. Brain imaging shows differences in mood‑regulating circuits, and neurotransmitter dysregulation contributes to instability. Early life adversity and environmental stressors can trigger onset in vulnerable individuals.

Symptoms

Mania: elevated/irritable mood, high energy, decreased need for sleep, impulsivity, possible psychosis

Hypomania: elevated/irritable mood and increased energy, noticeable change in functioning, but no psychosis or hospitalization

Depression: sadness, hopelessness, fatigue, appetite/sleep changes, suicidal thoughts

Cyclothymia: chronic mood instability with alternating hypomanic and mild depressive symptoms, never meeting full criteria for episodes

Differential Diagnosis

Major Depressive Disorder — no history of mania/hypomania

Borderline Personality Disorder — mood reactivity tied to relationships vs. episodic cycling

ADHD — distractibility and impulsivity without mood episodes

Substance‑Induced Mood Disorder — symptoms linked to intoxication/withdrawal

Medical Conditions — thyroid disease, neurological disorders

Treatment

Treatment Options

Psychotherapy is an essential component of bipolar disorder treatment alongside medication management where indicated. At Karasick Psychology we provide evidence-based therapy tailored to your specific presentation, episode history and life circumstances.

Treatment focuses on mood stability, relapse prevention, understanding triggers, improving relationships and quality of life, and building the skills to manage the full spectrum of bipolar experience with greater confidence and resilience.

Living with Bipolar Disorder

Bipolar disorder is a lifelong condition — but it is one that can be managed effectively with the right support. Many people with bipolar disorder lead full, meaningful and productive lives. The key is accurate diagnosis, appropriate treatment and ongoing support from a clinician who understands the full complexity of the condition.

If you have been living with unexplained mood episodes, have been diagnosed with depression that hasn’t responded to treatment, or suspect that bipolar disorder may be part of your experience — reaching out is the first step toward understanding and stability.

You are not alone

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Reaching out for therapy is hard, but struggling alone is harder. Contact us to learn how we can support your path toward healing, development, and lasting improvement.