Bipolar Disorders vs Mood Swings: What You Need to Know

There’s no shortage of online information about mental health subjects available at your fingertips. But in some cases, a little knowledge may do a lot of harm, especially when discussing serious conditions like bipolar disorder. With a little reading or perhaps taking a misleading online survey to inform them, the layperson may see a friend or family member’s mood swings and incorrectly assume bipolar disorder.

These assumptions can create tensions and misunderstandings in relationships. Dr. Sid Khurana recently spent some time explaining what differentiates the two, as well as treatment options for those who may indeed suffer from bipolar disorder.

The Broad Umbrella of Mood Disorders

Bipolar disorders fall into the mood disorder category in the DSM, or Diagnostic and Statistical Manual of Mental Disorders. However, there are many mood disorders out there, and several types of bipolar disorders as well.

To distinguish mood from bipolar disorders, Dr. Khurana says to envision a pendulum. On the far left is a depressive disorder, the far right a manic disorder. A person can swing to the left with bouts of depression then come back to the middle and feel fine. In these cases, they have a depressive disorder, he explains.

However, if a person swings from a depressive state all the way to the manic side, they have a bipolar disorder. Manias are high-energy states. In most cases, the person does not sleep much, yet still maintains an elevated energy level. They may also be compulsive and have grandiose thoughts about themselves. They also speak fast and may go on shopping or selling sprees, compulsively gamble, become sexually promiscuous, and engage in other extremes.

“The ability for the brain to think ‘no I should not do these things’ does not exist,” Dr. Khurana adds.

To classify a person as bipolar, however, you must have both the depressive disorder as well as the manic disorder, not just one.

“We know from centuries of research about bipolar disorders, that nobody just stays in the middle, the pendulum swings from being depressed to being manic,” he adds.

Types of Bipolar Disorder

The length of the manic episodes also factors into the type of bipolar disorder a patient may have. The most severe is bipolar 1. This is characterized by a manic episode lasting at least a week. This condition requires hospitalization, as the person may engage in high-risk activity that could harm themselves or others.

Bipolar 2, also called hypomanic, involves manic episodes that last four to five days, and the symptoms are less severe than bipolar 1. People may notice something is off, and the extreme risk-taking level may or may not exist.

“With the type 2 patients, people might notice ‘wow, something is different about this person,’ and you may or may not need to be hospitalized,” Dr. Khurana notes.

Unspecified bipolar is another type where a patient either doesn’t have enough symptoms or the person’s manic episodes do not last for at least four days. There is also a minor type of bipolar disorder called cyclo-thymic disorder, Dr. Khurana explains. It’s where the pendulum does not swing severely to the left or right, but the person does clearly show signs of moving from depression to mania, and episodes may last only a day or two.

Mood Swings

Many may still ask: So, how do I know if someone is just having mood swings? That gets back to Dr. Khurana’s earlier explanation about a person needing both the depressive and manic disorders to be considered for a bipolar disorder diagnosis.

“Mood swings are one part of bipolar disorder, not the entire diagnosis,” Dr. Khurana adds. “In bipolar there is a depressed phase where the mood is sad, even irritable, and there is a manic, euphoric phase, which can sometimes involve irritability, too; but each of those moods alone without the other are mood swings. You need to have both, and for certain periods of time, for them to be considered a bipolar disorder.”

When to Reach Out for Help

It’s important to remember mood swings can happen for any number of reasons, Dr. Khurana cautions. Changes in life situations, stress, and even physiological problems such as endocrine or thyroid dysfunction can contribute to mood swings. Mood swings also typically last for a few minutes to an hour, maybe an entire day at most. However, once you start seeing three to five-day episodes, combined with other symptoms, there may be cause for concern.

“Being impulsive is not a mood swing, but being impulsive, talking fast, being grandiose, some people can become delusional or psychotic, those are not just mood swings,” he clarifies. “But in bipolar disorder, the hallmark is sleeping less. It’s not because you are trying but can’t fall asleep. You are full of energy and you’re thinking ‘Who needs sleep?’”

Treatment Options, and What Makes Nevada Mental Health Unique

There are more than two dozen FDA-approved psychotropic medications to help patients with a bipolar disorder. An early diagnosis, coupled with an individualized treatment plan, are the keys to effectively managing the psychiatric condition, Dr. Khurana says.

At Nevada Mental Health, psychiatrists take the time to investigate your situation and understand the context and background. The psychiatrist may ask to speak to friends or family members, and multiple sessions are involved. In addition, a blood draw may be needed to reveal if there are issues with electrolytes, hormones, the thyroid or endocrine, and other systems, all of which can impact mood and behavior.

“We take our time. That has been our core mantra,” Dr. Khurana adds. “It’s not just filling out a questionnaire and a five-minute conversation. We sit down, take a history, contextualize your situation and look at your background, your culture, and all other factors to see if what’s going on makes sense. These are the keys to an accurate psychiatric diagnosis.”

Nevada Mental Health has no pharmaceutical affiliations, and its experts bring deep knowledge of long-time and new cutting-edge therapies. Nevada Mental Health also integrates lifestyle interventions and psychotherapy into your treatment plan. Complementary psychiatric approaches are also used, if appropriate. Those may include TMS (Transcranial Magnetic Stimulation), ketamine, and even ECT (electroconvulsive therapy), among other options.

“We find the best medicine for that patient, with real-life factors in mind, financial status, insurance, and everything else. We tailor the treatment to the patient’s reality,” Dr. Khurana says. “This is not a cookie-cutter approach. It’s really about taking the time to figure out the patient’s needs and finding the right treatment fit. That’s the key to our recipe.”