Understanding and managing bipolar disorder

Bipolar disorder is a complex mental health condition that affects millions of people worldwide. It is characterised by extreme mood swings, ranging from manic highs to depressive lows, which can have a profound impact on an individual’s daily life, relationships, and overall well-being.

With World Bipolar Day approaching on 30th March, the anniversary of Vincent Van Gogh’s birth, a renowned artist who was posthumously believed to have had bipolar disorder, it is an opportune moment to shed light on the condition, its challenges, and the pathways to effective management.

¿Qué es el trastorno bipolar?

Bipolar disorder is a mood disorder that causes significant shifts in energy levels, emotions, and behaviour. There are several types, including:

• Bipolar I disorder – Characterised by severe manic episodes that may require hospitalisation, often followed by depressive episodes.
• Bipolar II disorder – Involves less severe manic episodes (hypomania) and prolonged depressive episodes.
• Cyclothymic disorder – Marked by frequent mood swings but with less intensity than Bipolar I or II.

Symptoms of mania can include heightened energy, reduced need for sleep, grandiose thinking, impulsive behaviour, and excessive euphoria. Depressive episodes, on the other hand, can manifest as overwhelming sadness, fatigue, hopelessness, and even suicidal thoughts. These extreme fluctuations can make it difficult for individuals to maintain stability in their personal and professional lives.

How depression and bipolar disorder can be confused.

Depression and bipolar disorder share some overlapping symptoms, which can sometimes make them difficult to distinguish. Because both conditions involve episodes of depression, some individuals with bipolar disorder may be initially misdiagnosed with depression.

This is particularly common in cases where the person has not yet experienced a noticeable manic episode or where the mania manifests as hypomania, which can be mistaken for periods of high energy or productivity rather than a symptom of illness.

A key difference is that people with bipolar disorder will at some point experience elevated moods or mania/hypomania, while those with depression do not. This distinction is crucial, as treating bipolar disorder with antidepressants alone (without mood stabilisers) can sometimes trigger or worsen manic episodes.

Symptoms of depression.

Depression, or major depressive disorder (MDD), is characterised by prolonged feelings of sadness, hopelessness, and emptiness. Symptoms can include:

• A persistent low mood.
• Fatigue and lack of energy.
• Cambios en los patrones de sueño y alimentación.
• Pérdida de interés por actividades que antes disfrutaba.
• Dificultad para concentrarse.
• Feelings of guilt or worthlessness.
• Pensamientos de autolesión o suicidio.

Persistent depressive disorder (formerly known as dysthymia) is a milder but long-lasting form of depression, with symptoms lasting at least two years. While individuals with persistent depressive disorder may be able to function in daily life, they still experience a continuous low mood.

Symptoms of bipolar disorder.

Bipolar disorder, previously known as manic depression, is characterised by extreme mood swings that include episodes of mania (or hypomania) and depression. Symptoms of mania/hypomania include:

• Increased energy and restlessness.
• Reduced need for sleep.
• Racing thoughts or rapid speech.
• Impulsivity and reckless behaviour (e.g., excessive spending, risky sexual activity).
• Inflated self-esteem or grandiosity.
• In some cases, delusions or psychosis.

These manic or hypomanic episodes are typically followed by depressive episodes that resemble major depression, creating a cycle of emotional highs and lows.

The impact on mental health.

Bipolar disorder can significantly impact an individual’s quality of life. The unpredictability of mood swings may strain relationships, interfere with work or academic responsibilities, and lead to financial or legal issues due to impulsive behaviour during manic episodes. The depressive phases can be equally debilitating, making even the simplest tasks feel insurmountable. Without proper treatment, those with bipolar disorder are at increased risk of substance misuse, self-harm, and suicide. 

The connection between bipolar and substance use.

Bipolar and other depressive disorders: including major depressive, persistent depressive and seasonal defective; are both closely linked to substance abuse. Many individuals struggling with mood disorders turn to alcohol or drugs to self-medicate, either to numb depressive symptoms or to manage the high energy of mania.

• Bipolar disorder and substance use: Those with undiagnosed bipolar disorder may misuse stimulants to sustain their manic energy or use depressants like alcohol to calm themselves. This pattern increases the likelihood of addiction, financial problems, and deteriorating mental health.
• Depression and substance use: People experiencing depression often use alcohol or drugs as a way to temporarily escape sadness, anxiety, or hopelessness. Unfortunately, substance use can worsen depressive symptoms, leading to a vicious cycle of dependency.

According to research, individuals with bipolar disorder are over six times more likely to struggle with alcoholism and nearly four times more likely to have major depressive disorder. This highlights the importance of proper diagnosis and treatment before self-medicating leads to additional complications.

How residential rehab can help.

For individuals struggling with bipolar disorder, particularly when compounded by addiction or severe instability, residential rehabilitation can provide a structured and supportive environment for recovery. At Ibiza Calm, our holistic treatment approach includes:

• Comprehensive assessments – A thorough evaluation to establish an accurate diagnosis and tailor an individualised treatment plan.
• Medical stabilisation – If necessary, supervised detox and medication adjustments under the care of experienced professionals.
• Therapeutic interventions – Evidence-based therapies such as Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), and mindfulness techniques to help individuals gain coping skills and emotional regulation.
• Lifestyle and wellness support – Exercise, nutrition, and mindfulness practices to promote overall well-being.
• Dual diagnosis treatment – Addressing co-occurring addiction issues alongside bipolar disorder to ensure long-term stability.
• Estimulación magnética transcraneal (EMT) – Ibiza Calm has an on-site TMS machine, an innovative and non-invasive treatment proven to be highly effective for treatment-resistant depression.

A diagnosis of bipolar disorder does not define an individual nor dictate their future. With the right support, treatment, and self-care strategies, it is possible to live a fulfilling and stable life. As we recognise World Bipolar Day, let us continue to foster understanding, reduce stigma, and offer hope to those affected by this condition.

If you or a loved one is struggling with bipolar disorder, Ibiza Calm provides expert-led care in a tranquil and nurturing environment. Reach out to us today to learn more about our tailored treatment programmes.