Mood swings versus bipolar disorder: What’s the difference?

Shifts in mood are a normal part of life — our emotional state naturally changes depending on our circumstances and our ability to cope with challenges. But how do you know when ups and downs are a sign of something more serious, like bipolar disorder?

Once known as manic depression, bipolar disorder is a mental health condition that causes extreme and extended mood changes. The emotional highs are referred to as mania or hypomania (a less intense form of mania) and the lows are known as depression.

“A common misconception about bipolar disorder is that these mood shifts happen quickly throughout the day,” says Lauren Baker, MS, LMHCA, a mental health therapist with the MultiCare Behavioral Health Network. “But the changes aren’t quick. Episodes of mania last at least a week or longer. Episodes of hypomania last at least four days and can go on for months, while bouts of depression can sometimes last years, depending on the person.”

Learn more about bipolar disorder and tips for coping with this condition.

What causes bipolar disorder?

Bipolar disorder is more common than people think, affecting about one in 40 American adults, according to the organization Mental Health America. While the exact causes of bipolar disorder are not known, this condition tends to run in families. It’s most likely to emerge between the ages of 16 and 24.

“Just because a person has a genetic predisposition for bipolar disorder doesn’t necessarily mean they will go on to develop it,” Baker says. “Environmental stressors, such as experiencing trauma in childhood or going through a major life change, can also play a role in triggering the first episode.”

“Bipolar disorder doesn’t just happen to a single person — it affects the entire family. So it’s important for caregivers not to overextend themselves and for everyone in the family system to have coping strategies that are effective and long-lasting.”

Types of bipolar disorder

There are different types of bipolar disorder, which are classified according to the pattern and severity of symptoms. One of the most common types is known as bipolar 1 disorder — where a person has at least one manic episode at some point in their life. Before or after the manic episode, they may experience symptoms of depression or their mood may be stable.

“Mania can be very disruptive, causing sleep deprivation and affecting a person’s ability to function,” says Mark Ingoldby, LICSW, a clinical social worker and supervisor of the primary care behavioral health program at the MultiCare Behavioral Health Network.

He continues, “Someone experiencing mania may have a lot of drive to accomplish different tasks but not be organized enough to get them done. They may take unnecessary risks like driving too fast, and they can even experience hallucinations or delusions.”

Another common type is bipolar 2 disorder — where a person has experienced at least one episode of hypomania and one episode of depression in their life.

“Hypomania can feel good to people — it may give them energy to get things accomplished without disrupting their lives like mania does,” Ingoldby says. “But people with bipolar 2 can also suffer severe clinical depression, to the point where they can’t get out of bed.”

It’s common for bipolar disorder to go undiagnosed or to be misdiagnosed. Mental Health America reports that on average it can take about 10 years from the time a person first experiences symptoms of this condition to the point where they receive an accurate diagnosis.

“Symptoms of bipolar disorder can overlap with symptoms of other conditions like ADHD,” Baker says. “It can also be easy to assume that a person just has depression if no one’s assessed them for mania or hypomania. That’s why it’s really important to get a full history of a person’s symptoms and also understand how other factors, like substance use or trauma history, could be affecting their mental health.”

Treating bipolar disorder

Bipolar disorder is a lifelong condition, but effective treatment strategies can keep symptoms under control and help you to live well. Because bipolar disorder is due, in part, to a chemical imbalance in the brain, medication is the first-line treatment.

“There is no one-size-fits-all approach to medication,” Baker says. “It can take time to find the type and dosage of medication that is the right fit.”

Psychotherapy, in conjunction with medication, also supports well-being.

“Medications can treat the symptoms of bipolar disorder and help stabilize a person’s mood, but they can’t change behaviors,” Ingoldby says. “Therapy is crucial for helping someone facing this illness understand more about themselves, what helps them cope and what doesn’t.”

Cognitive behavioral therapy (CBT), which explores how thoughts influence behaviors, is often used in the treatment of bipolar disorder.

Coping with bipolar disorder

Living with bipolar disorder can be difficult for the person with the diagnosis as well as the loved ones who care for them. Here are some tips to support long-term health and well-being for all involved.

Keep a mood diary. One of the biggest challenges of bipolar disorder can be the unpredictability of mood changes. While they don’t happen quickly, they can happen at random, with no apparent cause.

“Keeping a mood diary can you help you recognize patterns — signs that you may be shifting into depression or mania — so that you can ask for support from the people in your life and make adjustments to your routines that support your health,” Baker says.

Build and maintain healthy routines. Healthy routines support a stable mood, decreasing the risk of experiencing mania, hypomania or depression. Ensure you’re getting adequate sleep on a consistent schedule, eating regular nutritious meals, exercising consistently and avoiding substances. Alcohol and other substances can make symptoms of bipolar disorder worse and can also interact poorly with prescribed medications.

Have a plan. Life’s stressors can worsen symptoms of bipolar disorder, so you need to have a plan in place for managing these situations when they crop up.

“If you notice yourself becoming agitated due to life events or an issue like lack of sleep, know what tool you can use or what strategy you can put in place to help you address the problem and get back on track,” Ingoldby says. “Psychotherapy can help you develop that skillset.”

Prioritize communication. Maintaining open lines of communication with friends and family members is key. They can help you maintain healthy routines, spot the signs of impending mood shifts and foster an environment that enables you to thrive. It’s also important to be forthright with your care team about how you’re feeling so they can make adjustments to medications as needed.

Get caregiver support. If you’re caring for a loved one with bipolar disorder, it’s critical to prioritize your own self-care. The Depression and Bipolar Support Alliance provides in-person and online support groups for those living with mood disorders as well as their friends and family members.

“Bipolar disorder doesn’t just happen to a single person — it affects the entire family,” Ingoldby says. “So it’s important for caregivers not to overextend themselves and for everyone in the family system to have coping strategies that are effective and long-lasting.”