Bipolar Disorder

Bipolar disorder is a mental health condition marked by

extreme mood swings that include emotional highs (mania or

hypomania) and lows (depression). These shifts in mood,

energy, activity levels, and ability to function can last days,

weeks, or even longer, and are more severe than typical ups

and downs.


Types of Bipolar Disorder

1. Bipolar I  Disorder

Involves at least one full manic episode, which may be preceded or followed by depressive episodes.

2. Bipolar II Disorder

Involves recurring depressive episodes and hypomanic episodes (less severe than full mania), but no full manic episodes.

3. Cyclothymic Disorder (Cyclothymia)

Milder, fluctuating mood symptoms that don’t meet full criteria for mania or depression but last for at least 2 years (1 year in children/teens).

Mania/Hypomania Symptoms: 

     - Elevated or irritable mood

     - Increased energy, activity, or restlessness

      - Decreased need for sleep

      - Inflated self-esteem or grandiosity

      - Racing thoughts or pressured speech

      - Risky behavior (e.g., spending sprees, unsafe sex,                         impulsivity)    

 Depression Symptoms:

     - Persistent sadness or emptiness

     - Loss of interest or pleasure

     - Fatigue or low energy

     - Feelings of worthlessness or guilt

     - Sleep disturbances

     - Suicidal thoughts or behaviors


How Bipolar Disorder Is Treated with a Mental Health Counselor

Mental health counselors do not diagnose or treat with medication, but they play a key role in supporting emotional stability, behavior management, and insight.

1. Psychoeducation

         - Teaches clients (and their families) about:

         - The nature of bipolar disorder

         - Early warning signs of mood episodes

         - The importance of medication adherence

         - Helps reduce stigma and build self-understanding

2. Cognitive Behavioral Therapy (CBT)

         - Addresses negative thinking patterns in depression and impulsivity in mania

         - Teaches clients how to manage triggers, stress, and risky behaviors

         - Builds realistic self-talk and better coping skills

3. Mood Tracking and Routine Building

         - Counselors help clients track moods, sleep, energy, and life events to identify patterns

         - Encourages consistent daily routines, sleep hygiene, and structure, which are critical for mood stability

4. Interpersonal and Social Rhythm Therapy (IPSRT)

         - A therapy designed specifically for bipolar disorder

         - Focuses on maintaining regular daily rhythms and improving interpersonal relationships

         - Helps prevent mood episodes by stabilizing lifestyle and relationships

5. Family or Couples Counseling

         - Helps family members understand the condition and reduce conflict or misunderstanding

         - Teaches how to respond supportively during mood episodes

         - Reduces emotional stress in the home, which can trigger relapses

6. Relapse Prevention Planning

         - Clients learn to recognize early signs of mania or depression

         - Develop action steps to take when symptoms return (e.g., adjusting meds, contacting providers)

7. Support with Medication Adherence

         -While therapists don’t prescribe medication, they can support clients in:

                         -- Managing side effects

                         -- Talking with their psychiatrist

                         -- Sticking to their medication plan

Other Important Supports

         - Psychiatric treatment is essential—usually includes mood stabilizers, antipsychotics, or antidepressants under careful monitoring.

         - Peer support or bipolar-specific support groups can reduce isolation and provide connection.

Goals of Counseling for Bipolar Disorder

         - Increase emotional regulation and insight

         - Build healthy routines and coping strategies

         - Reduce the frequency and intensity of mood episodes

         - Strengthen relationships and social support

         - Support ongoing recovery and stability

Bipolar disorder is manageable. With proper treatment, education, and support, people living with bipolar disorder can lead balanced, fulfilling lives.