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Dealing with the Uncertainty of Bipolar Disease

Bipolar disorder is a mental disorder characterized by extreme changes in a person’s mood. A person with bipolar disorder fluctuates between episodes of extremely elevated mood known as mania, and episodes of severe depression. Due to this bipolar disorder is also known as manic depression or bipolar disease. People living with bipolar disorder are living a life full of uncertainty. You never know when you might be feeling well or feeling acutely depressed. One minute mania might make you feel overwhelmed, while the next itself you may feel a wave of intense sadness wash over you. And you never know when you may need to go to the hospital. It is this type of uncertainty that makes it so hard to live with bipolar disorder. We take a look at how to deal with the uncertainty of bipolar disease.

Overview of Bipolar Disorder

Overview of Bipolar Disorder

Bipolar disorder is a type of chronic mental disorder that brings about severe and sudden shifts in mood, ranging from extreme highs (known as episodes of mania) to extreme lows (depression). These sudden highs and lows may occur several times a year, or in some cases, only rarely.(1)

There are many types of bipolar disorder, including:(2)

  1. Bipolar I Disorder: This is characterized by at least one manic episode, which may or may not be followed by an episode of depression.(3)
  2. Bipolar II Disorder: Bipolar II disorder is marked by at least one major episode of depression that lasts for at least two weeks, and at least one episode of hypomania. Hypomania is a condition that is milder than mania. The hypomanic episode also lass for at least four days.(4)
  3. Cyclothymic Disorder: This type of bipolar disorder is marked by at least two years of symptoms. In cyclothymic disorder, a person suffers from many episodes of hypomanic symptoms, but these do not meet the complete criteria for a hypomanic episode. A patient also has depression symptoms that, again, do not meet the full diagnostic criteria for a major depressive episode. A patient of cyclothymic disorder does not remain symptomless for longer than two months at a time.(5)

The specific symptoms of bipolar disorder vary from person to person and also depends on which type of bipolar disorder they have. However, there are many symptoms that are common in most people with this disorder. These common symptoms include:

  • Irritability
  • Anxiety
  • Trouble concentrating
  • Depression and mania at the same time
  • Disinterest and loss of pleasure in most activities
  • Inability to feel better even when good things happen
  • Psychosis that leads to a detachment from reality, often leading to delusions and hallucinations

If you have a loved one or a friend with bipolar disorder, it is essential to remain patient with them and understand their condition. Due to the uncertainty attached to bipolar disease, helping a person with bipolar disorder is not always easy. Here’s how you can try to understand how to deal with the uncertainty of bipolar disease.

How To Deal With A Manic Episode?

When a patient of bipolar disorder suffers from a manic episode, they will experience feelings of creativity, high energy, and extreme happiness even. They will start talking very quickly, get very little sleep, and may also act hyperactively. They are likely to feel invincible, leading to risk-taking behaviors.

Some of the symptoms of a manic episode include:

  • Extreme irritability
  • Unusually optimistic or ‘high’ attitude
  • Abundant energy
  • Being easily distracted

Having unreasonable and grand ideas about one’s power or skills – this may lead to criticizing family members or partners for being up to the mark or ‘accomplished’ as they perceive themselves to be above everyone else at that moment

  • Trouble concentrating
  • Racing thoughts that jump from one idea to another
  • Reckless behavior with no thought of the consequences
  • Poor judgment and impulsiveness
  • Delusions and hallucinations (though this is a rare complication of bipolar disorder)

During a manic episode, a person who has bipolar disease may start acting recklessly. Sometimes they may even go as far as endangering their own life or even the lives of people around them. Remember that a bipolar patient is unable to fully control their actions during a manic episode. Therefore, it is not always an option or a good idea to try to reason with them in order to try to stop their behavior.

It is important to know and watch out for the warning signs of a manic episode so that you are able to react accordingly. People who have bipolar disorder may show different symptoms, but there are some common warning signs such as:

  • Very sudden improvement in mood
  • Unrealistic sense of optimism
  • Sudden irritability and impatience
  • Burst in energy and talkativeness
  • Discussing unreasonable ideas
  • Spending money in an irresponsible or reckless manner

How to help or react during a manic episode primarily depends on the severity of the patient’s manic episode. In some cases, doctors respond by increasing the dosage of their medication, changing the medication, or even admitting to the hospital for treatment. It is important to keep in mind that convincing a loved one to go to the hospital while experiencing a manic episode is not going to be easy. This is primarily because they feel really good at that time and are completely convinced that there is nothing wrong with them.(6)

It is best to avoid entertaining or going along with any unrealistic or grand ideas from your loved one who is suffering from a manic episode as this is only going to increase the likelihood of engaging in risky and dangerous behavior.

Talking calmly to the patient and encouraging them to contact their doctor or go to the hospital will help.

Living with and taking care of a person who is suffering from a chronic mental health condition such as bipolar disorder is no doubt difficult. Often the negative behaviors of such patients are aimed towards those who are closest to them.

Having an honest discussion with your loved one, but while they are not in the throes of a manic episode, and opting for counseling will prove to be helpful. However, if you have trouble handling their behavior, then it is best to reach out to a professional for help. Always keep their doctor informed about what is happening and also consider joining a support group for bipolar disorder. Discussing the problems you are facing with others in a similar situation may help.

How To Deal With A Depressive Episode?

As challenging as it is to help a loved one deal with a manic episode, it is equally as tough to help them deal with a depressive episode.

Some of the common symptoms of a depressive episode include:

  • Irritability
  • Hopelessness
  • Sadness
  • Emptiness
  • Fatigue
  • Loss of energy
  • Inability to take pleasure in activities
  • Mental and physical lethargy
  • Having trouble with sleeping, including sleeping too much or too little
  • Changes in appetite or weight – this may include gaining weight and eating too much, or losing weight and eating too little
  • Problems remembering things
  • Trouble concentrating
  • Problem focusing
  • Thoughts about suicide or death

During a depressive episode also doctors may recommend a change in medication, increasing the dosage of medication, or keeping the patient in the hospital if the depressive episode is accompanied by suicidal thoughts.

You should keep a coping plan ready for depressive episodes as well, even when the patient does not show any symptoms. This is because when a depressive episode strikes, it becomes difficult to come up with a plan of action.

Signs of an Emergency in Bipolar Patients

If you are living with a bipolar patient or if you know someone who has bipolar disorder, then it is important to keep an eye on the following signs of emergency:

  • Risky behavior
  • Violet speech or behavior
  • Threatening speech or behavior
  • Suicidal speech or actions
  • Talk about death

If you feel like you are unable to help a person who is going through a depressive or manic episode, then you should not wait to get expert help. Call their doctor immediately, especially if you are feeling worried about how the episode is escalating.


Bipolar disorder is a lifelong condition and there is no cure for the disease. Sometimes it can feel to be extremely challenging for not just the patient, but also the caretaker. This is why it is necessary that the caretaker also takes good care of themselves. Keep in mind that with the proper treatment, support, and coping skills, most people with bipolar disorder can continue to go through life managing their condition properly and living a happy and healthy life.


  1. Belmaker, R.H., 2004. Bipolar disorder. New England Journal of Medicine, 351(5), pp.476-486.
  2. Mind.org.uk. (2020). Types of bipolar | Mind, the mental health charity – help for mental health problems. [online] Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/types-of-bipolar/ [Accessed 22 Jan. 2020].
  3. Behavenet.com. (2020). Bipolar I Disorder | Behavenet. [online] Available at: https://behavenet.com/bipolar-i-disorder [Accessed 22 Jan. 2020].
  4. Psycom.net – Mental Health Treatment Resource Since 1986. (2020). The Difference Between Bipolar Disorder I and II. [online] Available at: https://www.psycom.net/bipolar-disorder-difference-one-two [Accessed 22 Jan. 2020].
  5. Howland, R.H. and Thase, M.E., 1993. A comprehensive review of cyclothymic disorder. The Journal of nervous and mental disease, 181(8), pp.485-493.
  6. Uofmhealth.org. (2020). Bipolar Disorder: Preventing Manic Episodes | Michigan Medicine. [online] Available at: https://www.uofmhealth.org/health-library/ty6584 [Accessed 22 Jan. 2020].

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 27, 2020

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