1. Episodes of mania and depression
    1. Bipolar disorder involves episodes of mania where a person feels extremely “up” — full of energy, elated, sometimes euphoric — and depressive periods where they feel sad, apathetic, and hopeless.
  2. Interference with life and increased risks
    1. This disorder can severely interfere with people’s lives and when left untreated, it can increase the risk of substance misuse and suicide.
  3. Considerations in storytelling
    1. Use storytelling to help  counter stereotypes that are painful for those living with the condition.

Storytelling Tips

Portray a Range of Mental Health Experiences
  • When portraying mania or hypomania avoid simply depicting the “positive” aspects of these states, like the increased energy or the elevated mood. 
  • Think about how to depict the negative aspects of these mood states — such as increased risk taking, increased impulsivity, and irritability — so viewers understand the realities of this condition.
Depict Effective, Realistic Help-Seeking and Treatment
  • Show what it looks like to maintain recovery. 
  • Treatment for people living with bipolar disorder can be complicated because medications restrict the euphoric feelings associated with mania, making adherence hard. 
  • These challenges can sometimes make it feel difficult or impossible to maintain recovery, so showing the stories of people who have found that balance can help encourage people with this condition and their support network to continue treatment. 
Consider the Impact of Language
  • Avoid using the term “bipolar” to refer to someone who is simply “moody” or has “mood swings, and avoid using “manic” as a descriptor for someone who is high-energy or “all over the place” to prevent misconceptions about bipolar disorder.
Move Past Stereotypes
  • Be cautious of stereotypes that can perpetuate stigma, such as the stereotype that individuals with bipolar disorder are dangerous or violent. 
  • In reality, the data does not suggest people with this condition are more likely to be violent (outside of drug or alcohol use).
In Modern Love, Anne Hathaway stars as Lexi, a woman navigating life and the dating world while living with bipolar disorder. (Image courtesy of Amazon Prime Studios).

Snapshot

Bipolar disorder causes intense and unusual shifts in a person’s mood, energy, concentration, and activity levels. This condition is characterized by episodes of mania during which a person feels extremely “up” — full of energy, elated, sometimes euphoric — and depressive periods where they feel sad, apathetic, and hopeless. 

During a manic period, people may feel invincible and extremely important, talented, or powerful. Mania often involves compulsive behaviors — like purchasing a lot of items or reckless sex — and sometimes a decreased need for sleep. Hypomania refers to an elevated state with similar attributes, but with lower intensity and less impact on one’s ability to function. 

The depressive period often follows the mania and is compounded by the reality that the person with the condition is dealing with the depression and the consequences of their behaviors during the manic episode. 

The three main types of bipolar disorder are bipolar I, bipolar II, and cyclothymia.

Facts and Stats

4.4% of adults in the United States struggle with bipolar disorder
The prevalence of the disorder among young adults is similar for males and females.
An estimated 82.9% of people with bipolar disorder had serious impairment due to their disorder and an estimated 17.1% had moderate impairment
The average age of onset of the condition is 25.

Types of Bipolar DIsorder

  • Bipolar I disorder is defined by manic episodes that last at least 7 days or require hospitalization. Generally, mania is followed by a depressive episode that lasts at least 2 weeks. 
  • Bipolar II disorder involves less severe manic episodes — called hypomania — and depressive episodes.  
  • Cyclothymic disorder is a chronically unstable mood state involving hypomania and mild depression for at least two years. People with cyclothymia may have windows of normal moods, but these rarely last less more than eight weeks.

Symptoms and Warning Signs

Mania:

  • Feeling very elated, “up”, extremely high mood
  •  Feeling very “wired”
  •  Decreased need for sleep
  •  Talking very fast
  •  Racing thoughts
  •  Increased energy
  • Increased risk-taking
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People having a depressive episode:

  •  Very sad, down, hopeless
  •  Trouble sleeping
  •  Lack of energy
  •  Lack of interest in almost all activities
  •  Inability to experience pleasure
  •  Feeling hopeless or worthless
  •  Thoughts of death or suicide

Treatment Options

Bipolar is a lifelong illness and episodes of mania and depression can occur throughout a person’s life, even during treatment. However, advances in treatment now allow individuals with this condition to have a quality of life more like that of individuals without the condition. 

  • Medication is an important part of bipolar treatment and can include mood stabilizers, antipsychotics and antidepressants. Getting the right medication regime can be difficult and evolve over time, so frequent sessions with mental health professionals are recommended. 
  • Psychotherapy can help people with bipolar disorder develop coping skills and implement lifestyle changes that support recovery. 
  • Inpatient treatment is sometimes recommended to help stabilize and fine-tune a person’s medication plan in a safe environment. 
  • Family counseling can be important since the amplified, and sometimes damaging, impact of mania can be difficult for friends and family to understand and manage. 
  • Self-care is an important part of any treatment plan, but especially so for people with bipolar disorder because lack of sleep, high levels of stress, and substance use can worsen the condition or trigger manic or depressive episodes. 

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Mental health is a continuum that we all move across throughout our lives. At one end we are doing well and thriving, in the middle we’re finding ways to cope with struggles and challenges, and at the far end those struggles are interfering with central aspects of our lives — school, work, relationships — and negatively impacting our overall well-being. In the simplest definition, mental health conditions like depression and anxiety disorders are diagnosed when someone experiences the concerning end of the continuum for a period of weeks or months. Like many physical illnesses, these conditions are the result of a convergence of internal, external, and societal factors

Mental health conditions are common in the United States, with 1 in 5 adults experiencing a mental health condition each year. Most people will show their first symptoms of a mental health condition between their mid-teens and 20s, though this can differ depending on factors like gender and the type of condition. Some people may experience comorbidity — or managing multiple mental health conditions simultaneously, like depression and an eating disorder.

The most common types of mental health conditions (in order from most to least prevalent) within the United States are:

  • Depression: A mood disorder that causes a persistent feeling of sadness and can impact ability to function.
  • Anxiety disorders: Conditions like social anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder (PTSD), characterized by varying degrees and types of excessive fear and worry.
  • Substance use disorders: Occurs when a person continues to use substances after usage has led to health issues or problems at work, school, or home.
  • Eating disorders: Conditions like anorexia nervosa, bulimia nervosa, and binge-eating disorders that involve severe disturbances in people’s body image, eating behaviors, and related thoughts and emotions.
  • Bipolar disorder: A condition that involves severe and uncontrollable mood shifts that include emotional highs (mania) and lows (depression).
  • Schizophrenia: A serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions, and relate to others.

As many as 90% of people who die by suicide had a diagnosable mental health condition at the time of their death, though in some cases the condition had not been diagnosed. The conditions most often associated with suicide are depression and substance use disorders.

While mental health conditions can impact thoughts, feelings, and behaviors in negative ways, these conditions are also treatable. For many people, the right treatment and self-care plan allows them to recover from the condition permanently or for a period of time and live a full, purposeful life. 

When developing stories about people living with mental health conditions, it’s important to ensure the condition isn’t being used to create an incapacity that can be exploited, to justify violent or frightening behavior, or to socially or physically isolate a character. Rather, look for opportunities to accurately and empathetically show the realities of these conditions — both the struggles and the opportunities for hope, help, and healing.

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