What to know about mood changes and bipolar disorder

Bipolar disorder is a mental health condition where a person experiences intense mood changes. These mood changes can vary from periods of high energy and excitement (mania) to episodes of deep sadness and hopelessness (depression). 

Bipolar disorder can result in mood changes due to brain changes that affect how you regulate emotion. External stressors and life events can also trigger symptoms for some people.

Is there a connection between bipolar disorder and mood changes?

Mood changes and bipolar disorder are related to one another, as mood changes are a hallmark symptom of bipolar disorder. According to a 2022 study, changes in neurotransmitter levels and activity within the brain may be the reasons people with bipolar disorder experience mood changes. Neurotransmitters are chemical messengers that help brain cells communicate with each other.

The study suggested that people with bipolar disorder often have imbalances in neurotransmitters such as dopamine, serotonin, and norepinephrine, which help regulate mood, emotions, and thinking abilities.

During manic episodes, there is an excess of neurotransmitter activity, primarily involving dopamine. This increased dopamine can cause heightened energy, euphoria, and impulsivity. However, during depressive episodes, there may be reduced activity of these neurotransmitters, leading to feelings of sadness, hopelessness, and decreased motivation.

An older 2015 study also revealed structural and functional abnormalities in specific brain regions responsible for mood regulation in people with bipolar disorder. These abnormalities affect the circuits involved in emotional processing, leading to intense mood changes.

What do mood changes look like in bipolar disorder?

Mood changes refer to rapid and extreme shifts in emotional states. In bipolar disorder, mood changes can often be intense and involve distinct periods of mania and depressive episodes. They may last for days, weeks, or even months.

Manic episodes

During manic episodes, you may experience an extreme and persistent elevation in your mood. Although it may initially appear positive, mania can escalate rapidly and become harmful to your daily functioning. 

Some common symptoms of manic episodes include:

• intense euphoria
• extreme irritability
• increased energy levels and decreased need for sleep
• impulsive behavior, such as excessive spending or engaging in harmful sexual behaviors
• racing thoughts and rapid speech
• having exaggerated beliefs about your abilities or feeling a sense of superiority (grandiose beliefs)
• difficulty concentrating and being easily distracted

However, mania can manifest differently in every person. Some people may show highly productive and goal-directed behavior, while others may experience extreme restlessness or agitation. In severe cases, mania can escalate to a state of psychosis, which involves hallucinations or delusions.

Depressive episodes

Depressive episodes in bipolar disorder involve profound sadness, hopelessness, and a loss of interest or pleasure in activities you previously enjoyed.

Depressive symptoms may include:

• persistent feelings of sadness, emptiness, or worthlessness
• fatigue or loss of energy, leading to decreased motivation
• increase or decrease in appetite or weight
• insomnia or excessive sleeping
• difficulty concentrating, making decisions, or having trouble with memory
• recurrent thoughts of death or suicide

Depressive episodes can be challenging and may significantly affect daily life, including work, relationships, and overall well-being. 

However, not every person with bipolar disorder experiences the same symptoms, and the severity can also vary. Additionally, periods of stability can occur between episodes.

If you or someone you know is considering suicide or self-harm, please seek support:

• Call or text the 988 Suicide and Crisis Lifeline 24 hours a day at 988.
• Text “HOME” to the Crisis Textline at 741741.
• Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency number if you feel it’s an emergency.

While you wait for help to arrive, stay with someone and remove any weapons or substances that can cause harm. You are not alone.

Treatment options for bipolar disorder

Treating bipolar disorder often involves a combination of medications and therapy. A healthcare professional can work with you to put together a treatment plan that is suitable for your needs.

Medications that are commonly prescribed for mood changes in bipolar disorder include: 

Mood stabilizers

Healthcare professionals often prescribe mood stabilizers to manage and prevent mood changes. They help regulate neurotransmitter activity to stabilize mood.

Some commonly prescribed mood stabilizers include:

• lithium (Eskalith)
• valproic acid (Depakene)
• lamotrigine (Lamictal)

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Antipsychotics

Doctors prescribe antipsychotic medications to manage symptoms during manic or mixed episodes of bipolar disorder by regulating dopamine and serotonin levels in your brain.

Common examples include:

• aripiprazole (Abilify)
• quetiapine (Seroquel)
• olanzapine (Zyprexa)
• cariprazine (Vraylar)

Psychotherapy

In addition to medications, psychotherapies, such as cognitive behavioral therapy (CBT), can help those with bipolar disorder to understand and manage their thoughts, emotions, and behaviors.

Therapy can also help improve coping strategies and communication and manage any underlying psychological factors that may be contributing to bipolar disorder.

What lifestyle measures can help with bipolar disorder?

Lifestyle measures can play a supportive role in managing bipolar disorder. Examples can include:

• Prioritizing good sleep habits: Getting enough sleep and maintaining a regular sleep schedule can help manage bipolar symptoms and decrease the chances of manic episodes.
• Engaging in regular physical activity: Staying physically active through regular exercise can help reduce depressive symptoms in bipolar disorder.
• Practicing stress reduction techniques: Stress can trigger or worsen bipolar episodes. Using stress management techniques such as mindfulness or deep breathing exercises can be beneficial.
• Maintaining a balanced diet: Consuming nutrient-dense foods such as fruits, vegetables, whole grains, lean proteins, and healthy fats can support overall health. Avoiding excessive consumption of processed foods, sugary snacks, and alcohol (if you drink) is also important, as they can disrupt mood stability.
• Establishing a consistent routine: Creating a structured daily routine, including regular sleep patterns, mealtimes, and daily activities, can provide stability and help regulate mood fluctuations.

Support options for bipolar disorder

There are several support options for people with bipolar disorder, including:

• Support groups: Joining a support group can provide a safe and understanding space to share experiences, receive emotional support, and learn coping strategies from other people with bipolar disorder. The Depression and Bipolar Support Alliance (DBSA) provides a search tool to help you find online and local in-person support groups.
• Therapy: This may involve different approaches, such as CBT or dialectical behavior therapy (DBT). Therapy can help you develop coping skills and manage your symptoms.
• Speaking with family and friends: Speaking with your loved ones about your experience with bipolar disorder can help them understand your challenges and provide the assistance you may need.
• Online communities: Connecting with others through online platforms can offer a sense of belonging. Participating in discussions, seeking advice, and sharing experiences with like-minded people can be beneficial. However, it can be helpful to ensure the online community is reputable and monitored by professionals.

Support options can vary depending on your location and personal preferences. Consider talking with a healthcare professional about the resources available in your community.

When to speak with a doctor

Consider speaking with a healthcare professional if:

• you are experiencing new symptoms of mania or depression, or if your existing symptoms are becoming more severe
• you notice frequent, rapid, or intense mood changes, or if your mood fluctuations are interfering with your daily functioning
• you experience thoughts of self-harm, suicide, or engaging in dangerous behaviors during mood episodes
• you notice significant changes in your bipolar symptoms or if your current treatment plan is no longer effective 

Summary

Bipolar disorder is a complex mental health condition involving mood changes that can range from manic episodes to depressive episodes. Neurochemical imbalances, genetic factors, and environmental triggers can influence these variations in mood. 

Treatment options for bipolar disorder include a combination of medication and therapy, such as mood stabilizers, antipsychotics, and psychotherapy. Lifestyle measures, support groups, and involvement from loved ones are also important when it comes to managing bipolar disorder.

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