Caroline Anawate, Kristina Brown and Nicole Hodges of Sanare

Bipolar Disorder

Bipolar disorder causes shifts in mood, energy and activity that go well past ordinary ups and downs. Periods of mania or hypomania, when someone sleeps little, talks fast, spends freely or takes big risks, alternate with periods of depression. About 2.8% of U.S. adults have it in a given year, according to the National Institute of Mental Health.

Types

Bipolar I. At least one full manic episode, often severe enough to need hospital care. Depressive episodes are common too.
Bipolar II. Hypomania, a milder high, along with major depressive episodes. The depression is often the bigger problem.
Cyclothymia. Repeated milder highs and lows over at least two years.

Some people also have psychotic symptoms during episodes. When psychosis continues outside of mood episodes, the diagnosis may be schizoaffective disorder instead.

What the swings cost

A manic week can undo months of progress. Credit cards get maxed out. A job ends after an argument with a manager. Relationships take hits that are hard to repair. Then depression follows, and getting out of bed to deal with any of it feels impossible.

Medication from a psychiatrist is the base of treatment for most people. The hardest part is often everything around it: taking it consistently, noticing early signs, keeping sleep regular, and having a plan for when things start to tilt.

How Sanare helps

We work with adults with bipolar disorder in their homes and around Denver, typically one to five visits a week with a small team who gets to know their pattern.

Spotting early signs. Each person's warning signs are different. For one client it's staying up to reorganize the kitchen; for another it's a sudden interest in a new business. We learn them together.
Sleep and routine. Regular sleep and wake times are among the most protective things a person with bipolar disorder can do.
Medication support. Routines, side effect questions to bring to the prescriber, and staying on track when feeling well makes medication seem unnecessary.
Money safeguards. Spending limits, a trusted person on accounts, and a plan made while well.
Depression work. Behavioral activation and small daily goals during low periods.
Relapse plans. A written plan, shared with family if the client wants, for what to do as symptoms build.

Safety

Depressive episodes in bipolar disorder carry a real risk of suicide. If you're worried about someone, read our suicide fact sheet, and in an emergency call 911, or call or text 988.