bipolar depression college essay

Understanding Bipolar Disorder: An In-Depth Essay

Imagine living in a world where emotions oscillate between exhilarating highs and crippling lows. Where one moment, you feel invincible, and the next, you are engulfed in a darkness so profound it seems suffocating. Welcome to the complex and enigmatic realm of bipolar disorder.

At some point in our lives, we all experience fluctuations in our moods. However, for individuals with bipolar disorder, these mood swings are extreme, unpredictable, and can have devastating consequences. It is a mental health condition that possesses the power to disrupt lives, strain relationships, and challenge society’s understanding.

In this in-depth essay, we will delve into the intricate facets of bipolar disorder, unraveling its definition, prevalence, and impact. We will explore the different types of the disorder and investigate the causes and risk factors that contribute to its development.

Furthermore, we will examine the symptoms associated with bipolar disorder and the diagnostic criteria used to identify it. We will highlight the challenges faced by individuals with bipolar disorder and the effects this condition can have on personal relationships. Additionally, we will confront the societal stigma and misunderstandings that permeate the public’s perception of bipolar disorder.

Treatment and management play a critical role in the lives of those with bipolar disorder, and we will explore the medication options, therapeutic approaches, and lifestyle changes that can provide support and stability.

To navigate such a vast and complex topic, it is important to understand how to approach writing an essay on bipolar disorder. We will discuss strategies for choosing a focus, structuring your essay, addressing controversial topics, and providing reliable sources.

This essay aims to shed light on the intricacies of bipolar disorder, debunk myths, and promote understanding and empathy. By gaining knowledge and insights into this often-misunderstood condition, we can facilitate a more inclusive and compassionate society. Join us on this journey of discovery as we strive to comprehend the multifaceted nature of bipolar disorder.

Overview of Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a chronic mental health condition that affects a person’s mood, energy levels, and ability to function effectively. It is characterized by extreme shifts in mood, ranging from manic episodes, where individuals experience heightened euphoria and energy, to depressive episodes, where they feel overwhelming sadness, hopelessness, and a lack of interest in activities.

What is Bipolar Disorder?

Bipolar disorder is a complex condition that involves various biological, genetic, and environmental factors. It affects approximately 2.8% of U.S. adults, according to the National Institute of Mental Health. The onset of bipolar disorder usually occurs in late adolescence or early adulthood, although it can manifest at any age.

During manic episodes, individuals may exhibit symptoms such as increased talkativeness, racing thoughts, impulsivity, inflated self-esteem, and a decreased need for sleep. They may engage in risky behaviors, such as excessive spending or substance abuse. On the other hand, depressive episodes are characterized by symptoms like persistent sadness, fatigue, sleep disturbances, difficulty concentrating, and thoughts of death or suicide.

Types of Bipolar Disorder

Bipolar disorder is further categorized into several subtypes:

1. Bipolar I Disorder: This is the most severe form of the illness, involving manic episodes lasting for at least seven days or requiring hospitalization. Depressive episodes lasting for two weeks or more often accompany these manic episodes.

2. Bipolar II Disorder: In this type, individuals experience recurring depressive episodes but have hypomanic episodes that are less severe than full-blown mania. These hypomanic episodes do not usually lead to significant impairment in functioning.

3. Cyclothymic Disorder: Cyclothymic disorder is a milder form of bipolar disorder where individuals have frequent, but less intense, mood swings. They experience hypomanic symptoms and depressive symptoms that persist for at least two years, with brief periods of stability.

Causes and Risk Factors

The exact cause of bipolar disorder is not fully understood. However, research suggests that a combination of genetic, biological, and environmental factors contribute to its development. Individuals with a family history of bipolar disorder or other mood disorders are at a higher risk.

Other factors that may influence the development of bipolar disorder include abnormal brain structure and function, neurotransmitter imbalances, hormonal imbalances, and high levels of stress. Substance abuse or traumatic experiences may also trigger the onset or exacerbation of symptoms.

Understanding the different types of bipolar disorder and the contributing factors can help demystify this complex condition. By recognizing the signs and seeking appropriate diagnosis and treatment, individuals with bipolar disorder can lead fulfilling lives and manage their symptoms effectively.

Symptoms and Diagnosis of Bipolar Disorder

Bipolar disorder is a complex mental health condition characterized by distinct symptoms that significantly impact an individual’s daily life. Accurate diagnosis of bipolar disorder is crucial to ensure appropriate treatment and support. In this section, we will explore common symptoms of bipolar disorder, the diagnostic criteria used for its identification, and how it is distinguished from other mental health conditions.

Common Symptoms of Bipolar Disorder

The symptoms of bipolar disorder can vary depending on the specific episode and its severity. During manic episodes, individuals often experience an intense euphoria, increased energy levels, and a heightened sense of self-esteem. They may engage in risky behavior, such as excessive spending or engaging in dangerous activities. Rapid speech, racing thoughts, and impulsivity are also commonly observed.

Conversely, depressive episodes are characterized by persistent feelings of sadness, hopelessness, and a loss of interest in previously enjoyed activities. Individuals may experience changes in appetite and sleep patterns, difficulties concentrating, and thoughts of self-harm or suicide. Fatigue, a lack of motivation, and a general feeling of emptiness are also common symptoms.

Diagnostic Criteria for Bipolar Disorder

To diagnose bipolar disorder, healthcare professionals refer to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, the presence of manic, hypomanic, and depressive episodes is necessary for a bipolar disorder diagnosis.

For a diagnosis of bipolar I disorder, an individual must have experienced at least one manic episode, lasting for a minimum of seven days or requiring immediate hospitalization. Depressive episodes may or may not occur alongside the manic episodes.

In bipolar II disorder, individuals experience at least one major depressive episode and at least one hypomanic episode, which is characterized by milder manic symptoms that do not cause significant impairment in functioning.

Cyclothymic disorder, a milder form of bipolar disorder, is diagnosed when an individual experiences numerous periods of hypomanic symptoms and depressive symptoms over a two-year period.

Distinguishing Bipolar Disorder from other Mental Health Conditions

Differentiating bipolar disorder from other mental health conditions can be challenging due to overlapping symptoms. Depression alone, for example, may resemble the depressive episodes experienced by individuals with bipolar disorder. However, bipolar disorder is distinguished by the presence of manic or hypomanic episodes, which are not present in unipolar depression.

Other conditions such as borderline personality disorder and attention-deficit/hyperactivity disorder (ADHD) may exhibit symptoms similar to bipolar disorder, further complicating the diagnostic process. Thorough evaluation by a mental health professional is essential to accurately differentiate bipolar disorder from other conditions and develop an appropriate treatment plan.

Understanding the symptoms and diagnostic criteria of bipolar disorder helps in early identification and intervention, leading to improved outcomes for individuals living with this complex condition. Seeking professional help and support is crucial for accurate diagnosis and developing an effective management plan to mitigate the impact of bipolar disorder on daily life.

Impact of Bipolar Disorder on Individuals and Society

Bipolar disorder not only affects the lives of individuals diagnosed with the condition but also has a significant impact on their personal relationships, daily functioning, and society as a whole. In this section, we will explore the effects of bipolar disorder on personal relationships, the challenges faced by individuals with the condition, and societal stigma and misunderstandings surrounding bipolar disorder.

Effects of Bipolar Disorder on Personal Relationships

Living with bipolar disorder can strain personal relationships. The extreme mood swings, impulsivity, and erratic behavior exhibited during manic episodes can be confusing and distressing for partners, family members, and friends. Loved ones may struggle to understand the sudden changes in mood and energy levels, leading to strained communication and emotional instability within the relationship.

During depressive episodes, individuals with bipolar disorder may withdraw from social interactions, isolate themselves, and have difficulty expressing their needs and emotions. This can result in feelings of loneliness and isolation, further impacting the dynamics of personal relationships.

Challenges Faced by Individuals with Bipolar Disorder

Individuals with bipolar disorder face numerous challenges that affect their daily lives. The unpredictability of mood swings can make it difficult to maintain stable employment or pursue educational goals. Managing relationships, parenting responsibilities, and financial stability may also become more challenging due to the episodic nature of the condition.

Additionally, the presence of comorbid conditions, such as anxiety disorders or substance abuse, further compounds the difficulties faced by individuals with bipolar disorder. The stigma associated with mental illness may also create barriers in accessing proper treatment and support, exacerbating the challenges they encounter.

Societal Stigma and Misunderstandings

Despite growing awareness and understanding of mental health, societal stigma and misunderstandings surrounding bipolar disorder still persist. Many people hold misconceptions that individuals with bipolar disorder are simply “moody” or “unstable.” Such stigmatization can lead to social exclusion, discrimination, and a reluctance to seek help.

Moreover, the portrayal of bipolar disorder in popular culture and media often exaggerates the extreme behaviors associated with the condition, further perpetuating misconceptions and reinforcing stereotypes. This portrayal not only contributes to societal misunderstandings but also hinders individuals with bipolar disorder from openly discussing their experiences and seeking support.

Reducing stigma and promoting understanding are crucial steps towards creating a compassionate society that supports individuals with bipolar disorder. Educating the public about the true nature of bipolar disorder, highlighting the strengths and resilience of individuals living with the condition, and providing resources for support and education can help combat these misconceptions.

By acknowledging the impact of bipolar disorder on personal relationships, understanding the challenges faced by individuals with the condition, and challenging societal stigma, we can foster an environment that promotes empathy, acceptance, and support for those affected by bipolar disorder.

Treatment and Management of Bipolar Disorder

Effective management of bipolar disorder is essential for individuals to lead stable and fulfilling lives. Treatment typically involves a combination of medication, therapeutic approaches, and lifestyle changes. In this section, we will explore the different options available for treating bipolar disorder.

Medication Options for Bipolar Disorder

Medication plays a crucial role in managing bipolar disorder and stabilizing mood swings. Mood-stabilizing medications are commonly prescribed, such as lithium, which has proven efficacy in reducing the frequency and severity of manic and depressive episodes. Other mood stabilizers, such as valproate or lamotrigine, may also be prescribed.

Antipsychotic medications can be used to manage acute manic or depressive symptoms. They help regulate neurotransmitters in the brain, reducing the intensity of mood episodes. Antidepressant medications may be prescribed cautiously in combination with mood stabilizers to address depressive symptoms, considering the risk of triggering manic episodes.

It is important for individuals to work closely with healthcare professionals to find the most suitable medication regimen, as each individual’s response to medication varies. Regular monitoring and adjustments may be necessary to achieve optimal symptom management.

Therapeutic Approaches for Bipolar Disorder

Therapeutic interventions, such as psychotherapy, play an integral role in the treatment of bipolar disorder. Cognitive-behavioral therapy (CBT) can help individuals identify and modify negative thought patterns and behaviors associated with the disorder. Interpersonal and social rhythm therapy (IPSRT) focuses on stabilizing daily routines and addressing interpersonal issues that may trigger mood episodes.

Family-focused therapy involves educating and involving family members in the treatment process, enhancing communication, and providing support to both the individual with bipolar disorder and their loved ones. For those experiencing difficulties with medication adherence, psychoeducation can be beneficial in promoting understanding about the disorder and the importance of treatment.

Lifestyle Changes to Support Mental Health

In addition to medication and therapy, adopting certain lifestyle changes can be beneficial in managing bipolar disorder. Regular exercise has been shown to improve overall mood, reduce stress, and promote better sleep patterns. A balanced and nutritious diet can also contribute to physical and mental well-being.

Establishing a consistent sleep schedule is crucial, as disrupted sleep patterns can trigger mood episodes. Practicing good sleep hygiene, such as creating a calming bedtime routine and maintaining a comfortable sleep environment, is recommended.

Avoiding or minimizing the use of alcohol and recreational drugs is important, as these substances can negatively interact with medication and exacerbate mood symptoms. Building a strong support system, including seeking support from support groups or engaging in individual counseling, can provide valuable emotional support.

While bipolar disorder presents unique challenges, it is a treatable condition. By finding the right combination of medication, therapeutic approaches, and lifestyle changes, individuals with bipolar disorder can stabilize their moods, reduce the severity and frequency of episodes, and lead fulfilling lives. A comprehensive treatment approach that addresses the complex biological, psychological, and social aspects of the disorder is key to managing and mitigating the impact of bipolar disorder on daily functioning. Collaborating with healthcare professionals and accessing necessary support systems are vital steps towards successful management of this condition.

Writing an Essay on Bipolar Disorder

Writing an essay on bipolar disorder allows for a deeper exploration of this complex topic. However, it is important to approach the subject with sensitivity, accuracy, and a focus on providing valuable information. In this section, we will discuss key considerations when writing an essay on bipolar disorder.

Choosing a Focus for the Essay

Bipolar disorder encompasses a wide range of topics, so it is essential to narrow down your focus based on your interests and the scope of your essay. Consider exploring specific aspects of bipolar disorder, such as its impact on creativity, the relationship between bipolar disorder and substance abuse, or the experiences of individuals living with bipolar disorder.

Structuring the Essay

Organizing your essay in a logical manner is crucial for conveying information effectively. Consider using the introduction to provide an overview of bipolar disorder and set the context for the essay. Each subsequent section can delve deeper into specific aspects, such as symptoms, diagnosis, impact on relationships, treatment options, and societal understanding. Conclude your essay by summarizing key points and highlighting the significance of promoting awareness and support for individuals with bipolar disorder.

Addressing Controversial Topics

Bipolar disorder is a complex and multifaceted subject that may touch upon controversial areas. When discussing topics such as medication use, alternative therapies, or the link between creativity and bipolar disorder, it is important to present balanced viewpoints supported by credible sources. Acknowledge differing perspectives and engage in evidence-based discussions while considering potential biases or limitations in existing research.

Providing Reliable Sources

To ensure the credibility and accuracy of your essay, consult reputable sources that provide evidence-based information on bipolar disorder. Peer-reviewed academic journals, government health websites, and renowned mental health organizations are reliable sources of information. Remember to properly cite your sources using a recognized citation style, such as APA or MLA, to give credit to the original authors and avoid plagiarism.

Writing an essay on bipolar disorder provides an opportunity to educate and inform readers about this complex condition. By selecting a focused topic, structuring your essay logically, addressing controversies with balanced viewpoints, and using reliable sources, you can create an informative and compelling piece that contributes to understanding and promoting empathy for those with bipolar disorder. It is imperative to approach the topic with sensitivity and respect, recognizing the impact it has on individuals, their relationships, and society as a whole.In conclusion, bipolar disorder is a complex and multifaceted mental health condition that significantly impacts individuals and society as a whole. This in-depth essay has provided a comprehensive understanding of bipolar disorder, covering various aspects such as its definition, prevalence, and impact on personal relationships. We explored the different types of bipolar disorder and the causes and risk factors associated with its development.

Furthermore, we delved into the symptoms and diagnostic criteria used for identifying bipolar disorder while highlighting the importance of distinguishing it from other mental health conditions. The essay also shed light on the challenges faced by individuals with bipolar disorder, including the strain on personal relationships and the societal stigma surrounding the condition.

The treatment and management of bipolar disorder were extensively discussed, emphasizing the significance of medication options, therapeutic approaches, and lifestyle changes to support mental health. By adopting a comprehensive treatment approach, individuals with bipolar disorder can stabilize their moods and lead fulfilling lives.

Moreover, this essay provided insights into writing an essay on bipolar disorder, guiding readers on choosing a focus, structuring the essay effectively, addressing controversial topics, and providing reliable sources. By following these principles, writers can effectively promote awareness and understanding of bipolar disorder.

It is crucial to recognize the impact of bipolar disorder and combat societal misunderstandings and stigmas. By fostering empathy, educating the public, and providing support systems, we can create an inclusive and compassionate society that supports and empowers individuals living with bipolar disorder.

In conclusion, understanding bipolar disorder is integral to promoting mental health and fostering a more informed and accepting society. By spreading knowledge, reducing stigma, and advocating for appropriate support and resources, we can work towards creating a world where individuals with bipolar disorder can lead fulfilling and meaningful lives.

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How To Write An Essay On Bipolar Disorder

Introduction to understanding bipolar disorder.

When writing an essay on bipolar disorder, it's crucial to begin with a clear definition and understanding of the condition. Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Your introduction should provide insight into the complexity and seriousness of this disorder, its impact on individuals' lives, and why it's an important topic for discussion. Offer a brief overview of the various aspects of bipolar disorder you intend to explore, whether it's the clinical aspects, treatment options, societal perceptions, or personal accounts.

Examining the Clinical Aspects of Bipolar Disorder

The main body of your essay should delve into the clinical aspects of bipolar disorder. Discuss the symptoms associated with both the manic and depressive phases, and how these can affect a person's behavior, thoughts, and ability to function. Explore the different types of bipolar disorder, such as Bipolar I, Bipolar II, and Cyclothymic Disorder, each having unique patterns of mood swings. It's important to use medically accurate and sensitive language to describe these symptoms and types, relying on reputable sources like psychiatric journals or medical texts. This section should paint a clear clinical picture of bipolar disorder, contributing to a deeper understanding of the condition.

Addressing Treatment and Management

Another critical aspect of your essay should focus on the treatment and management of bipolar disorder. Discuss the various treatment options available, such as medication, psychotherapy, and lifestyle changes, and how these can help manage the symptoms and improve quality of life. Explore the challenges of treating bipolar disorder, including the need for personalized treatment plans, potential side effects of medication, and the importance of long-term management. This part of your essay should also touch upon the support systems, like family, friends, and support groups, which play a crucial role in the lives of those with bipolar disorder.

Concluding with Implications and Personal Reflections

Conclude your essay by summarizing the key points of your analysis and offering a perspective on the broader implications of understanding bipolar disorder. Reflect on the importance of awareness and destigmatization of mental health issues, and how society can better support individuals with bipolar disorder. Consider how advancements in medical research and changes in public perception can impact the treatment and management of the disorder. Your conclusion should not only provide closure to your essay but also encourage further thought and empathy regarding the challenges faced by individuals with bipolar disorder, highlighting the need for ongoing research, support, and understanding.

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• Bipolar Disorder

Going to College With Bipolar Disorder - Part II

Issues and challenges faced by college bound students with bipolar disorder..

Posted November 17, 2016 | Reviewed by Ekua Hagan

• What Is Bipolar Disorder?
• Find a therapist to treat bipolar disorder

This is the second part of a two-part blog presenting the revised book chapter—"Going to College With Bipolar Disorder ," included in the book Healthy Living with Bipolar Disorder , published by the International Bipolar Foundation . The revised second edition of the book will be available in the early part of 2017

Accepting the Diagnosis: The Most Difficult Challenge of the University Years

Most students with bipolar disorder don’t want it. That's not to say they don't value their experience of mild hypomania where they feel energized, optimistic , and cognitively turned on. Think about it; there’s a lot of brilliant creation that has occurred throughout history as a function of bipolar mood elevation. But the full picture isn't as desirable. Depression is depressing. An unpredictable mood creates a roller coaster-like reality. And full mania usually wreaks havoc. Again, most students don’t want it.

But isn't that so for the many difficult and painful things in life? Imagine one has been diagnosed with Type I Diabetes where daily blood level monitoring and insulin shots are an integral part of maintaining healthy functioning. Diabetic university students usually don't welcome this daily regimen; however, they generally comply because the alternative is far too detrimental to their well-being.

Similarly, when a student’s parent dies from cancer during the student’s first year of college, the event will usually take an enormous emotional toll. No one is really prepared to lose a parent at age 18 or 19. But the student’s life doesn't end because of parental loss. The student usually endures a painful period of bereavement . It's also probable that the student will successfully continue forward once figuring out how to live with the new reality of having a deceased parent.

Whether we're considering the loss of optimal physical health or the loss of a loved one, we generally do find ways of adapting and moving forward, but not without loss and adjustment. In many respects, this is what maturation is all about.

Late adolescence is a time of striving toward goals and ideals. Going to a good school, finding a fulfilling major, exploring emotional and physical intimacy , and developing options for gratifying and rewarding employment are dominant themes for late adolescent and young adults. As we progress through the lifecycle we all have to accept some modifications to our hopes and dreams . An ideal life exists in fairytales and movies. It doesn't exist in our lived realities. For most, these modifications of hopes and dreams typically occur somewhat later in life, when it gradually becomes clear that adolescent fantasies and adult realities aren’t a close match.

The college student with bipolar disorder needs to adjust expectations at an earlier age. The predominant lifestyle norms of university life won't work for the bipolar student. Indeed, they’re a recipe for instability. In order to work with this, the bipolar student needs to try to embrace his or her diagnosis; not because it's desirable, but because it’s real and to some degree, unchangeable. Denial won’t make it go away. Denial of bipolar disorder will temporarily allow students to do what they want. But when such choices disregard aspects of bipolar stability then there’s the inevitable price to pay for brief forays into denial and temporary wish fulfillment.

The necessary psychological adjustment for the bipolar student entails letting go of their ideal self - that person the student was striving to become - and accepting the realities of living with the bipolar diagnosis. This adjustment is a painful one and it usually isn’t achieved quickly. Just as with the process of grief, it needs to be revisited again and again, in order to gradually be replaced with a deep sense of acceptance. It actually is a process of grief: grieving the loss of that person that one wants to be.

So what does this look like in practice? Maybe it means working hard to find others whose lifestyle revolves around recreational activities other than drinking and partying. Maybe it means getting a physician’s letter documenting the need for a single dormitory room in order to have more control over “lights out” time. Maybe it even means getting some additional help or study skills coaching in order to develop really good study habits and effectively distribute one’s academic load over the duration of the semester. These are all important pragmatic approaches.

Beyond pragmatism, the real work underlying all of this entails the emotional process of coming to terms with the diagnosis. This is also where some good psychotherapy can be very helpful. Ultimately, once the reality of “being bipolar” is comfortably integrated into one's identity , then the pragmatic pieces will fall into place without a lot of difficulties.

Unfortunately, most students are not ready for this kind of acceptance during their late teens. In fact, for some, the reality of bipolar disorder is so not what they want, that they intentionally try to reject the whole ball of wax. It’s not uncommon for some to say, “I’ll deal with this all once I’m out of college!” Well, yes, they may have to, but what’s the price they will have paid for their deferment?

Neuroscience research involving the long-term course of bipolar disorder points to a phenomenon where the long-range prognosis for the course of one’s bipolar disorder is a reflection of the degree of instability that occurs early on with the disorder. In other words, early mood instability left untreated = long-term difficulty with continued instability, whereas early instability that is successfully contained = better chances for longer-term stability. This is referred to as the kindling effect (Post, 2007).

Think of a sprained ankle. Once an ankle is badly sprained it makes the ankle more susceptible to future sprains. Each successive sprain lowers the threshold for the kinds of physical stresses that will lead to subsequent sprains. The brain is not all that different. Vulnerabilities towards bipolar instability, especially when they are disregarded and simply allowed to occur, actually lower the threshold for future episodes of instability. This means that the strategies of those who want to wait until later years before they seriously deal with their disorder are significantly flawed. Once the neural circuitry of the brain is primed for longer-term instability, the individual doesn’t get to return to late adolescence for a redo.

The impact of the kindling effect is further illustrated through the results of a 2016 journal article (Joyce, K., Thompson, A., and Marwaha, S., 2016). The article reviews 10 different bipolar treatment outcome studies. The authors conclude, “There was a consistent finding suggesting treatment in earlier illness stage resulted in better outcomes in terms of response, relapse rate, time to recurrence, symptomatic recovery, remission, psychosocial functioning, and employment “

So accepting one’s diagnosis and adjusting accordingly is a big deal! The intent here is not to paint a picture of doom and gloom or to frighten one towards a preventative position, but more to draw attention to what's really at stake. When students are in the midst of their college life it's not easy to maintain a healthy perspective on the bigger picture. For college students with bipolar disorder, this very perspective may be essential to living a life that’s well-grounded in stability, effective functioning, and fulfillment.

The Appropriate Use of Academic Parachutes

An academic parachute refers to those supportive processes that can be put in place to assist a student during times of functional difficulty. When used appropriately, an effective parachute will also help a student land on his or her feet while avoiding the reality of a more devastating crash landing.

One of the frustrating aspects of living with bipolar disorder is its unpredictability. Even with the right combination of medications and lifestyle modification, a student can find that the stresses of academics and college life can still turn things upside down. Given this potential, it's prudent for bipolar students to know what kinds of parachutes are available to them.

The Americans with Disabilities Act requires that institutions of higher education provide assistance and necessary accommodations to students with diagnosed disabilities. As a function of this requirement, nearly all universities have an office that serves students with physical, psychiatric , and learning disabilities. Typically this office is referred to as Disability Support Services. Clearly, no college student wants to consider themselves as having a “psychiatric disability,” but there are times when bipolar symptoms can be just as disabling as any other condition.

If a student was in a wheelchair due to cerebral palsy, there wouldn't be much question as to whether some special assistance would be needed for that student. His or her classrooms would all need to be wheelchair accessible. If a student's arms were affected, it would also make sense that the student receive copies of comprehensive class notes. In other words, some accommodations would need to be made to assist the student to participate equally in the educational process along with other nondisabled students. Why should bipolar disorder be viewed any differently?

Strong symptoms of depression and/or hypomania can absolutely impair work productivity . The different medications used to help stabilize a student may also have unwanted side effects such as drowsiness, impaired attention, and concentration , or even the intensification of agitation. The process of trying to return to a stable mid-range mood after a period of depression or hypomania is not always a simple one. Here's where a good connection with a college’s Disability Support Services, as well as one's academic Dean, can make an important difference.

Through these services, it is usually possible for students with bipolar disorder to receive accommodations such as flexible class attendance requirements, extended work submission deadlines, and receipt of class notes when a student is not able to attend class. Usually, the main hurdle to receiving this help is not the institutional system itself. More often than not students are reluctant to swallow their pride and ask for help. Clearly, this is an echo of the kinds of issues raised in the discussion of accepting one's diagnosis.

A student’s academic dean can also be an effective advocate when communicating with professors around issues of disability-related performance difficulties. A good example involves medically excused late course drops. Most schools have an initial period of time each semester where students can add or drop courses without consequence. Occasionally a student may recognize that his or her performance in a particular course is more negatively impacted than performance in other courses. Sometimes this will not become apparent to the student until after the add/drop date. In these instances, when accompanied by appropriate medical documentation, academic deans can sometimes play an important role in facilitating exceptions to standard course drop policies.

Beyond the helpful advocacy roles provided by others, one of the best strategies is for a student to meet with professors and share the realities of his or her bipolar condition. It's even more helpful when this is done proactively, early in the semester, rather than waiting until the point where it feels like the semester is a lost cause. In most instances, university professors are more than willing to be flexible and supportive of students as long as they perceive the student’s sincerity and all claims are backed up by appropriate documentation.

There's also the occasional outcome where the semester does become a lost cause. A ten-day hospitalization occurs and the student doesn't return to effective stable functioning until a month later. A hypomanic high derail a student’s productivity for the entire first half of the semester. By the time things have smoothed out the possibility of catching up with missed work is unrealistic. A student enters college in late August and does quite well, but hits a wall of depression by mid-November. The student’s energy, motivation , and ability to concentrate are all greatly diminished and the challenges of completing the semester are only compounding the depressive symptoms. In instances such as these, a full medical withdrawal from enrollment can be a wise decision.

The official notation on one's transcript is simply “Withdrawal,” or something quite similar. There is nothing on an academic transcript that reads, “Withdrawal Due to Psychiatric Instability.” By taking this course of action a student is also able to protect against the strong negative impact of Ds and Fs upon their overall grade point. Such can be especially important if long-range goals are to gain access to a competitive graduate school or some other post-baccalaureate professional program.

It's not uncommon that when discussing these choices with students, their response is something like, “but that will put me behind the rest of my class!” Well, it may. But there’s always the potential of making up courses during summer school or doing the kinds of two-week intensive courses that some universities offer just following the winter break.

It's important to recognize that getting an education isn't a race to the finish line. Some will get there ahead of others while some will take longer. That’s life both in and out of college. There’s no official established formula for success in higher education. It's also a given that by the time students reach midlife , they're not going to be looking back on their college years and thinking that things would have been so much better if only they had graduated one semester sooner!

We’ve often heard the phrase uttered by adults, “My college years were the best years of my life!” Typically when this is expressed we’re seeing some degree of retrospective distortion. No doubt, the college years do involve some wonderful experiences. But if the truth be told, they are also years of high stress and high complexity. Even for those without any psychiatric diagnosis, the transition from late teens to early adulthood is no walk in the park. For those transiting this phase of development while trying to manage their bipolar disorder, the experience is more like a trek through the Himalayan peaks. There are amazing highs and dangerous precipices. The journey requires good preparation, excellent conditioning, extra gear, and well-developed skills. It’s also a time to connect with the best guides you can obtain. There will be setbacks. There will even be times when adverse conditions seem overwhelming. However, if the bipolar student is able to successfully commit to the journey and accrue many new life skills in the process, the experience will add to the foundation of stability that is needed to live well with bipolar disorder.

Copyright Russ Federman, 2016

Joyce, K, Thompson, A and Marwaha, S. 2016. Is treatment for bipolar disorder more effective in illness course? A comprehensive literature review. International Journal of Bipolar Disorders. 4:19.

Post, R. 2007. Kindling and sensitization as models for affective episode recurrence, cyclicity, and tolerance phenomena. Neuroscience and Biobehavioral Reviews. 31:6. 858-873

Baethge, C., Hennen, J, Khalsa, H.K., Salvatore, P, Mauricio, T. and Baldessarini, R.J. 2008. Sequencing of substance use and affective morbidity in 166 first-episode bipolar I disorder patients. Bipolar Disorders. 10:6. 738-741

Russ Federman, Ph.D., A.B.P.P ., specializes in psychotherapy with individuals diagnosed with bipolar disorder. He is the coauthor of Facing Bipolar .

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Should you discuss mental health issues in your college essay?

by Erica L. Meltzer | Oct 20, 2018 | Blog , College Essays | 6 comments

Image ©Nickshot, Adobe Stock

Note, January 2022: This post was written in 2018, before the start of the Covid-19 pandemic. Obviously, many things have changed since then, not least the amount of psychological pressure that many high school students have experienced. Clearly, some of the boundaries and expectations surrounding acceptable/advisable topics for admissions essays have shifted, and applicants undoubtedly have more leeway in discussing mental-health issues than they did in the past. That said, I would still caution against making this subject the exclusive focus of your essay(s). If it happens to be relevant—and it very well might be, given the events of the last couple of years— then you should focus on discussing it in a mature way that conveys qualities such as empathy and resilience, and that demonstrates your ability to reflect insightfully on what may have been very difficult situations.  

As regular readers of my blog may know, I periodically trawl the forums over at College Confidential to see what’s trending. Recently, I’ve noticed a concerning uptick in the number of students asking whether it’s appropriate for them to write about mental health issues, most frequently ADD and/or anxiety, in their college applications.

So the short answer: don’t do it.

The slightly longer version:

If you’re concerned about a drop in grades or an inconsistent transcript, talk to your guidance counselor. If these types of issues are addressed, the GC’s letter is the most appropriate place for them. If, for any reason, the GC is unable/unwilling to discuss them and the issues had a significant impact on your performance in school that unequivocally requires explanation, you can put a brief, matter of fact note in the “is there any additional information you’d like us to know?” section, but think very carefully about how you present it. Do not write your main essay about the issue.

The full version:

To understand why these topics should generally be avoided, you need to understand what information colleges are actually seeking to gain from the personal statement. Although it is technically a personal narrative, it is, in a sense, also a persuasive essay: its purpose is to convey what sets you apart from the thousands of others with equally good grades and scores, and to suggest whether you have qualities that make you more likely to thrive at university x than the other 10 or 15 or even 20 applicants clamoring for that spot.

Now, whether such thing can actually be determined from 650 words (with which some students receive significant help) is of course questionable; however, the bottom line is that, adcoms are looking for students who will be successful in college. Discussing one’s inability to focus or intense aversion to social situations does not exactly inspire confidence, even if a student insists those problems have been overcome. Leaving home, dealing with professors and roommates and more challenging classes… Those are all major stressors. There is a tacit understanding that of course some students will flame out, have breakdowns, etc., but adcoms are understandably hesitant to admit anyone who is already at a higher risk for those issues. You want them to be excited about the prospect of admitting you, not debate whether you’ll really be able to handle college. (In fact, I had multiple students with various issues who were not truly ready for college and who did flame out — colleges have good reason to take these things seriously.)

This concern goes beyond any particular student’s well-being: graduation rates get factored into rankings, and every student who doesn’t make it through drags that statistic just a little bit lower. If a student does develop serious problems while on campus, there are also potential legal/liability issues involved, and no school wants to deliberately court those.

Besides, if your grades are iffy, it is extremely difficult not to sound as if you are making excuses. You are much better off talking about an experience or interest that will make them look past the transcript and think, “Hey, I really like this kid.” And the reality is that if your grades are that iffy, you’re probably not a competitive candidate at super-selective colleges anyway. These schools are looking for applicants who are on the way to fulfilling their potential, not for ones who need to explain away chronic underachievement.

In addition, one thing applicants — and sometimes their parents — have difficulty wrapping their heads around is the sheer number of applications the average admissions officer has encountered. Situations that may seem extreme and dramatic to adolescents who have recently confronted them may in fact have already been experienced — and written about — by thousands of other applicants. A 17-year old may believe that describing their anxiety in morbid detail will make them seem complex and introspective, but more likely it will only come off as overwrought and trite.

I know that might sound harsh, but please remember that admissions officers are coming at this process with no pre-existing knowledge of you as a person, only a few minutes to spend on your essay, and hundreds of other applications to get through. They are also under intense pressure to ensure that the appropriate demographics targets are being met and all the various institutional constituencies (coaches, development office, orchestra conductor) are being satisfied. They’re not ogres, and they’ll try to give you the benefit of the doubt, but if yours is the fifth essay about overcoming anxiety they’ve seen in the last 48 hours, they will look at it and reflexively think, “oh, another one of these.” That is not a first impression you want to make.

Now, are there exceptions? Yes, of course, but they are rare. In all the time I did college admissions work, I had exactly one student successfully discuss anxiety in an essay. It was, however, introduced in the context of a family tragedy that had profoundly shaped the student’s life; given that background, the discussion seemed natural and matter of fact rather than overdramatized. Even so, I made the student take a good week to think about whether that topic was truly the one they wanted to write about.

Ultimately, of course, the decision is yours, and the choice depends on the larger story you want to tell as well as your ability as a writer, but these topics are so difficult to pull off well that you are best off avoiding them if you can (particularly if you don’t have access to someone with a lot of admissions experience who can review your essay). Find another topic/ experience that you enjoy writing about (and that others are likely to enjoy reading about); that presents you as someone interesting and thoughtful; and that suggest you are ready to thrive in college.

If you really are concerned about your ability to function in college, most schools have plenty of resources for you to take advantage of (academic support, counseling center, etc.). But those are things to investigate after you get admitted. Before that, don’t go out of your way to fly red flags where none are warranted.

Why is Dyslexia ok to mention on an essay, but overcoming selective mutism is not?

Dyslexia is a learning disability that lends itself to proof that it has been overcome through excellent scores in reading and writing. It’s not easy to overcome or cope with dyslexia so an essay showing how a student did it demonstrates their tenacity and resourcefulness. Grades and scores are proof that the dyslexia will not be a problem in college, while the essay can highlight the characteristics that led to the student’s success and which will serve them well in college.

I wrote about how my dog helped me overcome me ending my life/depression and moving to another school is that too common

Thanks for the tips and perspective. It seems like common sense to me as a parent and tutor, but now I have an “established author” to cite!

I want to write about how depression had change me. But my grades and statistics are all great. Is this okay to write? My bad mental health somehow didn’t manage to get to the others parts of my life.

Is it okay to write about how despite psychosis I could manage to get good grades?

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• Bipolar disorder

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.

Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).

Bipolar disorder care at Mayo Clinic

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There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.

• Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
• Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.
• Cyclothymic disorder. You've had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
• Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.

Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.

Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.

Mania and hypomania

Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.

Both a manic and a hypomanic episode include three or more of these symptoms:

• Abnormally upbeat, jumpy or wired
• Increased activity, energy or agitation
• Exaggerated sense of well-being and self-confidence (euphoria)
• Decreased need for sleep
• Unusual talkativeness
• Racing thoughts
• Distractibility
• Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

Major depressive episode

A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:

• Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
• Marked loss of interest or feeling no pleasure in all — or almost all — activities
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
• Either insomnia or sleeping too much
• Either restlessness or slowed behavior
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Decreased ability to think or concentrate, or indecisiveness
• Thinking about, planning or attempting suicide

Other features of bipolar disorder

Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.

Symptoms in children and teens

Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.

Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.

The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.

When to see a doctor

Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need.

And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.

If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.

When to get emergency help

Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline , available 24 hours a day, seven days a week. Or use the Lifeline Chat . Services are free and confidential.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

• Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
• Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

Risk factors

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

• Having a first-degree relative, such as a parent or sibling, with bipolar disorder
• Periods of high stress, such as the death of a loved one or other traumatic event
• Drug or alcohol abuse

Complications

Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:

• Problems related to drug and alcohol use
• Suicide or suicide attempts
• Legal or financial problems
• Damaged relationships
• Poor work or school performance

Co-occurring conditions

If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:

• Anxiety disorders
• Eating disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Alcohol or drug problems
• Physical health problems, such as heart disease, thyroid problems, headaches or obesity

More Information

• Bipolar disorder and alcoholism: Are they related?

There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.

If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:

• Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel you're falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.
• Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
• Take your medications exactly as directed. You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.
• Reilly-Harrington NA et al. A tool to predict suicidal ideation and behavior in bipolar disorder: The Concise Health Risk Tracking Self-Report. Journal of Affective Disorders. 2016;192:212.
• Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Dec. 2, 2016.
• Bipolar disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml. Accessed Dec. 2, 2016.
• Bipolar disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/bipolar-disorder-tr-15-3679/index.shtml. Accessed Dec. 2, 2016.
• Bipolar disorder in children and teens. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens-qf-15-6380/index.shtml. Accessed Dec. 2, 2016.
• Bipolar disorder. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Bipolar-Disorder. Accessed Dec. 2, 2016.
• AskMayoExpert. Bipolar disorder. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016. Accessed Dec. 2, 2016.
• Suppes T, et al. Bipolar disorder in adults: Clinical features. http://www.uptodate.com/home. Accessed Dec. 2, 2016.
• Axelson D, et al. Pediatric bipolar disorder: Overview of choosing treatment. http://www.uptodate.com/home. Accessed Dec. 2, 2016.
• Birmaher B. Pediatric bipolar disorder: Epidemiology, pathogenesis, clinical manifestations, and course. http://www.uptodate.com/home. Accessed Dec. 2, 2016.
• Picardi A, et al. Psychotherapy of mood disorders. Clinical Practice and Epidemiology in Mental Health. 2014;10:140.
• Fountoulakis KN, et al. The International College of Neuro-Psychopharmacology (CINP) treatment guidelines for bipolar disorder in adults (CINP-BP-2017), part 2: Review, grading of the evidence and a precise algorithm. International Journal of Neuropsychopharmacology. In press. http://ijnp.oxfordjournals.org/content/early/2016/11/05/ijnp.pyw100.long. Accessed Dec. 6, 2016.
• Beyer JL, et al. Nutrition and bipolar depression. Psychiatric Clinics of North America. 2016;39:75.
• Qureshi NA, et al. Mood disorders and complementary and alternative medicine: A literature review. Neuropsychiatric Disease and Treatment. 2013;9:639.
• Sansone RA, et al. Getting a knack for NAC: N-acetyl-cysteine. Innovations in Clinical Neuroscience. 2011;8:10.
• Sylvia LG, et al. Nutrient-based therapies for bipolar disorder: A systematic review. Psychotherapy and Psychosomatics. 2013;82:10.
• Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 27, 2016.
• Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 4, 2017.
• Post RM. Bipolar disorder in adults: Choosing maintenance treatment. http://www.uptodate.com/home. Accessed Jan. 4, 2016.
• Janicak PG. Bipolar disorder in adults and lithium: Pharmacology, administration, and side effects. http://www.uptodate.com/home. Accessed Jan. 4, 2017.
• Stovall J. Bipolar disorder in adults: Pharmacotherapy for acute mania and hypomania. http://www.uptodate.com/home. Accessed Jan. 4, 2017.
• Bipolar disorder in children: Is it possible?
• Bipolar medications and weight gain
• Bipolar treatment: I vs. II

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Bipolar Disorder

What is bipolar disorder.

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration. These shifts can make it difficult to carry out day-to-day tasks.

There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, irritable, or energized behavior (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

• Bipolar I disorder  is defined by manic episodes that last for at least 7 days (nearly every day for most of the day) or by manic symptoms that are so severe that the person needs immediate medical care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible. Experiencing four or more episodes of mania or depression within 1 year is called “rapid cycling.”
• Bipolar II disorder  is defined by a pattern of depressive episodes and hypomanic episodes. The hypomanic episodes are less severe than the manic episodes in bipolar I disorder.
• Cyclothymic disorder  (also called cyclothymia) is defined by recurring hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.

Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, and this is referred to as “other specified and unspecified bipolar and related disorders.”

Bipolar disorder is often diagnosed during late adolescence (teen years) or early adulthood. Sometimes, bipolar symptoms can appear in children. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

What are the signs and symptoms of bipolar disorder?

People with bipolar disorder experience periods of unusually intense emotion and changes in sleep patterns and activity levels, and engage in behaviors that are out of character for them—often without recognizing their likely harmful or undesirable effects. These distinct periods are called mood episodes. Mood episodes are very different from the person’s usual moods and behaviors. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks.

Sometimes people have both manic and depressive symptoms in the same episode, and this is called an episode with mixed features. During an episode with mixed features, people may feel very sad, empty, or hopeless while at the same time feeling extremely energized.

A person may have bipolar disorder even if their symptoms are less extreme. For example, some people with bipolar II disorder experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done, and keep up with day-to-day life. The person may not feel that anything is wrong, but family and friends may recognize changes in mood or activity levels as possible symptoms of bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression.

Receiving the right diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a health care provider is the first step. The health care provider can complete a physical exam and other necessary medical tests to rule out other possible causes. The health care provider may then conduct a mental health evaluation or provide a referral to a trained mental health care provider, such as a psychiatrist, psychologist, or clinical social worker who has experience in diagnosing and treating bipolar disorder.

Mental health care providers usually diagnose bipolar disorder based on a person’s symptoms, lifetime history, experiences, and, in some cases, family history. Accurate diagnosis in youth is particularly important.

Find  tips to help prepare for and get the most out of your visit with your health care provider.

Bipolar disorder and other conditions

Many people with bipolar disorder also have other mental disorders or conditions such as  anxiety disorders ,  attention-deficit/hyperactivity disorder (ADHD) ,  misuse of drugs or alcohol , or  eating disorders.  Sometimes people who have severe manic or depressive episodes also have symptoms of  psychosis , which may include hallucinations or delusions. The psychotic symptoms tend to match the person’s extreme mood. For example, someone having psychotic symptoms during a depressive episode may falsely believe they are financially ruined, while someone having psychotic symptoms during a manic episode may falsely believe they are famous or have special powers.

Looking at a person’s symptoms over the course of the illness and examining their family history can help a health care provider determine whether the person has bipolar disorder along with another disorder.

What are the risk factors for bipolar disorder?

Researchers are studying possible causes of bipolar disorder. Most agree that there are many factors that are likely to contribute to a person’s chance of having the disorder.

Brain structure and functioning:  Some studies show that the brains of people with bipolar disorder differ in certain ways from the brains of people who do not have bipolar disorder or any other mental disorder. Learning more about these brain differences may help scientists understand bipolar disorder and determine which treatments will work best. At this time, health care providers base the diagnosis and treatment plan on a person’s symptoms and history, rather than brain imaging or other diagnostic tests.

Genetics:  Some research suggests that people with certain genes are more likely to develop bipolar disorder. Research also shows that people who have a parent or sibling with bipolar disorder have an increased chance of having the disorder themselves. Many genes are involved, and no one gene causes the disorder. Learning more about how genes play a role in bipolar disorder may help researchers develop new treatments.

How is bipolar disorder treated?

Treatment can help many people, including those with the most severe forms of bipolar disorder. An effective treatment plan usually includes a combination of medication and psychotherapy, also called talk therapy.

Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment can help people manage these symptoms.

Certain medications can help manage symptoms of bipolar disorder. Some people may need to try different medications and work with their health care provider to find the medications that work best.

The most common types of medications that health care providers prescribe include mood stabilizers and atypical antipsychotics. Mood stabilizers such as lithium or valproate can help prevent mood episodes or reduce their severity. Lithium also can decrease the risk of suicide. Health care providers may include medications that target sleep or anxiety as part of the treatment plan.

Although bipolar depression is often treated with antidepressant medication, a mood stabilizer must be taken as well—taking an antidepressant without a mood stabilizer can trigger a manic episode or rapid cycling in a person with bipolar disorder.

Because people with bipolar disorder are more likely to seek help when they are depressed than when they are experiencing mania or hypomania, it is important for health care providers to take a careful medical history to ensure that bipolar disorder is not mistaken for depression.

People taking medication should:

• Talk with their health care provider to understand the risks and benefits of the medication.
• Tell their health care provider about any prescription drugs, over-the-counter medications, or supplements they are already taking.
• Report any concerns about side effects to a health care provider right away. The health care provider may need to change the dose or try a different medication.
• Remember that medication for bipolar disorder must be taken consistently, as prescribed, even when one is feeling well.

It is important to talk to a health care provider before stopping a prescribed medication. Stopping a medication suddenly may lead symptoms to worsen or come back. You can find basic information about medications on  NIMH's medications webpage . Read the latest medication warnings, patient medication guides, and information on newly approved medications on the  Food and Drug Administration (FDA) website. 

Psychotherapy

Psychotherapy, also called talk therapy, can be an effective part of treatment for people with bipolar disorder. Psychotherapy is a term for treatment techniques that aim to help people identify and change troubling emotions, thoughts, and behaviors. This type of therapy can provide support, education, and guidance to people with bipolar disorder and their families.

Cognitive behavioral therapy (CBT) is an important treatment for depression, and CBT adapted for the treatment of insomnia can be especially helpful as part of treatment for bipolar depression.

Treatment may also include newer therapies designed specifically for the treatment of bipolar disorder, including interpersonal and social rhythm therapy (IPSRT) and family-focused therapy.

Learn more about the  various types of psychotherapies .

Other treatment options

Some people may find other treatments helpful in managing their bipolar symptoms:

• Electroconvulsive therapy (ECT)  is a brain stimulation procedure that can help relieve severe symptoms of bipolar disorder. Health care providers may consider ECT when a person’s illness has not improved after other treatments, or in cases that require rapid response, such as with people who have a high suicide risk or catatonia (a state of unresponsiveness).
• Repetitive transcranial magnetic stimulation (rTMS)  is a type of brain stimulation that uses magnetic waves to relieve depression over a series of treatment sessions. Although not as powerful as ECT, rTMS does not require general anesthesia and has a low risk of negative effects on memory and thinking.
• Light therapy  is the best evidence-based treatment for  seasonal affective disorder (SAD) , and many people with bipolar disorder experience seasonal worsening of depression or SAD in the winter. Light therapy may also be used to treat lesser forms of seasonal worsening of bipolar depression.

Unlike specific psychotherapy and medication treatments that are scientifically proven to improve bipolar disorder symptoms, complementary health approaches for bipolar disorder, such as natural products, are not based on current knowledge or evidence. Learn more on the  National Center for Complementary and Integrative Health website  .

Finding treatment

• A family health care provider is a good resource and can be the first stop in searching for help. Find tips to help prepare for and get the most out of your visit .
• To find mental health treatment services in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357), visit the SAMHSA online treatment locator  , or text your ZIP code to 435748.
• Learn more about finding help on the NIMH website.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline   at 988 or chat at 988lifeline.org   . In life-threatening situations, call 911.

Coping with bipolar disorder

Living with bipolar disorder can be challenging, but there are ways to help make it easier.

• Work with a health care provider to develop a treatment plan and stick with it. Treatment is the best way to start feeling better.
• Follow the treatment plan as directed. Work with a health care provider to adjust the plan, as needed.
• Structure your activities. Try to have a routine for eating, sleeping, and exercising.
• Try regular, vigorous exercise like jogging, swimming, or bicycling, which can help with depression and anxiety, promote better sleep, and support your heart and brain health.
• Track your moods, activities, and overall health and well-being to help recognize your mood swings.
• Ask trusted friends and family members for help in keeping up with your treatment plan.
• Be patient. Improvement takes time. Staying connected with sources of social support can help.

Long-term, ongoing treatment can help control symptoms and enable you to live a healthy life.

How can I find a clinical trial for bipolar disorder?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

• NIMH’s Clinical Trials webpage : Information about participating in clinical trials
• Clinicaltrials.gov: Current Studies on Bipolar Disorder  : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country
• Join a Study: Bipolar Disorder – Adults : List of studies being conducted on the NIH Campus in Bethesda, MD

Where can I learn more about bipolar disorder?

Free brochures and shareable resources.

• Bipolar Disorder : A brochure on bipolar disorder that offers basic information on signs and symptoms, treatment, and finding help. Also available en español .
• Bipolar Disorder in Children and Teens : A brochure on bipolar disorder in children and teens that offers basic information on signs and symptoms, treatment, and finding help. Also available en español .
• Bipolar Disorder in Teens and Young Adults: Know the Signs : An infographic presenting common signs and symptoms of bipolar disorder in teens and young adults. Also available  en español .
• Shareable Resources on Bipolar Disorder :  Digital resources, including graphics and messages, to help support bipolar disorder awareness and education.
• NIMH Experts Discuss Bipolar Disorder in Adults : Learn the signs and symptoms, risk factors, treatments of bipolar disorder, and the latest NIMH-supported research in this area.
• Mental Health Minute: Bipolar Disorder in Adults : A minute-long video to learn about bipolar disorder in adults.
• NIMH Expert Discusses Bipolar Disorder in Adolescents and Young Adults :  A video with an expert who explains the signs, symptoms, and treatments of bipolar disorder.

Research and Statistics

• Journal Articles   : This webpage provides information on references and abstracts from MEDLINE/PubMed (National Library of Medicine).
• Bipolar Disorder Statistics : An NIMH webpage that provides information on the prevalence of bipolar disorder among adults and adolescents.

Last Reviewed: February 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

Bipolar Disorder in Clinical Practice Essay

Case background.

Mental health-related issues impact human beings in various ways. Psychological issues cause behavioral change that is hard to comprehend. In Sabrina’s case, the client has bipolar disorder. Bipolar disorders are a common condition that is disabling and can be life-threatening. Bipolar disorder involves interchanging episodes of depression, mania, hypomania, or a combination. However, many clinicians face diagnostic and therapeutic challenges related to bipolar disorders (Myczkowski et al., 2018). The psychological field is essential as it focuses on achieving prevention and treatment strategies to reduce distress. Therefore, for proper treatment, a professional therapist must follow the psychiatric diagnostic criteria for the disorder. Hence, the DSM-5 is a fundamental and reliable criterion for accurately diagnosing mental health conditions.

Presented Problem

Depression and mania, or a combination of the two, are hallmarks of bipolar disorder, a serious, long-term psychiatric condition. The first step to accurately diagnosing bipolar I or II disorder is identifying current or previous manic, hypomanic, or depressive episodes. This type of mood episode has specific diagnostic criteria and clinical probes for identifying key symptoms. Bipolar disorder subtypes Bipolar-I and Bipolar-II and cyclothymic disorder, intermediate phenotypes of the disorder frequently encountered in clinical practice, can be diagnosed using the DSM-5 criteria.

Manic Episode

The client was experiencing a distinct period of abnormally elevated, irritable mood, lasting for at least one week (Mohammadi et al., 2018). The client has mood swings most of the day, taking 10 to 15 minutes to cry in the bathroom nearly daily.

The patient experienced the following symptoms during the period of mood disturbances and also presented a significant level of behavioral change:

• The client declined invitations by co-workers to happy hours and social events; hence, an indication of social isolation due to low self-esteem
• The client has a decreased need for sleep as she spends most evening times watching television
• The disorder makes the client have subjective experiences
• The client is overwhelmed with sadness, distracted, and faces psychomotor agitation
• The mood disturbance is severe to cause marked impairment in social functioning
• The client’s episode is not attributed to substance psychological effects or medical condition

Client Resources/ Competencies

• The client is educated as she has recently graduated with a degree in civil engineering
• The client has employment in an engineering firm in Manhattan
• The client is financially-able and can make positive decisions about her life. She plans to move to New York after getting the job
• The client has a loving and caring family, workmates, and friends, who support her achievements and are concerned about her social life

Goals and Objectives/Measurable Outcomes

The client will demonstrate a reduction of subjective experiences and sadness by 80% within six months:

• Monitor the mood by improving the sleeping period to five hours every night
• Develop a schedule. Routine is vital in keeping your mood consistent. Organize a timetable and attempt to keep to it regardless of the mood to maintain consistency.
• Limit stress by having reduced pressures in life
• Build an excellent support network. Allow family and friends to assist in managing your day-to-day symptoms by offering an outsider’s viewpoint on your mood.
• Engage in physical exercise 2 to 3 times a day for 30 minutes since exercise is effective as a technique to help control mood.

Treatment/Intervention Frequency and Duration

Family-focused treatment.

Family-focused treatment is based on the widely reproduced relationship between criticism and anger in caregivers and an increased chance of relapse in mood disorders. Family-focused therapy involves the patient and caregivers in up to 21 sessions of psychoeducation, communication skills training, and problem-solving skills training (Miklowitz et al., 2020). The intervention should take 2-3 times a week, including family meetings, to improve the client’s social interaction.

Cognitive-Behavioral Treatment

Cognitive-behavioral treatment presumes that recurrences of mood illness are governed by pessimistic thinking in reaction to life events and basic dysfunctional beliefs about the self, the environment, and the future. Cognitive-behavioral treatment to treat depression has been developed for individuals with bipolar illness, with the knowledge that manic periods are typically linked with overly positive thoughts (Furukawa et al., 2021). CBT is an evidence-based treatment that involves 12 to 16 weekly sessions depending on the degree of the manic episode. CBT has greater efficacy for all mental diseases than psychoanalysis and person-centered treatment. Hence, it will help recognize unhealthy, negative ideas and habits and replace them with healthy, constructive ones. CBT can assist in discovering what triggers bipolar episodes and useful techniques to control stress and cope with stressful events.

Cognitive stimulation therapy (Furukawa et al., 2021):

• CST enhances patients’ quality of life as it provides favorable effects on cognition improvement
• The technique exhibits more notable cognitive gain in females than males and elderly persons than the younger age group.
• CST enhances patients’ attention, and alertness boosts willingness to engage in conversation or socialize and improves memory.
• The treatment technique is cost-effective
• The problem with CST is that it is only influential on particular cultures.
• The strategy displays efficacy in household situations. Older patients prefer a customized therapy method versus group-based therapy.

Furukawa, T. A., Suganuma, A., Ostinelli, E. G., Andersson, G., Beevers, C. G., Shumake, J.,… & Cuijpers, P. (2021). Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data. The Lancet Psychiatry , 8 (6), 500-511.

Miklowitz, D. J., Schneck, C. D., Walshaw, P. D., Singh, M. K., Sullivan, A. E., Suddath, R. L.,… & Chang, K. D. (2020). Effects of family-focused therapy vs enhanced usual care for symptomatic youths at high risk for bipolar disorder: a randomized clinical trial. JAMA psychiatry , 77 (5), 455-463.

Mohammadi, Z., Pourshahbaz, A., Poshtmashhadi, M., Dolatshahi, B., Barati, F., & Zarei, M. (2018). Psychometric properties of the young mania rating scale as a mania severity measure in patients with bipolar I disorder. Practice in Clinical Psychology , 6 (3), 175-182.

Myczkowski, M. L., Fernandes, A., Moreno, M., Valiengo, L., Lafer, B., Moreno, R. A.,… & Brunoni, A. R. (2018). Cognitive outcomes of TMS treatment in bipolar depression: safety data from a randomized controlled trial. Journal of affective disorders , 235 , 20-26.

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1. IvyPanda . "Bipolar Disorder in Clinical Practice." November 10, 2023. https://ivypanda.com/essays/bipolar-disorder-in-clinical-practice/.

Bibliography

IvyPanda . "Bipolar Disorder in Clinical Practice." November 10, 2023. https://ivypanda.com/essays/bipolar-disorder-in-clinical-practice/.

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• Bipolar Disorder and Its Main Phases
• The Bipolar Disorder and Its Management
• Mental Disorder: Treating a Family Member
• Identified Clinical Problem: Analysis
• Patient Evaluation: Differential Diagnoses and Communication Techniques
• Psychotic Tendencies: Andy's Case
• Bulimia Nervosa: The Cognitive Behavioral Therapy

Should I Mention Depression on My College Application?

Colleges scrutinize applications from troubled students more closely.

Should I Put Depression on My College Apps?

Phil Bliss | TheiSpot.com for USN&WR

Growing up in New York City, Emily Isaac studied Hebrew, performed in school musicals, and played soccer. She fantasized about going to a prestigious university like Harvard and becoming a lawyer for Hollywood celebrities. But her drive and ambition faded when she reached high school. She ignored homework assignments and argued with teachers. Her grades dropped to mostly C's and D's. She was so difficult that she was asked to leave three private schools in two years. Emily says she was angry and depressed over a family member's drug use. At age 17 last fall, she was applying to colleges and had a tough decision to make: How to present herself to admissions officers increasingly wary of troubled students?

Concerned about liability and campus safety in the wake of shootings at Northern Illinois University and Virginia Tech, more colleges and universities are scrutinizing the character of applicants. They want to know about students' past behavior, and, if there is any doubt, they will call high school counselors for answers. Admissions officers say "youthful indiscretions" like a schoolyard brawl or an unpaid traffic ticket aren't likely to result in denial letters. But a pattern of troubling behavior could cost someone an admission.

"We're not only admitting students for intellectual reasons but for community reasons," says Debra Shaver, director of admissions at Smith College, a private women's liberal arts school in Massachusetts. "We want to make sure they will be good community members." Smith and other schools acknowledge that making judgments about character is sometimes a messy process. It doesn't involve precise measures like SAT scores or grade-point average. "In some cases, you say, 'This makes me nervous,' and maybe it is an intuition and some reasonable people would disagree, but it goes with the territory," says Bruce Poch, dean of admissions at Pomona College in Claremont, Calif.

Full disclosure. It's not surprising, then, that students like Emily agonize over the decision to disclose personal and academic problems. "We finally hired an independent counselor," says Lisa Kaufman, Emily's mother.

Not all counselors agree on what advice to give families. Some discourage students from bringing up mental illnesses and emotional problems altogether. Others say full disclosure helps when a student's records show poor grades or other inconsistencies that are likely to make colleges suspicious. Shirley Bloomquist, an independent college counselor in Great Falls, Va., says she once called a liberal arts college in Massachusetts to say she was disappointed by its decision to reject an applicant who had written about overcoming a drug addiction. The student had completed a drug rehabilitation program and had been clean for a year. "Colleges are more concerned than ever about student emotional stability," Bloomquist says. "I think it is imperative that the student, the parent, and the high school counselor discuss the situation and decide what should or should not be revealed."

Sally Rubenstone, senior counselor with CollegeConfidential.com and coauthor of Panicked Parents' Guide to College Admission, says being forthright about past behavior or mental health problems doesn't mean "The Jerry Springerization of the College Admissions Essay." "Sometimes I have to implore [students] to stay mum," she says. "There are clearly times when personal problems are too personal—or inappropriate—to include in a college essay."

Emily's problems, however, needed airing—but not all of them. For example, she didn't disclose her troubles in middle school because colleges asked only (via the Common Application) about academic and behavioral misconduct in high school. She says she was asked to leave one high school after a confrontation with another student, but the offense was never recorded in her file, so she didn't volunteer that information either. On the advice of her counselor, Emily wrote cover letters and an essay focusing instead on the reasons for her documented troubles in school and how she had grown from those experiences.

Although colleges would know from her transcripts that she had been at a boarding school for troubled teens, Emily didn't explicitly mention depression in her essay. Rubenstone, who served as Emily's counselor in the admissions process, says, "Colleges can run scared when they hear the word depression. " Emily, who got treatment, hoped colleges would pay attention to her improvement instead. "I thought I was taking a risk, but I had faith that people would understand," she says. In one of her cover letters, Emily wrote: "What I am trying to say is that my past no longer dictates my future and that I am a far more capable, hard-working, mature student than depicted in my forms."

Colleges cannot legally deny admission specifically on the basis of mental illness, but it's hard to account for how that characteristic figures into the calculus of who gets in and who doesn't. Admissions officers undoubtedly are aware that the shooters at Virginia Tech and Northern Illinois had troubled histories before they applied to school: Indeed, the graduate student responsible for the NIU attack had written about his emotional struggles in adolescence in his admission application. Admissions officers, ever mindful of the diversity on campus, also are aware that reports of depressed college students are on the rise.

Not all colleges offer students a second chance. One high school senior in Tucson, Ariz., with an impressive academic record was rejected by a selective liberal arts college after his counselor says he told the school that the student had been disciplined for smoking marijuana on a field trip. The counselor says he helped the student with his essay, believing that if it struck the right tone and offered a sincere apology and a pledge from the student that he would not make the same mistake again, the essay would persuade the college to admit him. It didn't. "This particular school was trying very hard to diminish its reputation as being 'kind of tolerant of druggies'—the very words used by the college representative," the counselor says.

Barmak Nassirian of the American Association of Collegiate Registrars and Admissions Officers says too much pressure is being put on college admission officers who lack the expertise to evaluate the seriousness of an offense or an applicant's emotional well-being. In the absence of clear guidelines, Nassirian says, colleges should stop asking about past behavior altogether. "It's very tempting for colleges to say we're excluding the next Jack the Ripper from sitting next to your son or daughter," he says. "But it's really your son or daughter who is getting nabbed and getting nabbed for having done something stupid in high school."

Common Application. That may be the reason that many high schools don't disclose information about a student's disciplinary history. A recent survey of 2,306 public and private high schools found that only 23 percent of schools said they allowed for the disclosure of such information to colleges, 39 percent said they disclose sometimes, and 38 percent said they never do. The results refer to questions asked by about 340 colleges that use the Common Application, which inquires if students have ever been convicted of a crime or been severely disciplined in high school. This year, 347,837 high school students used the Common Application. Of those, only 2 percent said they had a serious discipline problem in high school, and 0.22 percent said they were convicted of a misdemeanor or felony.

It's not clear how many students refuse to answer the questions or conceal their past troubles. In what one admissions counselor sees as a separate, disturbing trend, high schools that once suspended or expelled students for offenses such as academic dishonesty now strike deals with parents and students that result in less severe consequences and no record of the student's indiscretion. One New York student who has been accepted to several competitive schools says he caught a lucky break when the private high school he attended his freshman year decided that rather than expel him, it would let him quietly transfer to another school after he was caught stealing a biology exam. The school told him it would not notify colleges about the incident. At his new high school, the student was suspended for insulting another student. And again he was able to cut a deal with the principal at that school. The student, who requested anonymity, says he was able to "work off" the suspension from his record by performing community service. He says his guidance counselor discouraged him from bringing up either incident on his college applications. "It's not that I wanted to lie," he says. "I just didn't want to lose everything that I've worked so hard for."

If an applicant's school records raise suspicion, colleges say they will make every effort to verify the information. Some, for instance, will turn to Google, Facebook, or another source on the Internet. But it's not clear how thorough most colleges are when high schools don't cooperate. It is often the case, some say, that an anonymous tipster or an upset parent of a child who was not admitted to the school will come forward. Colleges say a high school's refusal to share information could damage the school's relationship with the college, especially in the event that the applicant is admitted and later commits a crime.

Marlyn McGrath Lewis, director of admissions at Harvard, says high schools that knowingly withhold troubling information about applicants will be held responsible. "We're not a detective agency," she says. "We operate on the assumption that schools are behaving honorably." If administrators learn that an applicant has lied, colleges can rescind offers of admission. That's what happened in 1995 when Harvard administrators found out that an admitted applicant had killed her mother when she was 14. The applicant, a straight-A student, had not disclosed the incident in her Harvard application on the advice of her lawyer.

Seth Allen, dean of admissions at Grinnell College, a liberal arts school in Iowa, says colleges expect that students will answer questions about their past behavior truthfully and completely. "We want to understand if you slipped up why it happened," he says. "If we understand that there is a death in the family or a personal crisis that would help us say, 'This is not a normal pattern of behavior,' we can forgive you." Sometimes, he adds, an honest and thoughtful response can make a candidate more appealing.

Earlier this year, Emily was offered admission to six schools; she has decided to attend Simmons College in Boston. She was turned down by four other schools. "I'm grateful because I feel people are willing to take a chance on me," she says. "It just makes me hopeful that the world is moving away from fear and towards acceptance of those of us who haven't had the easiest times."

Tags: college admissions , mental health , depression

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Should I admit my bipolar disorder in my essay or should I say something else...

<p>I wrote two versions of my essay. For the prompt, I have to explain why I got bad grades for my first two years of high school. </p>

<p>The true one talks about living with a undiagnost bipolar disorder for 17 years. I talked about having extreme bursts of productivity which resulted in great grades and accomplishments. And then, during a low state, I would have lesser grades and struggle with staying involved in life. I mention that now I am on medication that keeps me stable and acting like a normal human being as of 4 months ago… There is some other explanations in between but basically what I am saying is that I am a 4.0 student that due to an extreme emotional disorder and an extremely hard life suffered during most of high school academically.</p>

<p>My other essay says the same thing, except that I don’t mention bipolar disorder. The essay sounds good, but it is bs about lack of parenting, teenage rebellion, angst, and confusion. I talk about my real family traumas having a lot to do with it too. A reason that has happened to a lot of kids that have a bad high school record. </p>

<p>I guess I don’t want to lie but I really want to get into a college/university. I am very much on the edge of having to go to a community college. I can’t help sounding kind of crazy in my bipolar version and that I am only normal because I am meded out (which is true to an extent). From personal experience, most people don’t know what bipolar is or misunderstand it. It is also known that bipolar is sometimes diagnosed because of drug companies wanting to make more profits. I also know a lot of people who literally don’t believe in emotional disorders.<br> On top of this, I read an article about how colleges reject students because they have emotional problems and they do not want students like that in their college.</p>

<p>I want to make sure I am not making a mistake.</p>

<p>edit: I have a 1480 SAT score which isn’t that good. I can do a lot better and I am studying to retake it. So, that is another problem. I know I can’t get into a top school as of now, but some “lesser” university would still be better then community college.</p>

<p>I mentioned in another thread that stories of personal hardship work so long as you can demonstrate that you’re grown from the experience and aren’t just using it as an excuse or for pity points. </p>

<p><a href=“ http://talk.collegeconfidential.com/college-essays/1109925-do-sob-stories-work.html[/url] ”> http://talk.collegeconfidential.com/college-essays/1109925-do-sob-stories-work.html&lt;/a&gt;&lt;/p&gt ;

<p>It’s up to you whether you want to disclose your mental health. Whatever you decide, tie it back to why your experience/perspective would still make a good addition to the university. </p>

<p>I had a friend in college who included mention of something that happened to her just sort of in passing and it made for a pretty effective essay. “After surviving [horrible thing], I went on to do awesome things 1, 2, and 3 because I’m passionate about blah blah blah…”</p>

<p>I would not mention it. Honestly, schools don’t want the liability and it’s none of their business. And I would not dismiss community college, either - a year or two with great grades there will get you into a college you want and save you or your parents a lot of money.</p>

<p>Schools are wary of admitting students with mental disorders. Of course, you’d want them to be able to help you when you got there, so hiding it might not be the best idea. It’s a tricky balance.</p>

<p>i’m looking at it now and it sounds like a really bad "sob’ story. i only had a few days to write it after deciding not to turn in my polished teen angst one. haha i’m not going to get in. it has no balance and it’s over the top. i am going to re write it…</p>

<p>so do you think a teenaged angst story will sound better in the future for college applications? i did a good job writing that essay, it has good balance of tragic things and learning from your mistakes and improving. it’s close to misszebra’s idea of essays. but, mentioning bipolar, with the negatives asides, conveys that i was never a rebel and always wanted to succeed academically but the disorder got in the way. </p>

<p>the colleges i’m applying at aren’t that selective. also, i really dislike the idea of spending a year at community college. i want to live in the dorms on campusm for my freshman year, that seems fun.</p>

<p>anyone have any sources for their claims that colleges don’t like to accept students with a mental/ mood disorder?</p>

<p>a hospital,</p>

<p>I am not sure how far along you are with your application process, or if your deadlines have already passed. But as an applicant who is/was in a situation similar to yours, I feel I may be able to offer some insight.</p>

<p>I wrote my transfer application essay (from a community college) on my experience with panic disorder. To make a long story short, I was diagnosed at 12 years old, and I struggled with them until I was 18 years old… right through high school. As a result, my HS grades were so-so (ranged from a 2.0 to a 4.2 some semesters), although they weren’t atrocious. </p>

<p>The first third of my essay portrayed what it is like to have panic attacks on a daily basis, and how it affected my life. The last part (and majority) elaborated on how I overcame it, and how I am stronger because of it. Gaining control of the panic enabled me to control my future, and after spending weeks locked in my house… life is beautiful. It pretty much said: “Go ahead and throw an unimaginable college workload at me. My diaphragmatic breathing techniques can get me through the freakin’ apocalypse.”</p>

<p>I’ve been accepted to Smith College and Mount Holyoke College thus far; both are schools with about 50% acceptance rates, give or take. I am waiting for other responses. Granted, the essay was paired with college transcripts with a 4.0, and other evidence of my improvement.</p>

<p>I am not sure how the first-year essay is different from the transfer essay. I hate to say I am “cured” of my anxiety, but I have certainly overcome it; I haven’t had in attack in two years. If you feel as though bipolar disorder is no longer an impediment to your success, and that you have truly matured as a person because of your recovery, then I don’t see it as a problem at all. </p>

<p>Good luck! If you have any other questions, feel free to PM me.</p>

<p>Hi, you can write about a disorder that you have faced or still facing. But, as one of the earlier members said, make sure that this essay is not about sympathy or empathy grabbing, but a real and painful experience that you have gone through. As the disorder that you spoke about was before and after medication. so, there must have been an emotional side to it. Try to bring it forth and use words which do not make the essay an emotional black mail but an experience about a genuine problem. Please do not take my words as offensive but take them positively.</p>

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David Wallace-Wells

Are smartphones driving our teens to depression.

By David Wallace-Wells

Opinion Writer

Here is a story. In 2007, Apple released the iPhone, initiating the smartphone revolution that would quickly transform the world. In 2010, it added a front-facing camera, helping shift the social-media landscape toward images, especially selfies. Partly as a result, in the five years that followed, the nature of childhood and especially adolescence was fundamentally changed — a “great rewiring,” in the words of the social psychologist Jonathan Haidt — such that between 2010 and 2015 mental health and well-being plummeted and suffering and despair exploded, particularly among teenage girls.

For young women, rates of hospitalization for nonfatal self-harm in the United States, which had bottomed out in 2009, started to rise again, according to data reported to the C.D.C., taking a leap beginning in 2012 and another beginning in 2016, and producing , over about a decade, an alarming 48 percent increase in such emergency room visits among American girls ages 15 to 19 and a shocking 188 percent increase among girls ages 10 to14.

Here is another story. In 2011, as part of the rollout of the Affordable Care Act, the Department of Health and Human Services issued a new set of guidelines that recommended that teenage girls should be screened annually for depression by their primary care physicians and that same year required that insurance providers cover such screenings in full. In 2015, H.H.S. finally mandated a coding change, proposed by the World Health Organization almost two decades before, that required hospitals to record whether an injury was self-inflicted or accidental — and which seemingly overnight nearly doubled rates for self-harm across all demographic groups. Soon thereafter, the coding of suicidal ideation was also updated. The effect of these bureaucratic changes on hospitalization data presumably varied from place to place. But in one place where it has been studied systematically, New Jersey, where 90 percent of children had health coverage even before the A.C.A., researchers have found that the changes explain nearly all of the state’s apparent upward trend in suicide-related hospital visits, turning what were “essentially flat” trendlines into something that looked like a youth mental health “crisis.”

Could both of these stories be partially true? Of course: Emotional distress among teenagers may be genuinely growing while simultaneous bureaucratic and cultural changes — more focus on mental health, destigmatization, growing comfort with therapy and medication — exaggerate the underlying trends. (This is what Adriana Corredor-Waldron, a co-author of the New Jersey study, believes — that suicidal behavior is distressingly high among teenagers in the United States and that many of our conventional measures are not very reliable to assess changes in suicidal behavior over time.) But over the past several years, Americans worrying over the well-being of teenagers have heard much less about that second story, which emphasizes changes in the broader culture of mental illness, screening guidelines and treatment, than the first one, which suggests smartphones and social-media use explain a whole raft of concerns about the well-being of the country’s youth.

When the smartphone thesis first came to prominence more than six years ago, advanced by Haidt’s sometime collaborator Jean Twenge, there was a fair amount of skepticism from scientists and social scientists and other commentators: Were teenagers really suffering that much? they asked. How much in this messy world could you pin on one piece of technology anyway? But some things have changed since then, including the conventional liberal perspective on the virtues of Big Tech, and, in the past few years, as more data has rolled in and more red flags have been raised about American teenagers — about the culture of college campuses, about the political hopelessness or neuroticism or radicalism or fatalism of teenagers, about a growing political gender divide, about how often they socialize or drink or have sex — a two-part conventional wisdom has taken hold across the pundit class. First, that American teenagers are experiencing a mental health crisis; second, that it is the fault of phones.

“Smartphones and social media are destroying children’s mental health,” the Financial Times declared last spring. This spring, Haidt’s new book on the subject, The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness, debuted at the top of the New York Times best-seller list. In its review of the book, The Guardian described the smartphone as “a pocket full of poison,” and in an essay , The New Yorker accepted as a given that Gen Z was in the midst of a “mental health emergency” and that “social media is bad for young people.” “Parents could see their phone-obsessed children changing and succumbing to distress,” The Wall Street Journal reflected . “Now we know the true horror of what happened.”

But, well, do we? Over the past five years, “Is it the phones?” has become “It’s probably the phones,” particularly among an anxious older generation processing bleak-looking charts of teenage mental health on social media as they are scrolling on their own phones. But however much we may think we know about how corrosive screen time is to mental health, the data looks murkier and more ambiguous than the headlines suggest — or than our own private anxieties, as parents and smartphone addicts, seem to tell us.

What do we really know about the state of mental health among teenagers today? Suicide offers the most concrete measure of emotional distress, and rates among American teenagers ages 15 to 19 have indeed risen over the past decade or so, to about 11.8 deaths per 100,000 in 2021 from about 7.5 deaths per 100,000 in 2009. But the American suicide epidemic is not confined to teenagers. In 2022, the rate had increased roughly as much since 2000 for the country as a whole, suggesting a national story both broader and more complicated than one focused on the emotional vulnerabilities of teenagers to Instagram. And among the teenagers of other rich countries, there is essentially no sign of a similar pattern. As Max Roser of Our World in Data recently documented , suicide rates among older teenagers and young adults have held roughly steady or declined over the same time period in France, Spain, Italy, Austria, Germany, Greece, Poland, Norway and Belgium. In Sweden there were only very small increases.

Is there a stronger distress signal in the data for young women? Yes, somewhat. According to an international analysis by The Economist, suicide rates among young women in 17 wealthy countries have grown since 2003, by about 17 percent, to a 2020 rate of 3.5 suicides per 100,000 people. The rate among young women has always been low, compared with other groups, and among the countries in the Economist data set, the rate among male teenagers, which has hardly grown at all, remains almost twice as high. Among men in their 50s, the rate is more than seven times as high.

In some countries, we see concerning signs of convergence by gender and age, with suicide rates among young women growing closer to other demographic groups. But the pattern, across countries, is quite varied. In Denmark, where smartphone penetration was the highest in the world in 2017, rates of hospitalization for self-harm among 10- to 19-year-olds fell by more than 40 percent between 2008 and 2016. In Germany, there are today barely one-quarter as many suicides among women between 15 and 20 as there were in the early 1980s, and the number has been remarkably flat for more than two decades. In the United States, suicide rates for young men are still three and a half times as high as for young women, the recent increases have been larger in absolute terms among young men than among young women, and suicide rates for all teenagers have been gradually declining since 2018. In 2022, the latest year for which C.D.C. data is available, suicide declined by 18 percent for Americans ages 10 to 14 and 9 percent for those ages 15 to 24.

None of this is to say that everything is fine — that the kids are perfectly all right, that there is no sign at all of worsening mental health among teenagers, or that there isn’t something significant and even potentially damaging about smartphone use and social media. Phones have changed us, and are still changing us, as anyone using one or observing the world through them knows well. But are they generating an obvious mental health crisis?

The picture that emerges from the suicide data is mixed and complicated to parse. Suicide is the hardest-to-dispute measure of despair, but not the most capacious. But while rates of depression and anxiety have grown strikingly for teenagers in certain parts of the world, including the U.S., it’s tricky to disentangle those increases from growing mental-health awareness and destigmatization, and attempts to measure the phenomenon in different ways can yield very different results.

According to data Haidt uses, from the U.S. National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration, the percent of teenage girls reporting major depressive episodes in the last year grew by about 50 percent between 2005 and 2017, for instance, during which time the share of teenage boys reporting the same grew by roughly 75 percent from a lower level. But in a biannual C.D.C. survey of teenage mental health, the share of teenagers reporting that they had been persistently sad for a period of at least two weeks in the past year grew from only 28.5 percent in 2005 to 31.5 percent in 2017. Two different surveys tracked exactly the same period, and one showed an enormous increase in depression while the other showed almost no change at all.

And if the rise of mood disorders were a straightforward effect of the smartphone, you’d expect to see it everywhere smartphones were, and, as with suicide, you don’t. In Britain, the share of young people who reported “feeling down” or experiencing depression grew from 31 percent in 2012 to 38 percent on the eve of the pandemic and to 41 percent in 2021. That is significant, though by other measures British teenagers appear, if more depressed than they were in the 2000s, not much more depressed than they were in the 1990s.

Overall, when you dig into the country-by-country data, many places seem to be registering increases in depression among teenagers, particularly among the countries of Western Europe and North America. But the trends are hard to disentangle from changes in diagnostic patterns and the medicalization of sadness, as Lucy Foulkes has argued , and the picture varies considerably from country to country. In Canada , for instance, surveys of teenagers’ well-being show a significant decline between 2015 and 2021, particularly among young women; in South Korea rates of depressive episodes among teenagers fell by 35 percent between 2006 and 2018.

Because much of our sense of teenage well-being comes from self-reported surveys, when you ask questions in different ways, the answers vary enormously. Haidt likes to cite data collected as part of an international standardized test program called PISA, which adds a few questions about loneliness at school to its sections covering progress in math, science and reading, and has found a pattern of increasing loneliness over the past decade. But according to the World Happiness Report , life satisfaction among those ages 15 to 24 around the world has been improving pretty steadily since 2013, with more significant gains among women, as the smartphone completed its global takeover, with a slight dip during the first two years of the pandemic. An international review published in 2020, examining more than 900,000 adolescents in 36 countries, showed no change in life satisfaction between 2002 and 2018.

“It doesn’t look like there’s one big uniform thing happening to people’s mental health,” said Andrew Przybylski, a professor at Oxford. “In some particular places, there are some measures moving in the wrong direction. But if I had to describe the global trend over the last decade, I would say there is no uniform trend showing a global crisis, and, where things are getting worse for teenagers, no evidence that it is the result of the spread of technology.”

If Haidt is the public face of worry about teenagers and phones, Przybylski is probably the most prominent skeptic of the thesis. Others include Amy Orben, at the University of Cambridge, who in January told The Guardian, “I think the concern about phones as a singular entity are overblown”; Chris Ferguson, at Stetson University, who is about to publish a new meta-analysis showing no relationship between smartphone use and well-being; and Candice Odgers, of the University of California, Irvine, who published a much-debated review of Haidt in Nature, in which she declared “the book’s repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science.”

Does that overstate the case? In a technical sense, I think, no: There may be some concerning changes in the underlying incidence of certain mood disorders among American teenagers over the past couple of decades, but they are hard to separate from changing methods of measuring and addressing mental health and mental illness. There isn’t great data on international trends in teenage suicide — but in those places with good reporting, the rates are generally not worsening — and the trends around anxiety, depression and well-being are ambiguous elsewhere in the world. And the association of those local increases with the rise of the smartphone, while now almost conventional wisdom among people like me, is, among specialists, very much a contested claim. Indeed, even Haidt, who has also emphasized broader changes to the culture of childhood , estimated that social media use is responsible for only about 10 percent to 15 percent of the variation in teenage well-being — which would be a significant correlation, given the complexities of adolescent life and of social science, but is also a much more measured estimate than you tend to see in headlines trumpeting the connection. And many others have arrived at much smaller estimates still.

But this all also raises the complicated question of what exactly we mean by “science,” in the context of social phenomena like these, and what standard of evidence we should be applying when asking whether something qualifies as a “crisis” or “emergency” and what we know about what may have caused it. There is a reason we rarely reduce broad social changes to monocausal explanations, whether we’re talking about the rapid decline of teenage pregnancy in the 2000s, or the spike in youth suicide in the late ’80s and early 1990s, or the rise in crime that began in the 1960s: Lives are far too complex to easily reduce to the influence of single factors, whether the factor is a recession or political conditions or, for that matter, climate breakdown.

To me, the number of places where rates of depression among teenagers are markedly on the rise is a legitimate cause for concern. But it is also worth remembering that, for instance, between the mid-1990s and the mid-2000s, diagnoses of American youth for bipolar disorder grew about 40-fold , and it is hard to find anyone who believes that change was a true reflection of underlying incidence. And when we find ourselves panicking over charts showing rapid increases in, say, the number of British girls who say they’re often unhappy or feel they are a failure, it’s worth keeping in mind that the charts were probably zoomed in to emphasize the spike, and the increase is only from about 5 percent of teenagers to about 10 percent in the first case, or from about 15 percent to about 20 percent in the second. It may also be the case, as Orben has emphasized , that smartphones and social media may be problematic for some teenagers without doing emotional damage to a majority of them. That’s not to say that in taking in the full scope of the problem, there is nothing there. But overall it is probably less than meets the eye.

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Further reading (and listening):

On Jonathan Haidt’s After Babel Substack , a series of admirable responses to critics of “The Anxious Generation” and the smartphone thesis by Haidt, his lead researcher Zach Rausch, and his sometime collaborator Jean Twenge.

In Vox, Eric Levitz weighs the body of evidence for and against the thesis.

Tom Chivers and Stuart Ritchie deliver a useful overview of the evidence and its limitations on the Studies Show podcast.

Five experts review the evidence for the smartphone hypothesis in The Guardian.

A Substack survey of “diagnostic inflation” and teenage mental health.

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Mental Health Awareness Month

Are you interested in learning more about mental health or practicing your own self-care? Check out the library’s Mental Health Awareness Month display located in the reading room. Reading recommendations this month include graphic novels, self-help books, and memoirs.

Marbles: Mania, Depression, Michelangelo, & Me – Ellen Forney | Graphic Memoir

Shortly before author and illustrator Ellen Forney turned 30, she was diagnosed with bipolar disorder. For years, she resisted the use of medication out of fear that they would cause her to lose her creativity.

Forney finds inspiration in mentally ill artists who came before her, such as Vincent van Gogh, Georgia O’Keeffe, William Styron, Michaelangelo, and Sylvia Plath. In this graphic memoir, she weaves their stories with her own experiences. She also does her own research on bipolar disorder to learn more about the pros and cons of treatment and pharmaceuticals.

Practicing Mindfulness: 75 Essential Meditations to reduce stress, improve mental health, and find peace in the everyday – Matthew Sockolov | Self-help

This self-help book is a guide for readers to discover calmness and clarity everyday through simple mindfulness techniques. Mindfulness is an evidence-based method meant to reduce stress and anxiety. Sockolov introduces activities that take from as little as 5 minutes up to 25 minutes in order for people to practice even with very busy schedules. He also includes mindfulness techniques targeted for specific stressful situations.

In addition to books, included in our display in the reading room are mindful affirmation cards. Shuffle the cards and pick one out at random or pick one specifically based on what you might need. The cards include sentiments such as “I am calm and peaceful,” “I will find joy today,” or “I love the way today feels.” Feel free to take 1-2 cards and keep them to refer back to as needed.

Burnout: The Secret to Unlocking the Stress Cycle – Emily Nagoski, Phd & Amelia Nagoski, DMA | Self-help

In this ground-breaking self-help book, the twin-sister authors explain why women experience burnout differently than men. The expectations for women in today’s world differs greatly from what it’s really like, and women experience burnout when trying to close that gap. The authors offer constructive tools to combat burnout. They focus on the biological stress cycle and ways to return your body to a state of relaxation. They instruct on how to manage the “monitor” in the brain that regulations emotions and how to defend yourself against the Bikini Industrial Complex . They support the theories that prioritizing rest, human connections, and “befriending your inner critic” are the keys to recovering from and preventing burnout.

Also by Emily Nagoski: Come As You Are

Lighter Than My Shadow – Katie Green | Graphic Memoir

Last fall, Lighter Than My Shadow was recommended by one of EHSL’s own and subsequently was read by the author of this blog post! Katie Green delicately writes about difficult subject matter which is sure to open the hearts of readers. Even though this graphic novel is primarily drawn in grayscale, the images are vivid and beautiful.

Before reading, please be aware of the content of this autobiographical work. Katie Green outlines her experiences with her eating disorder from a very young age into adulthood and multiple sexual assaults.

(Don’t) Call Me Crazy: 33 Voice Start the Conversation About Mental Health – Edited by Kelly Jensen | Nonfiction, Essays, Memoir

(Don’t) Call Me Crazy is an open conversation about the term “crazy.” Is using the term crazy offensive? What does it mean to be crazy? These questions, and more, are explored in this book by 33 different contributors.

This is a good read and guide for anyone who has either struggled with their own mental health or for those who want to learn more about mental health in general.

Hear about how each individual’s brain is wired differently from various writers, athletes, and artists (including famous actor Kristen Bell, who fun fact: also co-authors children’s books.)

Girl, Interrupted – Susanna Kaysen | Memoir

In 1967, Susanna Kaysen was involuntarily admitted to a psychiatric hospital. Girl, Interrupted is her memoir about this experience. She spent about two years hospitalized, among other teenage girls who were admitted long before her and some who remained there long after she was discharged.

The memoir was fictionalized and adapted into a motion picture in 1999, starring Angelina Jolie, Winona Ryder, and Brittany Murphy. The movie has been called a “cult classic.”

Both works provide engrossing portraits of the shifting landscape of 1960’s America and the inter-workings of the mental health system during that period of time.

Further self-care:

Don’t forget that the library hosts free yoga on Wednesdays and Fridays 12-1PM. Join in-person or on Zoom. Click here to launch Zoom meeting .

NAMI (National Alliance on Mental Illness) helpline: 800-950-6264

Crisis hotline, call or text: 988

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