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  • Sam DiFranco

Suicide and Bipolar Disorder

Bipolar disorder is a serious mental health condition affecting about 2.8% of the U.S. adults. Its main symptoms are mood shifts, which include episodes of mania and depression.

People who live with bipolar disorder are at an increased risk of suicide compared to the general population. Research suggests up to 20% of people with bipolar disorder, especially when untreated, die by suicide. A larger percentage, around 20% to 60%, attempt suicide at least once during their life.

Bipolar disorder can be debilitating, but the condition can be managed. Emotional support, medication, and therapy can help improve quality of life, lessen symptoms, and reduce the risk of suicide.

Risk Factors:

In addition to not being in treatment, there are certain risk factors that make someone with bipolar disorder more likely to attempt or die by suicide.

These include:

  1. family history of bipolar disorder or suicide

  2. being single or divorced

  3. a history of childhood abuse or trauma

  4. unemployment

  5. younger age at onset of bipolar disorder

  6. attention deficit hyperactivity disorder (ADHD)

  7. substance misuse

  8. hospitalization with bipolar disorder

  9. higher levels of depression when hospitalized

  10. having bipolar disorder with mixed features

The longer bipolar disorder goes untreated and after diagnosis, the higher the risk of suicide. Seeking care and managing your bipolar disorder can substantially reduce suicide risk and is the most important thing you can do for your health and safety.

Symptoms:

People living with bipolar disorder tend to cycle between mood states, which can include mania, hypomania, and depression. Between these episodes, there are periods of relatively stable mood called euthymia.

There are two main types of bipolar disorder: bipolar 1 and bipolar 2. Bipolar 1 involves more severe episodes of mania and depression. People with bipolar 2 will experience a more subdued form of mania called hypomania, along with depression.

Bipolar disorder shares some symptoms of other mental health conditions, and it’s common for people to be misdiagnosed at first. For example, one study found that an estimated 37% of people with bipolar disorder were first diagnosed with depression. Schizophrenia is also a potential misdiagnosis in people who have bipolar disorder.

The symptoms of bipolar disorder vary from one person to another. Although the two main mood states of the disorder are mania and depression, some people experience mixed episodes as well. In mixed episodes, features of both mania and depression are present.

Manic episodes

Mania can look like the following:

  1. feeling “high” and excitable, having more energy than usual

  2. feeling irritable or angry

  3. less need for sleep, insomnia

  4. racing thoughts or speech

  5. in rare cases, psychosis or hallucination 

These episodes can cause an inflated sense of invincibility and self-esteem, leading to reckless decision making. While mania is often associated with contributing to “creative genius,” untreated mania shouldn’t be romanticized, as it can be very dangerous.

Hypomania manifests as a more subdued form of these symptoms and may be harder to spot. Hypomania can feel like being more energetic or productive than usual.

Depressive episodes

The depression phase of bipolar disorder isn’t just about feeling sad or tired. It’s natural to feel down sometimes in response to troubling life events or bad days, but depression refers to a more severe state.

In bipolar disorder, depressive episodes can look like:

  1. feeling hopeless

  2. feeling down about yourself, low self-esteem

  3. trouble focusing, lack of interest in hobbies or activities

  4. isolating yourself, avoiding friends and family

  5. difficulty taking care of yourself and your space

  6. thoughts of death, dying, or suicide (suicidal ideation)

  7. engaging in forms of self-harm

When to seek help:

Being in treatment for bipolar disorder isn’t a guarantee you won’t have mood episodes, although treatment can lessen their severity. There may be times when you have a mental health crisis and need immediate care.

Pay attention to your moods, and reach out to your doctors and support network if you are feeling overwhelmed or unsafe. Remember: You’re not alone, and help is available.

Understanding the features of manic, hypomanic, and depressive episodes can help you or loved ones identify a possible flare. Some people find it helpful to keep a diary of their symptoms to spot any concerning patterns.

If you think you or someone you care about with bipolar disorder is thinking about harming themselves, it’s imperative that you seek immediate assistance.

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