Understanding How a Person with Bipolar Thinks

Every person has a unique experience with mental illness. However, understanding how a person with bipolar thinks can put a lot of their behaviors into perspective. It can equip loved ones with the necessary tools to provide support without judgment.

This article will outline how bipolar disorder affects a person’s thinking, what happens during manic and depressive episodes, and what you can do to support them.

What is Bipolar Disorder?

Bipolar disorder (formerly manic depression) is a chronic mood disorder that causes severe mood swings and changes to energy levels and behavior. These mood swings can last from hours to months and make it challenging to fulfill daily responsibilities.

According to the World Health Organization, roughly 40 million people live with bipolar disorder. It’s most often observed in working-age people but can also affect youths [*].

What’s the Difference Between Bipolar I and Bipolar II?

The main difference between bipolar I and II lies in the severity of mood episodes. People with bipolar II experience less severe mood episodes that last for shorter durations. Their depressive episodes can be chronic and debilitating but are generally more manageable.

On the other hand, people with bipolar I experience severe and potentially dangerous mood episodes that last for more extended periods. They might also experience psychosis or hallucinations.

People with either type of bipolar disorder can experience euthymia, which is a normal, calm, and stable mental state. It is considered the “baseline” state, during which time a person is neither manic nor depressed [*].

Can Bipolar Disorder Affect a Person's Thinking?

Bipolar disorder can affect a person’s thinking by causing distortions during manic and depressive episodes [*]. During a manic episode, a person might have high mental energy and racing thoughts [*]. Conversely, depressive episodes can make it difficult to concentrate and cause someone to slow mentally.

How affected a person’s thinking is depends on the type of bipolar they have. People with bipolar II may experience mania less severely and for shorter durations.

How a Person with Bipolar Disorder Thinks During Manic Episodes

During a manic bipolar episode, a person might experience the following:

• Disorganized, racing thoughts that can’t be easily “turned off”
  
• Difficulty concentrating on tasks or remembering things
  
• Impulsivity leading to dangerous, promiscuous, or reckless behavior
  
• High mental energy leading to extreme creativity

Compared to depressive episodes, manic ones cause “highs” that result in a decreased need for sleep and increased activity. People might become physically affected and experience an excessive need for things like food, substances, and sexual activity.

How a Person with Bipolar Disorder Thinks During Depressive Episodes

During depressive episodes, people may feel more anxious and depressed. They may also experience the following:

• Poor memory and an inability to concentrate
  
• Thoughts of self-harm or suicide
  
• Sleep issues, constant fatigue, and appetite changes
  
• Restlessness
  
• Feeling “slow”

People experiencing depressive episodes might also encounter cognitive distortions like catastrophizing certain outcomes or thinking solely about the negative aspects of their life.

Coping with Bipolar Thinking Patterns

Bipolar thinking patterns can cause people to become irritable, impulsive, and frustrated. By implementing coping mechanisms, they can feel more in control over their behaviors and cope with challenging symptoms. Here are some techniques you can adopt into your routine.

Use cognitive restructuring to challenge negative patterns

Cognitive restructuring can challenge negative patterns by identifying triggers for manic and depressive episodes [*]. This method is highly effective for adults, while children may require some guidance to understand its purpose. When children understand what affects them negatively, they can replace negative thoughts with positive and productive ones.

For instance, a student who failed their last exam might assume they will fail again. Through cognitive restructuring, they can perceive this failure as a learning opportunity and focus on what they can do to improve.

Cognitive restructuring also encourages people to question their assumptions by considering whether they base their emotions on facts or emotions. It asks them to examine whether evidence supports these thoughts and how they can respond better.

Practice relaxation techniques

Relaxation techniques are very effective for reducing stress when a child experiences mania or depression. Practicing daily techniques like deep breathing, listening to calming music, guided imagery, and meditation can keep depressive episodes at bay and make people feel more at ease.

Stick to a routine

Having a predictable and consistent routine can make a person with bipolar disorder feel stable. Structure can help prevent mood swings and regulate sleep patterns and appetite.

However, while maintaining a routine can significantly improve mood, it’s important to remain flexible. Allow for occasional adjustments—things won’t always happen as you expect.

Maintaining a regular sleep schedule is another critical aspect of developing a personalized routine. Consistent sleep supports circadian rhythms and reduces the probability of experiencing dramatic mood shifts [*].

Take medications as prescribed

It isn’t uncommon to forget to take your medication, but doing so as prescribed can keep you healthy and control symptoms. Taking your medication on time can reduce the risk of unpleasant side effects and keep your body safe.

It may seem simple, but sticking to your medication schedule helps your medicine work properly and stay effective. If you’re struggling to take your medications as prescribed, you can set an alarm on your phone or ask a family member to help keep you accountable.

Get support from others

Having a strong support system can make people with bipolar disorder feel less alone. When you spend time with someone, they can learn to recognize the symptoms of a mood episode and encourage you to engage in self-care.

It’s important to surround yourself with people who can relate to your experiences, so you might consider joining a support group. People from these support groups can provide tailored advice and offer practical help.

If your symptoms interfere with your daily life, seeing a psychologist or psychiatrist can be helpful. These professionals can help you improve your overall functioning by improving your understanding of the condition through psychoeducation and stabilizing daily routines.

Frequently Asked Questions

Can bipolar disorder change the way someone perceives reality?

Yes, bipolar disorder can change the way someone perceives reality, especially when they experience psychotic symptoms. Distorted bipolar perceptions can feel very real to the person experiencing them.

How do thoughts shift between manic and depressive episodes?

Thoughts shift between manic and depressive episodes based on mental energy levels. A person experiencing a manic episode might feel “high” and have racing thoughts, while a person experiencing a depressive episode may feel like they’ve slowed down.

Do people with bipolar disorder realize when their thinking changes?

Some people with bipolar disorder notice when their thinking changes, especially when they are aware of their symptoms. They might feel something “isn’t right” or become forgetful, confused, and have difficulty concentrating.

Does bipolar disorder affect decision-making?

Yes, bipolar disorder can affect decision-making, especially when a person feels impulsive or is engaged in risky behavior. People with bipolar disorder might make choices based on how depressed or manic they feel.

Does bipolar disorder affect memory and concentration?

Yes, bipolar disorder can affect memory and concentration because the condition impacts executive functioning. People with bipolar disorder might be more disorganized or struggle to control their impulses, which can make it difficult to focus.

Studies have shown that bipolar episodes can negatively impact working memory [*]. It can also affect prospective memory, which refers to the ability to remember things a person has previously planned.

The Bottom Line

Bipolar disorder is a lifelong condition that requires care, attention, and deep understanding. When you understand how a person with bipolar thinks, you can respond more thoughtfully.

If your child or teen has bipolar disorder, developing routines and coping skills at home can be a big help. Download our CBT worksheets to find strategies that can help them cope.

Sources:

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