There are probably some misconceptions spreading around about bipolar disorder thanks to Katy Perry. Bipolar symptoms are a lot more complicated than being hot and cold, yes and no, and “love bipolar” is an utterly bizarre phrase. Bipolar disorder, also known as manic depressive disorder, isn’t about being exasperatingly indecisive. It’s a mood disorder in which a person can cycle between episodes of “highs” and “lows,” which is where “Hot N Cold” might have gotten its idea of going back and forth.

Bipolar disorder symptoms depend on which type of bipolar disorder, type I or type II, and the symptoms are different depending on whether the individual is experiencing a high or a low. The presence of highs and lows to begin with is a general overall symptom that is associated with bipolar disorder. The high refers to a manic episode in which a person with bipolar disorder may exhibit symptoms like speaking fast, having racing thoughts, not needing to sleep, being impulsive, and having grandiose ideas. Sometimes people can be extremely creative and productive during mania, but they can also take big risks and act irrationally. The low refers to a depressive episode in which a person can have low mood, loss of pleasure, thoughts of suicide, fatigue, eating and sleeping problems, and impaired concentration. The bipolar disorder symptoms that a patient experiences determines the diagnosis. In bipolar I, the patient has to have had a manic episode. In bipolar II, the patient has to have had a depressive episode, and often has hypomanic episodes, which are a milder form of manic episodes.

Common treatments for bipolar disorder symptoms are medications that help stabilize the patient’s mood or function as antipsychotics. Lots of times bipolar patients have to take a combination of medications, and unfortunately they might be reluctant to take them because of the unpleasant side effects. Psychotherapy or psychoeducation can be administered in addition to medication so that the patient can learn to cope with the episodes and learn about their symptoms. For example, sometimes patients like the feeling of being in a manic episode because it feels like “being on top of the world,” but going to therapy and learning about bipolar disorder symptoms can help them realize the negative effects of mania on themselves and others. Bipolar disorder can’t be completely cured, but patients can learn to live with it by treating its symptoms.

One of the first books published on borderline personality disorder was titled I Hate You, Don’t Leave Me, which is an apt way of summarizing what borderline personality disorder (BPD) entails. People sometimes mistakenly associate unstable back-and-forth moods with bipolar disorder—borderline personality disorder fits that M.O. more accurately. Borderline personality disorder is named such because early in its conception psychologists described patients with the condition as being on the borderline between neurosis (impaired functioning) and psychosis (losing touch with reality). Since then, some believe that “borderline” is a misnomer because this differentiation of mental illness is outdated and borderline personality disorder is a condition that has more to do with emotional instability and dysregulation. Also, some find the term stigmatizing. Nevertheless, “borderline personality disorder” continues to stick.

Borderline personality disorder treatment can be difficult to implement—it’s one of the most difficult personality disorders to treat because of the nature of its symptoms. Symptoms of borderline personality disorder include fear of abandonment, unstable self-image, back-and-forth extremes of love and hate in interpersonal relationships, unstable intense moods, impulsive behavior, high rejection sensitivity, and paranoid/delusional thinking. Patients may sometimes manipulate others in response to perceived rejection. They might engage in attention-seeking behavior like attempting suicide to prevent people from leaving them. Borderline personality disorder treatment is made difficult because patients might exhibit this behavior toward their therapists out of fear that their therapists will reject or abandon them. In response, therapists might unconsciously distance themselves emotionally from their patients.

Borderline personality disorder treatment mainly involves therapy. Borderline personality disorder has been found to have a high correlation with traumatic experiences like abuse, neglect, and separation. There are many different types of therapy available that focus on different aspects like building self-esteem, developing interpersonal skills, emotional regulation, modifying distorted thinking, and coping with environmental conflict and stress. There also appear to be biological factors that might contribute to borderline personality disorder—patients have an imbalance of neurotransmitters that deal with mood, and increased activation in parts of the brain dealing with fear and impulsivity/aggression. Medication is also available as a borderline personality disorder treatment, and it can treat distorted thinking, stabilize moods or treat the symptoms of co-morbid disorders like depression and anxiety that are common in patients.

More studies need to be conducted on borderline personality disorder treatment, as it is one of the least researched fields of clinical psychology, given the difficulty in doing so. However, treatment still continues to improve and so does the scientific perception of borderline personality disorder itself. The challenge of research is accommodating and building upon these factors.