Bipolar Disorder

Bipolar disorder (previously known as manic depression) is a serious illness, and if affected you may experience depression lasting weeks or months, alternating with bouts of elation (otherwise known as ‘highs’ – see below for more information on elation) of variable duration. For months, even years, your mood is otherwise perfectly normal.

We are all familiar with everyday life, but the mood-swings of bipolar disorder are much more intense and prolonged. They also disturb your everyday life to a considerable degree. View our bipolar fact sheet here. 

Bipolar disorder usually begins between the early teens and forties. It affects about 1 in 100 people and both men and women equally. The causes are not fully understood but the following factors are known to be involved:

Genetics - although not directly inherited, if you have a parent with bipolar disorder, you have a 10% risk of developing it Biochemical factors - it is believed to be associated with a chemical imbalance in the brain.Stress – may trigger symptoms if you are already pre-disposed to the disorder Alcohol/drugs – can also trigger symptoms if you are pre-disposed

Symptoms vary from person to person – however, bipolar is usually characterised by:

• Feeling excited or over-enthusiastic with great energy, over-talkative, restlessness
• Racing thoughts, pressure in the head
• Poor concentration – jumping from one topic to anotherNeeding little sleep
• Making big plans
• Poor judgement
• Increased interest in pleasurable activities such as sex, alcohol, drugs, religion, music, art
• Being pushy and domineering Refusing to recognise that there is something wrong

Symptoms of elation

• Feeling ‘high’ ‘on top of the world’ ‘better than usual’ or ‘better than ever before’
• Uncharacteristic anger or irritability
• Great energy and not needing to rest
• Overactive, restless and easily distracted.
• Racing mind that cannot be switched off – ‘pressure in the head’
• Talking rapidly and jumping from one topic to another
• Decreased need for sleep.
• Excessive and unrealistic belief in one’s abilities.
• Poor judgment.
• Increased interest in pleasurable activities: new ventures, sex, alcohol, street drugs, religion, music or art.
• Demanding, pushy, insistent, domineering or provocative behaviour, not able to see the changes from ones usual self – ‘there is nothing wrong with me’.
• Delusions (false ideas) and or hallucinations (visions or voices) may occur and they usually relate to grandiose ideas about religion, creativity, sex, politics or business.
• Intense elation rarely goes undiagnosed for long but in its less intense form, hypomania, it is less apparent and, for the individual affected, is often, though not always, an enjoyable experience. With fewer symptoms of elation, it may even go unrecognised for years.

People affected are usually referred to a mental health team by their GP. A psychiatrist will decide the appropriate treatment for each individual and support will also be available from other mental health professionals such as a community psychiatric nurse. Medication is the main treatment for bipolar disorder and the mood stabiliser, lithium, works for 75% of people. Alternatives are available for the other 25%. Individuals may need a combination of drugs e.g. anti-depressants during the depressed phase or anti-psychotic drugs if hallucinations or delusions are present. 

Medication

Medication is the main treatment for bipolar disorder and the mood stabiliser, Lithium, works for 75% of people. Alternatives are available for the other 25%. Individuals may need a combination of drugs e.g. anti-depressants during the depressed phase or anti-psychotic drugs if hallucinations or delusions are present. After just one episode, it’s difficult to predict how likely you are to have another and you may not want to start medication at this stage, unless it was very severe and disruptive.

If you have a second episode, there is a strong chance of further episodes, so most psychiatrists would recommend a mood stabiliser at this point and it will usually be continued for at least 5 years. Some people will need to take them for much longer depending on the severity or frequency of symptoms.

Medication doesn’t cure bipolar disorder, it controls the mood swings. Psychotherapy or counselling may help you come to terms with the illness and provide support and guidance for you and your family. It can help you spot relapses and get help earlier. Cognitive Behavioural Therapy may help with depression. However psychotherapy does not control or stabilise bipolar disorder.