Bipolar disorder, previously known as manic-depression, is a mood disorder identified by exaggerated mood swings. Bipolar means two poles, or extremes.
Everyone has ups and downs, and they’re caused by lots of things, including hormones. However, bipolar disorder is a medical condition where you have extreme mood swings (or ‘mood episodes’) widely out of proportion, or totally unrelated, to what’s happening in your life.
These swings affect your thoughts, feelings, physical health, emotional health, behaviour and day-to-day functioning. These symptoms can extremely disrupt to your life. They can also be very disruptive and distressing to your relationships with friends and family.
Every time you experience symptoms at one extreme for at least one week, it is called an episode. There are four main types of mood episodes a person with bipolar disorder can have: mania, hypomania, depression and mixed mood.
Manic episode (mania)
A manic episode is when you have an unusually and constantly elevated or bad-tempered mood, lasting at least one week.
During times of mania, you might experience:
- Elevated or euphoric mood – this can include being full of energy and being happy. It’s often described as being on a high or “on top of the world”
- Changes in activity levels – there might be changes in your sleeping and eating patterns
- Faster thinking and speaking patterns – thoughts can be quicker than usual, which might lead you to speak faster and jump from subject to subject
- Lack of inhibitions – finding it more difficult to see what the consequences of your actions might be
- Irritability – you might be more likely to be angry or annoyed with others, particularly if they seem to reject your plans or ideas
- Unrealistic (or grandiose) plans and beliefs – you might have unrealistic beliefs about your talents eg you might believe that you’re a king, queen, film star, or a religious figure
- Risk taking behaviour – you might take unnecessary and unsafe risks
- Hypersexuality – increased sexual thoughts, feelings, or behaviours; using explicit sexual language
- Measuring behaviour – you might find it hard to decide what behaviour is appropriate to a particular situation.
Hypomanic episode (hypomania)
Hypomania is a milder form of mania that lasts at least four days. You don’t experience full manic episodes, but milder (hypomanic) episodes. It includes symptoms such as increased thought speed and processes, elevated mood, and irritability.
Major depressive episode (depression)
A depressive episode is when you have either a depressed mood or the loss of interest or pleasure in nearly all activities, lasting for at least two weeks. When you are experiencing a depressed mood you might:
- lose interest in day-to-day life
- feel unusually tired and exhausted
- have no appetite or an increased appetite, and changes in body weight
- feel worthless or guilty
- have difficulty concentrating.
Check out depression for more information on the symptoms and treatments.
A mixed episode is when you experience both manic and major depressive symptoms nearly every day for at least one week. Your mood can vary with the time of the day.
Types of bipolar disorder
Diagnoses of different bipolar disorder are based on your experience of mood changes, what relatives and friends tell mental health workers about what they have witnessed/experienced, observation, and an assessment by a psychiatrist. Understanding the different types or classifications of bipolar disorder can help to identify the best way of managing it.
Bipolar I is when you experience one or more manic episodes or mixed episodes and often one or more major depressive episodes. Each depressive episode can last for several weeks or months, alternating with intense symptoms of mania that can last just as long. Between these extremes, you might have periods where life continues normally. Your symptoms can also be affected by changes in season (eg winter months) or life situations that come up (eg exam stress).
Bipolar II is when you experience one or more major depressive episodes, along with at least one hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes, but are not as severe. Between episodes, there might be periods of normal functioning. Symptoms might also be related to seasonal changes and life situations.
Cyclothymic disorder is a chronic (lasting a long time) fluctuating mood pattern which involves periods of hypomanic symptoms and periods of depressive symptoms. It is a milder form of bipolar disorder – the duration of the symptoms are shorter, less severe, and not as regular.
Bipolar disorder not otherwise specified
When symptoms don’t fit any other type, it is called bipolar disorder not otherwise specified. The experiences of this bipolar disorder vary from person to person. Sometimes you might experience the symptoms of a manic episode and a major depressive episode, but not fit into the above types of bipolar disorder. Just like the other types of bipolar disorder, bipolar disorder not otherwise specified is a treatable disorder.
Causes of bipolar disorder
Males and females have an equal chance of developing bipolar disorder, although males are often diagnosed at an earlier age. Bipolar disorder might be associated with a combination of factors including genetics, biochemistry, stress and even the seasons. Approximately 1-5% of the population has a diagnosis of bipolar disorder.
Getting help for bipolar disorder
Bipolar disorder is a treatable disorder, and usually requires long-term management and treatment. Many people with bipolar disorder are creative and intelligent, and with proper management of their condition, they lead full and productive lives. There are treatment options available for managing both mania and depression. It’s a good idea to speak to your doctor about which options might be best for you. See face-to-face help for lots of practical information on how to get the best support.
Your local doctor should be able to tell you about what medications are available for those who experience bipolar disorder. Most people are referred to a psychiatrist for diagnosis and medical treatment. Mood stabilisers, anti-psychotics, and antidepressants can all be used in the control of bipolar disorder. Have a read of the sections on medication, management and treatment options, and talking to your doctor.
Seeing a counsellor or psychologist
If you are experiencing bipolar disorder you might also find it helpful to talk with someone like a psychologist, counsellor, social worker or another mental health worker. By doing this, you can gain a better understanding of what you are experiencing.
It can also be helpful just to talk about how you feel and these mental health workers should help you to work out why you feel this way. In most situations the psychiatrist manages any medication and monitors the situation, while the mental health worker assists you to manage your life better. Have a look at the face-to-face help section for more information about counsellors, psychologists and psychiatrists.
Alternative therapies such as mindfulness, can sometimes be helpful in managing Bipolar Disorder, but this should be done in conjunction with your doctor. Your doctor should have more information about what these are and how they may help. Regular meals and a balanced diet are also important in the management of bipolar disorder.
Family/friend support network
Family and friends can help with the day-to-day management of bipolar disorder by providing feedback on mood states, giving support, friendship, understanding, and a non-judgemental listening ear. Check family and friends to find out how these people can help.
Support groups for bipolar disorder offer valuable first-hand information from others who live with the disorder. Have a look at the Shine website to get a list of supports in your area. Aware also run support groups across the country.
Regulating patterns of eating and sleeping can help in the management of bipolar disorder, and can help to prevent manic, hypomanic, depressive, or mixed episodes.
Stress management and relaxation
Decreasing stress levels, planning ahead and learning relaxation techniques are also important in the management of bipolar disorder. Have a look at relaxation for more on this. Everyone’s different so it can take a little while to find something that works for you, but keep at it.
To keep safe and get the best support, it might be necessary to be admitted to hospital during more extreme episodes of mania or depression. Sometimes it can be the most effective way to deal with the situation for that period of time.
Managing bipolar disorder
It’s really important to remember that bipolar disorder is an illness that loads of people manage really well, and that people live full and successful lives with it. It’s not always easy at first, but through working with doctors and other supportive people/services, you can find a way of managing it that suits you, and get on with everything else.
Helping someone with bipolar disorder
If you have a friend or family member who has bipolar disorder, it can be hard to know how you can support them and be there to help. Learning about the condition can be really helpful. Take a look at supporting someone with a mental illness for information, advice and helpful signposts.
Edited by Headstrong