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What is Bipolar Disorder?

Bipolar disorder can be a life-long mental health problem that mainly affects your mood. It affects how you feel and your mood can change massively. 

You can experience episodes of:
• mania, and
• depression.

You may feel well between these times. When your mood changes, you might see changes in your energy levels or how you act. Bipolar disorder used to be called manic depression.

Symptoms of bipolar disorder can be severe. They can affect areas of your life, such as work, school and relationships.

You usually develop bipolar disorder before you are 20. It can develop in later life but it rarely develops after the age of 40.

You can have symptoms of bipolar disorder for some time before a doctor diagnoses you. A doctor might say you have something else such as depression before you get a bipolar disorder diagnosis.

What are the different types of bipolar disorder?

Bipolar I disorder

A diagnosis of bipolar I disorder means you will have had at least 1 episode of mania that lasts longer than 1 week. 90% of people will also have periods of depression. Manic episodes will generally last 3-6 months if left untreated. Depressive episodes will generally last 6-12 months without treatment.

Bipolar II disorder

A diagnosis of bipolar II disorder means it is common to have symptoms of depression. You will have had at least 1 period of major depression. And at least 1 period of hypomania instead of mania.

Bipolar I or II disorder with mixed features

You will experience symptoms of mania or hypomania and depression at the same time. You may hear this being called ‘mixed bipolar state’. You may feel very sad and hopeless at the same time as restlessness and being overactive.

Bipolar I or II disorder with rapid cycling

Rapid cycling means you have had 4 or more depressive, manic, hypomanic episodes in a 12 month period.

Bipolar I or II with seasonal pattern

Seasonal pattern means that either your depression, mania or hypomania is regularly affected in the same way by seasons. For example you may find that each winter you have a depressive episode but your mania does not regularly follow a pattern.

Cyclothymia

A diagnosis of cyclothymic disorder means you will have experienced regular episodes of hypomania and depression for at least 2 years. You wont be diagnosed with Bipolar because your symptoms will be milder. But they can last longer. Cyclothymia can develop into bipolar disorder.

General symptoms of Bipolar Disorder

Bipolar symptoms can make it difficult to deal with day-to-day life. It can have a bad effect on your relationships and work. The different types of symptoms are described below.

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Mania

Symptoms of mania can include:
• feeling happy or excited, even if things are not going well for you,
• being full of new and exciting ideas,
• moving quickly from one idea to another,
• hearing voices that other people can’t hear,
• being more irritable than normal,
• feeling much better about yourself than usual,
• talking very quickly, jumping from one idea to another, racing thoughts,
• being easily distracted and struggle to focus on one topic,
• not being able to sleep, or feel that you don’t want to sleep,
• thinking you can do much more than you actually can,
• make unusual, or big decisions without thinking them through, and
• do things you normally wouldn’t which can cause problems.

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Depression

Symptoms of depression can include:
• low mood,
• having less energy and feeling tired,
• feeling hopeless or negative,
• feeling guilty, worthless or helpless,
• being less interested in things you normally like doing or enjoying them less,
• difficulty concentrating, remembering or making decisions,
• feeling restless or irritable,
• sleeping too much or not being able to sleep,
• feeling more or less hungry than usual,
• losing or gaining weight, when you do not mean to, and
• thoughts of death or suicide, or suicide attempts. 



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Psychosis

Sometimes you can have psychotic symptoms during a severe episode of mania or depression. Symptoms of psychosis can be:
• hallucinations. This means that you may hear, see, or feel things that are not there, and
• delusions. This means you may believe things that are not true. Other people will usually find their beliefs unusual.

Psychotic symptoms in bipolar disorder can reflect your mood. For example, if you have a manic episode you may believe that you have special powers, or are being monitored by the government.

If you have a depressive episode, you may feel very guilty about something you think you have done. You may feel that you are worse than anybody else or feel that you don't exist.

Treatment and Help

Bipolar disorder requires long-term treatment, since it is a chronic, relapsing illness. The most effective treatment plan includes a combination of medication, psychotherapy, lifestyle changes and social support. Psychotherapy used to treat bipolar disorder includes cognitive behavioural therapy (CBT) and family-focused therapy. Psychotherapy may help you gain self-insight, change negative thoughts and feelings, and learn new behaviour and coping strategies. Talking about your emotions with a trained professional can help reduce symptoms.

Diagnosis of this disorder can be tricky and medication should be monitored closely by a psychiatrist. Medication is used to stabilize the extreme mood swings of mania and depression.

Mood-stabilizers provide relief or prevent acute episodes of depression or mania. Anti-depressants treat the symptoms of depression. Anti-psychotics treat psychotic symptoms such as delusions or hallucinations which may sometimes occur in bipolar disorder. Long-term treatment is important as maintenance treatment between episodes reduces the severity and frequency of depression and mania. Bipolar medications are powerful drugs. For this reason, medication should not be stopped without a doctor’s supervision.

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