Bipolar disorder, formerly known as manic depression, is a mental health condition marked by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
The disorder is fairly common, around 1 in every 100 people will be diagnosed with it at some point in their life and it can occur at any age, although it often develops between the ages of 15 and 19.
Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks (or even longer) and the pattern varies widely – some people only have a couple of bipolar episodes in their lifetime and are stable in between, while others have many episodes.
Symptoms
The manic phase of bipolar disorder may include:
- Increased activity, energy or agitation
- Euphoria or an exaggerated sense of wellbeing and self-confidence
- Unusual talkativeness
- Racing thoughts, feeling full of great new ideas and having important plans
- Being easily distracted
- Being delusional, hallucinating and disturbed or illogical thinking
- Not feeling like sleeping
- Poor decision-making — such as going on buying sprees or taking sexual risks
During a period of depression, symptoms may include:
- Feeling sad, irritable, hopeless and/or pessimistic most of the time
- Lacking energy and difficulty sleeping
- Difficulty concentrating and remembering things
- Loss of interest in everyday activities
- Being delusional, hallucinating and disturbed or illogical thinking
- Lack of appetite
- Suicidal thoughts
Between episodes of depression and mania, periods of ‘normal’ mood can occur. The patterns are not always the same and some people may experience:
- rapid cycling – where a person with bipolar disorder repeatedly swings from a high to a low phase quickly;
- mixed state – where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood.
If the mood swings last a long time but are not severe enough to be classed as bipolar disorder, the person may be diagnosed with a mild form of bipolar disorder called cyclothymia.
Causes
The exact cause of bipolar disorder is unknown and experts believe there to be a complex mix of physical, environmental and social factors.
It's thought bipolar disorder is linked to genetics, as family members of a person with bipolar disorder have an increased risk of developing it themselves. But no single gene is responsible for bipolar disorder. Instead, a number of genetic and environmental factors are thought to act as triggers.
There is also some evidence that bipolar disorder may be associated with chemical imbalances in the brain.
Diagnosis
If a GP thinks a person may have a bipolar disorder, they'll usually refer the individual to a psychiatrist who will do a specialist assessment. Depending on the symptoms, they may also need to do additional tests to see whether the person has a physical problem, such as an underactive or overactive thyroid.
Treatments
Treatment for bipolar disorder aims to reduce the severity and number of episodes of depression and mania to allow as normal a life as possible.
If a person is not treated, episodes of bipolar-related mania can last for between 3 and 6 months and episodes of depression tend to last longer, often 6 to 12 months.
Most people with bipolar disorder can be treated using a combination of different treatments. These can include 1 or more of the following:
- Medicine to prevent episodes of mania and depression – these are known as mood stabilisers, and you take them every day on a long-term basis;
- Medicine to treat the main symptoms of depression and mania when they happen;
- Learning to recognise the triggers and signs of an episode of depression or mania;
- Psychological treatment – such as talking therapies, which help you deal with depression and provide advice on how to improve relationships;
- Lifestyle advice – such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, and advice on improving your diet and getting more sleep.
Living with Bipolar Disorder
Although it's usually a long-term condition, effective treatments for bipolar disorder, combined with self-help techniques, can limit its impact on everyday life.
It’s important to:
- Stay healthy and eat well to help reduce the symptoms and reduce weight gain, which is a common side effect of medical treatments for bipolar disorder.
- Attend an annual health check up at least once a year to monitor your risk of developing cardiovascular disease or diabetes.
- Use self-management programmes to help take an active part in your own recovery so you're not controlled by your illness. Bipolar UK run self-management courses that may be helpful.
- Talk to family and friends about it or turn to charities and support groups.
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