Bipolar Disorder. What is it?

Bipolar disorder used to be referred to as manic depression, and some people still use this term. It can sometimes be called bipolar affective disorder too.

High or ‘manic’ periods typically consist of:

• Feeling euphoric, excited, confident, ambitious or adventurous
• Having racing thoughts, a feeling of not being able to get their words out fast enough, difficulty concentrating on one thing
• Increased activity levels and not being able to sit still
• Increased sex drive
• Excessive or extravagant spending
• Not feeling like eating or sleeping
• A feeling of being special, invincible or having enhanced physical and mental abilities
• In some cases, experiencing symptoms of psychosis such as hallucinations, delusions or thoughts not making sense.

Low, or depressive periods share a lot of characteristics with depression. They usually include:

• Feeling down, hopeless, empty, upset or tearful
• Feeling low in energy
• Low self-esteem, lack of confidence, feeling guilty or worthless
• Tired, heavy, sluggish feelings. Lack of motivation and an inability to enjoy things
• Feeling tense, frustrated, agitated
• Suicidal thoughts and feelings.

Some people also experience ‘mixed’ episodes, where they feel elements of both high and low moods.

Frequency

A stressful circumstance or situation can trigger the symptoms of bipolar disorder. Examples of stressful triggers include:

• the breakdown of a relationship
• physical, sexual or emotional abuse
• the death of a close family member or loved one
• These types of life-altering events can cause episodes of depression at any time in a person’s life.

Bipolar disorder may also be triggered by:

• physical illness
• sleep disturbances
• overwhelming problems in everyday life – such as problems with money, work or relationships

Cause and symptoms of it

The exact cause of bipolar disorder is unknown. Experts believe there are a number of factors that work together to make a person more likely to develop the condition.

These are thought to be a complex mix of physical, environmental and social factors.

Chemical imbalance in the brain – Bipolar disorder is widely believed to be the result of chemical imbalances in the brain. The chemicals responsible for controlling the brain’s functions are called neurotransmitters and include noradrenaline, serotonin and dopamine. There’s some evidence that if there’s an imbalance in the levels of one or more neurotransmitters, a person may develop some symptoms of bipolar disorder.

Genetics – it’s also thought bipolar disorder is linked to genetics, as the condition seems to run in families. The family members of a person with the condition have an increased risk of developing it themselves.

Treatments

If a person isn’t treated, episodes of bipolar-related mania can last for between three and six months. Episodes of depression tend to last longer, for between six and 12 months.

However, with effective treatment, episodes usually improve within about three months.

Most people with bipolar disorder can be treated using a combination of different treatments. These can include one or more of the following:

• medication to prevent episodes of mania, hypomania (less severe mania) and depression – these are known as mood stabilisers and are taken every day on a long-term basis
• medication to treat the main symptoms of depression and mania when they occur
• 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

Most people with bipolar disorder can receive most of their treatment without having to stay in hospital.

However, hospital treatment may be needed if your symptoms are severe, or if you’re being treated under the Mental Health Act, as there’s a danger you may self-harm or hurt others.

In some circumstances, you could have treatment in a day hospital and return home at night.

Several medications are available to help stabilise mood swings. These are commonly referred to as mood stabilisers and include:

• lithium carbonate
• anticonvulsant medicines
• antipsychotic medicines