Bipolar disorder

Bipolar disorder, known in the past as manic depression, is characterised by extremes of mood. A person with bipolar disorder is likely to experience periods of high energy and excitement, filled with ambitious plans, called mania, alongside episodes of lethargy and depression.

Symptoms of bipolar disorder will vary depending on which mood the person is experiencing. In some severe cases, manic episodes will be accompanied by symptoms of psychosis, where you see or hear things that are not there or become convinced of things that are not true.

Although some people with bipolar disorder may have relatively frequent manic and depressive episodes, others may have long periods in between them, when they experience good mental health. Episodes of depression are typically longer, lasting months, compared to manic periods lasting weeks.

Bipolar disorder is relatively common. One in 100 adults will be diagnosed with it at some point in their lives. Though it can affect people of any age, it most often develops between the ages of 18 and 24.

Bipolar disorder frequently co-occurs with other difficulties; of those diagnosed 75% meet the criteria for another condition and tragically 25% have attempted suicide (1).

Depression in bipolar

Depression phases of bipolar are often diagnosed first. People may be diagnosed with clinical depression before experiencing a manic episode; the diagnosis will be changed to bipolar disorder after that.

Mania in bipolar

During a manic phase, a person with bipolar disorder may experience feelings of elation, be motivated by grand ideas and exhibit behaviours such as spending money on things they do not want or need, or that are beyond their means.

Other symptoms include a loss of appetite, no desire to sleep, bursts of creativity or energy which can feel very liberating. During a manic phase, a person with bipolar may be irritable, easily distracted and acting out of character in general.

On the more severe end of the spectrum, people may also experience psychosis and delusions. A person experiencing a manic episode may not be aware of the change in their behaviour and may only realise the consequences of their actions when the episode has subsided.

Signs of mania

Rapid speech
Decreased need for sleep
Grandiosity
Racing thoughts

Irritability
Impulsivity
Distractibility
Possible psychosis/hallucinations

Types of bipolar disorder

There are various patterns of depression and mania which characterise an individual’s experience of bipolar disorder.

Rapid cycling is when a person swings from depression to mania without a ‘normal’ mood in between

Mixed state is when a person might experience symptoms of both depression and mania simultaneously, for example feeling hyperactive when depressed

Type 1 Bipolar Disorder is characterised strongly by manic episodes; some people with type 1 do not experience depressive episodes, but not all

Type 2 Bipolar Disorder is characterised by severe depressive episodes, with periods of hypomania. Hypomania is a less serious form of mania, where you might find yourself feeling energised, creative and positive, but it is often followed by a depressive period. If hypomania is not addressed it can develop into more severe forms of mania.

Cyclothymic Disorder is a type of bipolar characterised by shorter periods of depression and shorter periods of hypomania.

What causes bipolar disorder?

The causes of bipolar disorder are unknown. Extreme stress and upheaval in one’s personal life are largely accepted as triggers for bipolar disorder, as well as various genetic and chemical factors.

What can I do if I have bipolar disorder?

If you have been diagnosed with bipolar disorder you may have been prescribed mood stabilisers to prevent episodes of mania and depression.

Alongside medications it is recommended to take an interest in both your physical and mental health, by learning to recognise your moods, taking regular exercise, getting enough sleep and a good diet, and regularly partaking in activities which you enjoy and give you a sense of achievement. Therapy can also be extremely useful.

Did you know?

Bipolar UK estimate around 1.3 million people in the UK have bipolar disorder

How can therapy help?

A counsellor or therapist can help a person with bipolar disorder better understand their illness and in so doing enable them to recognise their own triggers and symptoms.

Long-term psychotherapy is often required for this disorder as those with bipolar tend to need and benefit from ongoing support, especially as the symptoms of bipolar disorder can vary in intensity depending on other life stresses and events too.

References

Gilkes, M., Perich, T., & Meade, T. (2018). Predictors of self-stigma in bipolar disorder: Depression, mania, and perceived cognitive function. Stigma and Health. https://doi-org.uoro.idm.oclc.org/10.1037/sah0000147

Last updated August 7 2024