Bipolar disorder

What is bipolar disorder?

Bipolar disorder is usually referred to as ‘bipolar’, or you may hear people refer to it as bipolar affective disorder or manic depression.

Bipolar is a mental health condition that affects your mood and describes how it can fluctuate between mania when you feel on a high and depression when you feel low. These are more intense feelings than having mood swings as the emotions are extreme and can last for weeks at a time, or even longer. Some people also experience psychotic symptoms.

Bipolar disorder symptoms

Episodes of mania and depression are different for everyone with bipolar disorder, but they are often extremely disruptive to your daily life and can leave you feeling overwhelmed.

You may not be fully aware that you’re in a manic phase during the time, and afterwards, you might feel shocked at how you behaved.

During a manic phase you may experience:

• Feeling happy, euphoric or ‘high’

• Being excited and energetic

• Having lots of new ideas and plans

• Feeling invincible, confident and self-important

• Talking very quickly

• A racing mind and getting easily distracted

• Seeing and hearing things that aren’t there (delusions)

• Behaving in ways that you wouldn’t usually, like spending lots of money on things you don’t need or doing things that are risky or harmful

During a depressive phase, you may experience:

• Feeling sad, upset and hopeless

• Lacking energy or motivation

• Finding it hard to concentrate or remember things

• Having low self-esteem and doubting yourself

• Losing your appetite

• Having sleeping problems

• Losing interest in the things you usually enjoy

• Self-harming or having suicidal feelings

• Seeing and hearing things that aren’t there (delusions)

What causes bipolar disorder?

The exact cause of bipolar disorder is unknown, but experts believe that several different factors can increase your risk of developing the condition.

A chemical imbalance in the brain – an imbalance in neurotransmitters (the chemicals that control the brain’s functions) is thought to be linked to the condition.

Childhood trauma – traumatic events, sexual or physical abuse and neglect in childhood can affect your ability to control your emotions as an adult.

Family history – there’s no evidence of a single gene that’s responsible for bipolar disorder, but your risk of developing bipolar is higher if you have a family member with the condition. Experts put this down to the shared ’environmental’ factors (or the type of lifestyle you lead) that can trigger bipolar disorder.

Stressful triggers – it’s thought that stressful life events, like the death of someone you love, abuse, or the breakdown of a relationship, can trigger the symptoms of bipolar disorder.

How is bipolar disorder diagnosed?

You can only be diagnosed with bipolar disorder by a mental health professional, like a psychiatrist. But first, you’ll need to talk things through with a GP, who can get an idea of the symptoms you’re experiencing and refer you to a specialist if needed.

It can be daunting to talk to a doctor about how you’re feeling. To help you feel more prepared, it can help to write down some notes about your symptoms before you go. Doctors sometimes ask you to keep a diary of your moods to help them understand your symptoms better. You could take this along if you’ve already started one. It might also help to bring a friend along for support.

If you’re referred to a specialist, they may ask you questions like:

• What symptoms have you experienced, and how long for?

• How do you feel before an episode?

• How many episodes have you had, and how long do they usually last?

• Have you ever harmed yourself or had thoughts about doing so?

• Do you have any family history of mental health conditions?

• What is your medical background?

You might need to have blood tests to see if there’s an underlying health issue (such as an underactive thyroid or overactive thyroid) causing your mania-like symptoms.

Episodes of bipolar disorder

Bipolar episodes aren’t the same for everyone – some people have more manic episodes and others have more depressive ones. It’s also possible to experience both states simultaneously, known as ‘mixed state’.

Many people with bipolar disorder have periods of time where they feel ‘normal’ in between episodes, but some don’t. If you repeatedly swing from high to low with no feelings of normality in between, it’s called ‘rapid cycling’.

Treatment for bipolar disorder

Usually, a combination of talking therapy and medication is used to treat bipolar disorder, but the exact treatment will depend on the type of episodes you’re experiencing.

Treatment may include:

Mood stabilisers – taken daily on a long-term basis to help control episodes of mania and depression

Antidepressants – to treat depression
Antipsychotic medication – to treat more severe episodes of mania where
behaviour is disturbed

Talking therapies – like cognitive behavioural therapy (CBT) to look at your thoughts, feelings and behaviour, and interpersonal therapy to help address your relationships with others

Hospital treatment – in severe cases, you may need treatment in a hospital if there’s a danger that you might hurt yourself or others - but this is rare.

How to manage bipolar disorder

With the right treatment, the severity of episodes usually improves within a few months. Most people with bipolar disorder can live a very normal life.

Other aspects of your treatment aim to give you an active role in your recovery. These might involve learning to understand what triggers an episode of depression or mania or following a self-management programme.

Changes to your lifestyle, like improving your diet and sleep and getting more exercise could also be recommended and can be a positive way for you to take control of your wellbeing.

When to see a GP

If your are concerned about your mental health, speak to a Livi GP. After discussing your symptoms, they may refer you to a psychiatrist who specialises in mental health conditions like bipolar disorder.

If you have already been diagnosed with bipolar disorder and your illness puts you at risk of harming yourself, your GP will arrange an urgent appointment.