What is bipolar disorder?
Bipolar Disorder is a mental health condition characterized by extremes of mood. Formerly known as Manic Depression, a sufferer can experience severe depression along with periods of mania or hypomania. The condition can affect anyone, regardless of age, gender or background and Bipolar is a relatively common illness affecting one in a hundred adults. It can occur at any age although it is more likely to develop between the ages of 18-24.
It has proven difficult to establish the exact causes of the illness although it’s been shown that certain factors such as extreme stress, genetics, life-changing events and environment can contribute. Bipolar Disorder tends to run in families and children of Bipolar parents are more likely to develop the condition. research is currently taking place in the US attempting to link the symptoms of Bipolar with specific genes that influence them.
Not everyone who has Bipolar Disorder will experience it in the same way. Some people will only have a few episodes of depression and mania in their lifetime, but others will have frequent swings between moods. Many people find they do not often experience a ‘normal’ mood very often. A mental health professional may classify your Bipolar as either Type 1, Type 2, Cyclothymic or Bipolar Disorder Not Otherwise Specified (BP-NOS) depending on the range, type and severity of symptoms.
- Type 1 Bipolar is characterized by having at least one episode of mania which has lasted longer than a week. It can also be accompanied by depression although not everyone has this.
- Type 2 Bipolar may be diagnosed if you have had at least one episode of severe depression AND symptoms of hypomania
- Cyclothymic – You may be told you have Cyclothymic if you have had both depressed and hypomanic moods over a period of two years or more and also if your symptoms are not as severe as those found in Bipolar types 1 and 2.
- BP-NOS may be diagnosed if you are experiencing moods which are outside of your normal range but do not necessarily meet the criteria for Bipolar Types 1 and 2.
Other categories relating to Bipolar include ‘rapid cycling’ and ‘mixed features’. Rapid cycling of moods is severe and can occur within the same hour, day or week. It can feature four or more episodes of mania or hypomania followed by depression in a year. It can occur at any point in the illness however some research shows it can occur more often in the later stages. women are also more likely than men to have rapid cycling and unfortunately, if you have this mood pattern there is an increased risk for severe depression. The term mixed features is used if opposite mood polarities occur at the same time during manic, hypomanic and depressive episodes; for instance feeling manic and energetic whilst also feeling hopeless, despairing and suicidal.
Bipolar moods are extreme and much more intense than the feelings that most people experience. During a Bipolar depressive episode it is common to feel low, lethargic, lacking in motivation and even suicidal. A manic phase can be identified by feeling unusually buoyant, reckless or impulsive. You may feel more easily irritated, take risks or spend large amounts of money on things you can’t afford. Other symptoms include talking very fast and not eating or sleeping. Some people find that mania is enjoyable and provides an outlet for creativity. Severe mania can result in psychosis however, a condition where you lose touch with reality and may hallucinate (see or hear things which aren’t there) or believe things which aren’t true.
Bipolar Disorder is a lifelong condition, however it can be managed successfully with the right treatment. The first step is diagnosis, which in itself can be complex as not all of the symptoms will necessarily present at the same time or in the same way. There is no test for Bipolar and it is diagnosed only by a psychiatrist or mental health professional, not a doctor. A doctor can make the referral however. As Bipolar Disorder involves changes in mood, you may be asked to keep a diary over a long period of time to record your depression and mania symptoms whilst your psychiatrist monitors them. Also, Bipolar has a lot of symptoms in common with other mental health disorders such as borderline personality disorder and schizophrenia so it is important that an incorrect diagnosis is not made.
Besides asking you about your symptoms and their severity, you may also be asked about the impact the symptoms have on your life as well as your family history. Your psychiatrist may also want to speak to your spouse or close relatives, to help build a picture of how your symptoms affect you. Part of your diagnosis will also involve ruling out any physical illnesses which could be causing Bipolar symptoms, such as thyroid problems. Due to the many factors involved, a diagnosis can take a long time, sometimes years.
Treatments can include medication, talking therapy and lifestyle changes. The most widely used medications are mood stabilizers such as Lithium or you may be prescribed anti-psychotics or anti-depressants. There are also lots of different self-help strategies for Bipolar Disorder – link to my article HERE. Research has shown that a combination of different treatments works best for most people, although it may take time to find out which methods suit you. There is also a vast amount of support available from charities, associations and organisations which are linked below.
- MIND Charity UK
- Bipolar UK charity
- International Bipolar Foundation
- Turn2me.org – peer support, professional support and self-help
- Depression and Bipolar Support Alliance
- PsychCentral Bipolar support groups