Bipolar disorder

What is bipolar disorder?

Bipolar disorder is a mental health condition that involves extreme changes in mood and energy levels, with periods of highs and low moods that are more intense than the usual ups and downs of life.

The ‘highs’ that people with bipolar disorder experience can cause issues in their personal or professional life since they may say or do inappropriate things or engage in risky or reckless behaviour.

During low periods, bipolar disorder can have a high risk of suicide.

For these reasons it’s extremely important to get an accurate diagnosis and treatment from a mental health professional.

Signs and symptoms of bipolar disorder

Bipolar disorder symptoms can vary greatly from person to person and episode to episode. The pattern of highs and lows can also be very different for each person. Some people can experience frequent mood swings, for example daily, while for others, high episodes can be rare.

Not everyone with bipolar disorder experiences the high mood of ‘mania.’ Some people experience ‘hypomania,’ which are highs where they are more euphoric or ‘up’ or hyper than usual, but less intense than mania.

Additionally, people with bipolar disorder also experience periods where they are clinically depressed, where symptoms of depression last for two weeks or more.

Symptoms of mania or hypomania can include:

• Racing thoughts or speech
• Impulsiveness
• Disinhibited behaviour or speech (this can manifest as saying or doing absurd things)
• Risky behaviour (e.g. excessive shopping/alcohol or drug use/gambling)
• Increased sex drive with potential risky behaviour related to sex
• More irritable or impatient
• Feeling more creative, more intense senses, having an epiphany, extreme confidence
• Not needing to sleep
  
• Restlessness or more hyper than usual
• Finding special meaning in everyday things—feeling enlightened or having mystical experiences or new perspective
• Hallucinations or delusions. Read more about hallucinations and delusions here. 

Symptoms of depression

• Changes in appetite or weight
• Changes to sleep patterns
• Withdrawing from people or activities you normally enjoy
• Struggling with motivation or concentration
• Feelings of sadness, hopelessness, guilt, or low self esteem
• Thoughts of suicide.

Bipolar disorder can be challenging to diagnose, and can look very different from one person to the next.  If you have symptoms you are concerned about you can do this online self-test. It will give you an idea whether your symptoms may be similar to bipolar disorder or a related disorder and suggest next steps. 

Types of bipolar disorder

Bipolar 1 

People with bipolar 1 have more extreme highs and can experience psychotic symptoms such as hallucinations or delusional thinking. Their manic episodes generally last for at least a week.  They are also more likely to need to be hospitalised than people with bipolar 2. 

Bipolar 2

Bipolar 2 involves mood swings with less intense highs and no psychotic symptoms. People with bipolar 2 usually don’t need to be hospitalised.

Cyclothymic disorder

Cyclothymic disorder involves unpredictable mood swings, but the highs and lows are shorter and less extreme than experienced by people with bipolar 1 or 2.

What causes bipolar disorder?

The exact cause of bipolar disorder isn’t known, and several factors may be involved.

Bipolar disorder has a strong genetic component and often runs in families. A child with one parent who has the condition has a 10% chance of developing it, and this rises to 40% if both parents have it.  It’s not yet known why some people with a family history develop bipolar disorder and others don’t.

Stressful experiences or events can trigger the onset of bipolar disorder, and have also been linked to relapse. Pregnancy or the birth of a baby haves also been linked to onset and relapse of bipolar disorder. Having bipolar disorder develop for the first time during pregnancy or just after the baby is born is more common among women with a family history.

Treatment for bipolar disorder

With the right support and treatment, bipolar disorder can be effectively managed and you can go on to live a full and productive life. It’s important to get treatment   even if you start to feel better as it’s likely that symptoms will happen again.

Treatment for bipolar disorder usually involves two parts. First, your doctor will work with you to treat the symptoms you’re currently experiencing. Depending on their assessment, you may be referred to a psychiatrist or a hospital emergency department. They will likely prescribe medicines to stabilise your mood and/or reduce psychotic symptoms.  If you have depression that doesn’t respond to medicines, they might recommend another treatment such as electroconvulsive therapy. Once you’re stable, treatment will focus on helping you to stay well, reducing the chance of another episode, and improving your quality of life. Psychological therapies and lifestyle changes can help with this (in addition to medicine).