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Bipolar disorder
What is bipolar disorder?
People with bipolar disorder experience periods, or episodes of mania and periods, or episodes, of depression.
During these episodes, people can have symptoms of psychosis. However, not all people experience psychosis, and psychotic symptoms are not necessary for a diagnosis of bipolar disorder to be given.
Sometimes people have separate episodes of mania and depression, but sometimes people have a mixture of depressed and manic symptoms at the same time. Episodes of mania and depression may alternate with one another. During episodes of ‘hypomania’, people have the symptoms of mania to a lesser extent.
The frequency of episodes varies: some people might have one episode a year, others have episodes more often. Rapid cycling bipolar disorder describes the experience of at least four depressive, manic, hypomanic or mixed episodes within a 12-month period.
People may be given a diagnosis of bipolar 1 disorder or bipolar 2 disorder. Bipolar 2 disorder involves the less severe symptoms of hypomania alternating with periods of depression.
Bipolar disorder used to be called manic depression.
Who gets bipolar disorder?
About one in every 100 people develops bipolar disorder. The first episode usually occurs before the age of 30. Men are more likely to first become ill when they are young adults while women are more likely to start developing symptoms later in life.
Mania
During the early stages of a manic episode, people can be very happy, productive and creative. They have less need for sleep and don’t feel tired.
But the energetic and high mood gets out of control. Even if they are physically exhausted, they have no desire to rest. People can become extremely irritable, overactive and restless. They may feel over-confident, and come up with extravagant ideas and wild or grandiose plans.
They begin to lose judgement, take risks and become impulsive. These risks can lead to bad decisions – bouts of spending that cause financial problems, for example. Their libido may rise and they may become promiscuous. They may talk or shout quickly and loudly. They may be difficult to understand because their thoughts and ideas are coming thick and fast. They may begin to drink a lot of alcohol or use more street drugs.
They may begin to have having delusions, hallucinations and confused thoughts, and not realise they are unwell.
An episode of mania can last for a few days or for a few months. Afterwards, people are often completely worn out and may feel ashamed of and humiliated by their behaviour.
Depression
The depression experienced by people with bipolar disorder is similar to major depression – what mental health professionals call unipolar depression.
People lose interest in their daily lives, feel very low, get very tired, put on or lose weight, have disrupted sleep patterns – finding it hard to sleep or difficult to stay awake, feel worthless and useless. They may experience delusions – feeling they are totally to blame for bad events in the world, for example – or hallucinations.
People often think about harming themselves or attempt to take their own lives during these periods. About 17 per cent of people with bipolar 1 and 24 per cent of people with bipolar disorder 2 attempt suicide. Most of these attempts are made when they are in a depressed episode. An episode of depression usually lasts for several months
Living with bipolar disorder
90 per cent of people with bipolar disorder get recurrent episodes. In between episodes, most people don’t experience any symptoms.
Manic episodes can be very disruptive to everyday life and can also be dangerous – they can lead to dangerous driving driving, financial problems, high-risk sexual behaviour, legal challenges or loss of a job, for example.
A number of treatments are given for bipolar disorder. These include medication for an episode of mania, antidepressants and talking therapies. Many people are given long-term medication and cognitive behaviour therapy to help stabilise their mood and try to prevent harmful new episodes.
Other useful websites
The BiPolar Organisation aims to help people with bipolar disorder to take control of their lives. The charity runs self-help groups, a 24-hour legal advice line for employment, legal, benefits and debt issues, a travel insurance scheme and a self management training programme. It also offers employment advice and produces publications and information about bipolar disorder.
