What is bipolar disorder?

Bipolar disorder, previously known as manic depression, is a mental illness that seriously affects the way a person acts, thinks and feels. It is generally characterised by a cycle of mood swings between elation and depression, varying from mild to extreme. Extreme elation is called ‘mania’.

About one per cent of the population develops bipolar disorder. The condition generally arises in early adulthood and, for many people, the disruption continues throughout his or her life. The effects on social and occupational functioning can be serious, such as withdrawing from family and friends and being unable to work.

The illness tends to occur in sporadic episodes, between which an individual may return to relatively normal functioning. However, about one third of people continue to suffer mood difficulties or social and work problems between bipolar occurrences. Without appropriate treatment, the number of episodes suffered on average is four in 10 years, although up to 15 per cent of sufferers can have many episodes in one year. People with bipolar disorder are often not fully aware of their condition.

What are the signs to look out for?

Early signs of a change in everyday functioning may occur in areas such as relationships, work or educational involvements. These might include increased irritability, anger, tension or depression. As with most illnesses, the best outcome results from early detection and intervention.

Bipolar disorder may include the following symptoms:

Elevated mood

  • Feeling extremely happy and ‘on top of the world’
  • Poor judgement, which may involve risky behaviour or grandiose plans and beliefs, such as believing one has extraordinary talents
  • Rapid thought and speech, which is often difficult for others to follow
  • Reduced sleep
  • Irritability

Depression

  • Overwhelming sadness
  • Poor concentration
  • Loss of appetite
  • Feelings of hopelessness or excessive guilt
  • Possible increased chance of suicide

Severe symptoms can lead to hospitalisation, despite the best attempts by family, friends and health professionals to provide external care.

What causes bipolar disorder?

The main contributing factors include:

  • Genetics: A history of the disorder in the family
  • Biology: Minor changes in brain chemistry
  • Lifestyle: Stressors that are difficult to cope with in everyday life
  • Environment: Some evidence suggests that this disorder varies seasonally, with mania being more common in spring and depression more prevalent in winter

How is it treated and managed?

There are several specialised treatments that can help minimise disruptions and improve self-management of symptoms and quality of life. Optimal treatment includes a combination of:

Medication
The drug, Lithium, is a common and effective treatment, along with a range of other mood-stabilising medications. Using medication requires close consultation and contact with a treating psychiatrist, particularly for the management of possible side effects.

Psychological intervention
The most common psychological intervention is Cognitive Behaviour Therapy (CBT), which provides strategies to change thinking patterns and behaviours. This approach helps people with bipolar disorder (and their families) to cope better with symptoms, which reduces stress and helps them gain control over their lives. Families can also benefit from psychoeducational family therapy, which provides a thorough understanding of the illness, as well as stress-reduction strategies. Therapy should be provided by a psychologist with extensive postgraduate training in the non-drug management of mental health disorders.

Case management
Case management may also be required, depending on the severity of the symptoms. For example, risky behaviour may require a coordinated management strategy, including the treatments already described as well as rehabilitation to promote maximum potential in everyday living skills.

Who can help?

It is important that people with bipolar disorder get treatment as soon as possible. Click here to find an APS Psychologist with experience in treating and managing the disorder.