What is bipolar disorder?
Bipolar disorder is a chronic (long-term) condition involving intense mood swings that disrupt daily life, from extreme highs to extreme lows. It usually first develops during the teenage years or early adulthood. Bipolar disorder tends to affect more women than men. It is also sometimes called manic depression .
People with bipolar disorder experience episodes of extreme mood at different times, such as:
- Manic (or hypomanic) episodes: A state of feeling extremely euphoric (good) or high. Hypomania means ‘less than mania’. Someone experiencing hypomania will have the same symptoms as a manic episode, but they are less severe and usually last for a shorter period of time. During manic episodes, the changes in mood are not severe enough to cause problems in functioning at work or socially.
- Depressive episodes: A state of feeling low energy, hopeless, anxious , and extremely sad. The person may feel extraordinarily unhappy.
If you have bipolar disorder, what you experience during each mood (and for how long) can vary. An episode can last for weeks or even months. Your mood may not make sense in the context of what is going on around you.
What are the types of bipolar disorder?
Mental health professionals distinguish 2 main types of bipolar disorder:
- Bipolar type 1: This is characterized by extreme, prolonged highs (mania) and depressive episodes and may include psychosis (difficulty knowing what is real and what is not).
- Bipolar type 2: This is characterized by fewer periods of extremely high (hypomania), depressive episodes, and normal mood swings lasting only a few hours or days.
Other types of bipolar disorder include cyclothymic disorder (mood changes that are less severe but still affect daily functioning) and substance-induced bipolar disorder (for example, alcohol or recreational drugs).
What causes bipolar disorder?
The exact cause of bipolar disorder is not fully understood. However, experts believe that a combination of physical, environmental and social factors (including mental stress) can make a person more likely to develop the condition.
Genetics is a major factor in 4 out of 5 people with bipolar disorder. If a parent has bipolar disorder, there is a 1 in 10 chance that their child will also develop the condition. If both parents have bipolar disorder, the odds increase to 4 in 10. Research is ongoing to better understand the genetic factors behind why some people experience bipolar disorder and others don’t.
Bipolar disorder is thought to occur when your body struggles to produce and break down certain brain chemicals (neurotransmitters) and certain hormones, such as adrenaline, dopamine, acetylcholine, serotonin, and GABA (gamma-aminobutyric acid). Brain imaging studies show that structural changes can be seen in the brains of people with bipolar disorder.
In some people who are vulnerable to bipolar disorder, a stressful situation or experience can trigger an episode of mania or depression. These could be physical, sexual or emotional abuse in childhood, family conflict, or other significant life events. Abuse of certain substances, such as recreational substance, is also linked to bipolar disorder.
The use of antidepressants for the treatment of depressive episodes is considered safe, but should be closely supervised by a psychiatrist because some people may experience episodes of mania or rapid cycling.
Bipolar symptoms are more likely to be triggered in the spring. Some experts think that increased bright sunlight may affect the pineal gland, a part of your brain that helps regulate sleep.
Women prone to bipolar disorder may experience their first attack while pregnant or after giving birth to their baby.
What are the symptoms of bipolar disorder?
A person with bipolar disorder experiences mood swings that alternate between manic and depressive episodes.
Symptoms during a manic episode may include:
- feeling high, extremely happy, or angry
- Inflated self-esteem or grandiose ideas
- Decreased need for sleep with increased energy, activity and creativity
- Increase in task-oriented behaviors (like staying up all night to get things done)
- Thinking and talking like in a race, jumping from topic to topic
- Easily distracted by any stimulus (like sounds or other people)
- Impulsive or risky behavior related to spending, work, or sexual activity
- unrealistic plans, delusions or hallucinations
Symptoms during a depressive episode may include:
- low mood
- lack of motivation
- Loss of interest in leisure activities or hobbies
- Changes in sleep patterns
- difficulty concentrating
- Withdrawal from social communication and activities
- Feelings of worthlessness or guilt, which may include suicidal thoughts
How is bipolar disorder diagnosed?
If you’re concerned about extreme mood swings in yourself or someone else, it’s important to seek support and help. A mental health professional may be spoken to to help determine if the problem is bipolar disorder.
If you are seeking help for yourself, a doctor or mental health professional will ask about your depressed or manic mood, how long you have been experiencing them, and how they are affecting your daily life.
Diagnosing bipolar disorder typically involves a thorough examination of your physical health to rule out a physical cause or other health problems. It also includes an assessment of your mental state, a careful assembly of details from your life and experiences.
How is bipolar disorder treated?
Bipolar disorder can be treated effectively, but it requires careful and ongoing treatment. Treatment usually includes long-term medication and may also include psychological therapy and other lifestyle changes.
Most people with bipolar disorder are initially prescribed medications to stabilize their excessive mood. These medications are tailored to the individual needs of the person with bipolar disorder and may include mood stabilizers and antipsychotics.
Electroconvulsive therapy (ECT) is sometimes recommended by psychiatrists when people are not responding to other acute treatments for their mood swings.
The goals of ongoing treatment are to prevent a relapse, build resilience, and help improve quality of life. This may include one or more of the following medications:
- Antidepressants (can be given for a short time and only important for people with bipolar disorder to be taken with a mood stabilizer)
- Lithium (a common long-term mood stabilizer)
- Anticonvulsants such as sodium valproate, carbamazepine, and lamotrigine
- Antipsychotic medications such as olanzapine, aripiprazole, quetiapine, and risperidone
To properly manage bipolar disorder, it is important to take your medication as directed. If you are concerned about any side effects, you should let your doctor know. Your doctor may change your treatment or suggest other ways to manage the problem.
Remember, your doctor will decide which medicine to take and how.
Psychological therapies or talk therapies such as psychotherapy, cognitive behavioral therapy, and counseling can help manage bipolar disorder alongside medications.
These treatments can help reduce the risk of relapse and improve quality of life. You learn how to think about events in your life, how to react to them, and how to deal with stressors that triggered events in the past.
Can bipolar disorder be prevented?
While there is no guaranteed way to prevent a person from developing bipolar disorder, many people successfully manage it with the right treatment and support. A successful strategy may include medication, therapy, and other self-help strategies.
If you have a family history of bipolar disorder, it’s important to be aware of the early warning signs and that your friends and family know about them, too. Substances that can trigger manic or hypomanic episodes, such as alcohol, caffeine, and recreational drugs, should also not be taken.
Other ways to prevent relapses include learning to manage your stress and getting enough sleep.
- Bipolar disorder causes extreme mood changes that affect or disrupt daily life.
- Symptoms of manic episodes include excessively high energy in speech and activity, agitation, and decreased need for sleep.
- Symptoms of depressive episodes include low energy and low motivation, a lack of interest in daily activities, and sometimes suicidal thoughts.
- While bipolar disorder is a chronic illness and has no cure, there are medications and other treatments that can help people function well and lead fulfilling lives.
- People with bipolar disorder will benefit greatly from the support of a close friend or family member.