Bipolar disorder
bipolar; disorder; disorders; manic; depression; depressed; mania; hypomania; delusions; mental; health; suicide; psychosis; psychotic;
Contents
Bipolar disorder is a treatable mental health problem, which causes episodes of extreme changes in mood, thought, energy and behaviour. These changes are caused by changes in the way parts of the brain work, particularly neurotransmitters (chemicals which carry messages from one nerve cell to another in the brain). It is not a sign of personal weakness.
Bipolar disorder is also known as manic depression because a person’s mood can alternate between the 'poles' of mania (highs) and depression (lows). These changes in mood or 'mood swings' can last for hours, days, weeks or months. Between these mood swings, the person has times of quite normal moods.
Bipolar disorder affects about 3% of the population. It usually begins in late adolescence (often appearing as depression during teen years) although it can start in early childhood or later in life. An equal number of men and women develop this illness (men tend to begin with a manic episode, women with a depressive episode) and it is found among all ages, races, ethnic groups and social classes.
Like many illnesses, there is a combination of factors that trigger bipolar disorder. It tends to run in families (young people are much more likely to develop bipolar disorder if their parents have the disorder). Emotional and physical stress, lack of sleep and substance use (including caffeine and other stimulants) can all trigger an episode of mood change. Sometimes there is no obvious trigger for an episode.
Many people with bipolar disorder abuse alcohol, tobacco and illicit drugs, which can make the mood swings worse, and well as causing harm due to the specific drug.
Like depression and other serious illnesses, bipolar disorder can also negatively affect partners, family members, friends and co-workers.
Bipolar disorder is different to other types of depression, although the symptoms for the depressed phase of the illness are similar.
Most people who have bipolar disorder talk about experiencing 'highs' and 'lows' – the highs are periods of mania or hypomania, the lows periods of depression. These swings can be severe, ranging from extreme energy to deep despair and they can seriously disrupt normal life activities. Most children and young adults with bipolar disorder have had behaviour thought to be ADHD, but almost all people with ADHD do not have bipolar disorder.
About 20% of people with bipolar disorder die from suicide, or they seriously attempt suicide.
Symptoms of mania - the 'highs' of bipolar disorder
Not all people will have all of these symptoms, and even the same person will have different symptoms with different episodes.
- Increased energy
- Racing thoughts
- Rapid speech
- Irritability and sometimes aggression
- Overactivity
- Impulsive behaviour (such as reckless spending),
- Poor judgement
- Risk taking behaviours (eg driving too fast)
- Decreased need for sleep
- Grandiose delusions, inflated sense of self-importance
- In the most severe cases, delusions and hallucinations.
Symptoms of hypomania
These symptoms are less severe than the mania described above and the 'highs' may only last for a few days.
Symptoms include:
- Mood is especially energetic or irritable
- Feeling unusually confident
- Needing less sleep
- Unusually talkative
- Thoughts come and go faster than usual
- More easily distracted or have trouble concentrating
- More goal-directed at work, school or home
- More involved in pleasurable or high-risk activities, such as spending or sex
- Feeling like you’re doing or saying things that are unlike your usual self
- Other people say you’re acting strangely or you’re not yourself.
Symptoms of depression - the 'lows' of bipolar disorder
- Prolonged sadness,
- Unexplained crying spells
- Changes in appetite and sleep patterns
- Irritability, anger, agitation, anxiety
- Pessimism
- Loss of energy, persistent tiredness
- Feelings of guilt, worthlessness
- Inability to concentrate
- Indecisiveness
- Inability to take pleasure in former interests, social withdrawal
- Unexplained aches and pains
- Recurring thoughts of death or suicide
Warning! If you feel so depressed that you want to harm yourself, it's important to talk to someone now. Tell a person you trust, or speak to a health care professional.
Depression is usually quite severe and may last for several weeks, and often for several months.
Diagnosing bipolar disorder
If you, or a relative or friend are experiencing some of the symptoms described above, see a doctor or other health professional. Many people with bipolar disorder do not know that this is the cause of the problems they are having, and they may not get the correct treatment. Some medications used for other types of depression can make things worse for people with bipolar disorder.
Many people do not seek medical attention during periods of mania because the increased energy, heightened mood, increased sexual drive, etc. feel good, and they are not able to see that they have a problem. But when symptoms of mania are left untreated, they can lead to illegal or life-threatening situations because mania often involves impaired judgment and reckless behaviour.
Types
of Bipolar Disorder
There are different types of bipolar disorder, which have different patterns and severity of symptoms.
- Bipolar I disorder is the most severe form of the illness marked by extreme manic episodes.
- Bipolar II disorder is the form of illness where there are one or more depressive episodes accompanied by at least one hypomanic episode. Hypomanic episodes have symptoms similar to manic episodes but are less severe.
- Cyclothymic disorder is the type where the periods of both depressive and hypomanic symptoms are shorter, less severe, and they do not occur with regularity as experienced with bipolar II or I. However, these mood swings can still impair social interactions and work.
Treatments for bipolar disorder
Because bipolar disorder can be difficult treat, it is highly recommended that you consult a psychiatrist or a general practitioner with experience in treating this illness. Your treatment may include medications and talking therapy.
Mood stabilisers such as lithium, sodium valproate and other 'antiepileptic' drugs may be helpful. Some antidepressant medications can help, but others may trigger an acute mood swing.
Psychological therapies such as cognitive behaviour therapy may help some people especially when they are feeling 'normal' between mood swings.
Managing bipolar disorder
- It is important to understand the illness and its treatment. Talking to others with the illness, reading stories about it, or looking at some of the many bipolar disorder Internet sites can be helpful.
- Find a therapist whom you can trust. Your doctor should be able to help you with this.
- Learn to recognise the early warning signs of a mood swing. With early treatment, you may be able to avoid a full relapse.
- Have a trusted friend or family member who can advise you to get help, because you may lose insight when the condition gets worse.
- Take your medicine!!!! It can be tempting to stop when you feel well, but this is a common cause of a relapse. If you medicine does not seem to be working, talk to your doctor. A different medicine may be more helpful.
- Exercise regularly, eat well, do not skip meals (a trigger for some people).
- Avoid artificial stimulants or depressants like caffeine, alcohol and illicit drugs.
Helping someone who has bipolar disorder
- Let the person know if you have noticed a change in his or her behaviour.
- Suggest they get professional help.
- Encourage them to keep taking their medicine and keep their doctor's or therapist's appointments.
- Learn about the illness, the things that might trigger a mood swing and warning signs of a new episode of illness. There is a lot of information on the Internet (see the sites listed below).
- Help the person, when he or she is well, make plans about how to limit some of the damage that might happen during a manic or depressed phase (eg making an agreement not to carry credit cards).
- Never ignore remarks about suicide. Report them to the person's therapist. Do not promise to keep something secret if you believe someone is close to suicide.
Look after yourself.
- It is not easy all the time to live with someone who has bipolar disorder.
- There may be a local support group.
- Talk with your doctor or a therapist about problems you might be having.
- Keep yourself physically and emotionally healthy.
What to do in an emergency
If you feel some immediate action needs to be taken, check the emergency agencies in your telephone book.
In South Australia
- Assessment Crisis Intervention Service (ACIS) Ph: 13 14 65
- Lifeline: 13 11 14
- Crisis Care Unit: 13 16 11
- Youth Healthline 1300 13 17 19
- Kid's Helpline 1800 55 1800
Other resources in South Australia
- Child Adolescent Mental Health Services (CAMHS)
- Mood Disorders Association
1 Richmond Road, Keswick
Ph: (08) 8221 5170
http://www.moodsa.info/
- The Second Story Youth Health Service
- Central: 57 Hyde St, Adelaide
- South: 50a Beach Rd, Christies Beach
- North: 6 Gillingham Rd, Elizabeth
Contact via the Youth Health line on 1300 13 17 19,
or for mobile phone callers (08) 8303 1691, normal rates apply.
- Your doctor
Internet sites
Australia
International sites
References
Beyondblue 'Bipolar disorder'
http://www.beyondblue.org.au/
Blackdog Institute
http://www.blackdoginstitute.org.au/index.cfm
Depression and Bipolar Support Alliance: 'Bipolar disorder'
http://www.dbsalliance.org/site/PageServer?pagename=home
EPPIC 'Psychosis and young people - fact sheet'
http://www.eppic.org.au/
Medical Journal of Australia, Supplement - Early Intervention in Youth Mental Health 2007
Click here
Scheffer RE 'Childhood onset bipolar disorder: a role for early recognition and treatment' Journal of Pediatrics, Vol 150, 485-490, May 2007
http://www.jpeds.com/article/PIIS0022347606010390/abstract
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).