Bipolar Disorder (Manic-Depressive Illness)

Bipolar disorder is a mental health state which is characterised by severe changes in mood; it used to be called manic depression. People with bipolar disorder struggle to control their emotions and experience periods of depression when their mood is very low and periods of mania when they feel high. Most people experience episodes of depression before they develop symptoms of mania and some are diagnosed with depression before being diagnosed with bipolar disorder.

Bipolar disorder is a relatively common condition and it is believed that around 1 percent of individuals in the UK go through the condition. It affects both men and women and it can develop at any age, although most people experience symptoms for the first time between the ages of 18 and 25.

What causes bipolar disorder?

The accurate cause of bipolar disorder is not known and study in this area is ongoing. However, experts believe that a blend of factors contributes to bipolar disorder, which includes neurological, physical, environmental and social factors.

Neurological factors: experts believe that bipolar disorder can be brought about by a chemical imbalance in the brain. An imbalance of neurotransmitters, which are chemicals that deliver messages in the brain and control brain function, can cause symptoms of bipolar disorder.

Genetics: there is indication to propose that bipolar disorder is hereditary, but no single gene has been identified for bipolar disorder.

Factors that can trigger episodes of symptoms include:

  • Abuse.
  • Disturbing life events, including relationship breakdowns.
  • Bereavement.

Symptoms of bipolar disorder

Symptoms differ according to the person. Some people have milder symptoms than others and some go for long phases of time without experiencing episodes of depression or mania. In some cases, symptoms can be so severe that they make daily life almost impossible and some people may experience suicidal thoughts.

Most people experience episodes of depression and mania, which signifies that they suffer a whole range of symptoms.

Symptoms of depression include:

  • Feeling worthless and isolated.
  • Loss of interest and enthusiasm.
  • Feeling low for a drawn out period of time.
  • Feeling guilty.
  • Changes in sleep patterns.
  • Fatigue.
  • Losing or gaining weight as a result of changes in appetite.
  • Lack of concentration.
  • Suicidal thoughts.

Symptoms of mania include:

  • Feeling very high.
  • Talking quickly.
  • Taking risks.
  • Disturbed sleep patterns.
  • Restlessness.
  • Becoming irritable.
  • Behaving aggressively.
  • Making poor decisions.
  • Feeling important.
  • Being delusional.
  • Hallucinating.

How is bipolar disorder diagnosed?

If you believe you or somebody close to you may have bipolar disorder, you should see your General Practitioner. They will take time to learn about your current condition and how you feel. If they suspect you have bipolar disorder they will transfer you to a specialist psychiatrist, who are experts in mental health conditions.

When you see a psychiatrist they will question you about your symptoms, talk to you about when, where and how often you develop symptoms and gather information about your medical history. They will also ask if you have a family history of bipolar disorder or any other mental health conditions. Your specialist may also order tests to assess your physical health.

If you are diagnosed with bipolar disorder you will be advised to see your GP on a habitual basis and a treatment plan will be drawn up.

Treatment for bipolar disorder

Treatment for bipolar disorder is usually very effective and, most of the time, a mixture of therapies is used, including:

  • Medication: medication is used to prevent episodes of depression, mania and treat symptoms linked to depression and mania.
  • Learning to spot the signs of an upcoming episode and identify triggers.
  • Hospital treatment: this is not required in most cases but is recommended for people with severe bipolar disorder.

Medication is the main treatment for bipolar disorder and patients can be prescribed medicines to prevent bouts of depression and mania, as well as treating symptoms associated with the two extreme states. In most cases, lithium carbonate is used to treat bipolar disorder and is a long-term treatment, which is usually prescribed for at least 6 months at a time. Anti-convulsant medicines and antipsychotic medication can be used to treat bouts of mania. If you experience quick successions of mood cycles (known as rapid cycling) you may be prescribed a combination of lithium and valproate. Anti-depressants are usually used to treat episodes of depression.

If you have bipolar disorder you may be able to spot the warning signs and triggers, which will then help you to get treatment sooner. Recognising the signs of an episode will not prevent it from happening but will enable you to get treatment as quickly as possible.

Hospital treatment is not usually required for people with bipolar disorder; however, it may be needed for people with severe bipolar disorder and those who are being treated under the Mental Health Act.

Other treatments may also be beneficial, such as:

  • Advice about diet and nutrition.
  • Psychological therapies.
  • Exercise.

Many people also find that keeping busy and active and arranging activities and outings is helpful.

Living with bipolar disorder

There is no way of preventing bipolar disorder but there are things you can do to try and make life easier and reduce symptoms. These include:

  • Avoiding alcohol and drugs.
  • Exercising on a regular basis.
  • Eating a healthy, balanced diet.
  • Taking medication and sticking to the dosage instructions.
  • Seeing your GP as soon as possible if you notice changes in your mood or you beginning to suffer side-effects of medication.
  • Reading and asking doctors about your condition can help you identify signs of an episode.  

If you have bipolar disorder there is support out there and you should not be ashamed or embarrassed to ask for help. Your GP will be able to provide details about local support groups or sessions that may be useful and you can contact charities such as Mind and MDF. The support of your friends and family is also very important.

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