Depression is a condition that causes a person to feel sad or miserable most of the time. It is a common condition that affects physical and mental health and can interfere with a person's ability to carry out daily activities. There is a range of treatments and support services available to help people recover.…
What is a bipolar disorder?
A bipolar disorder is a condition that affects a person's mood. While everyone has mood swings from time to time, someone with a bipolar disorder can have very extreme mood swings that range from feeling high or overexcited, to feeling low and depressed. It is estimated that around 1% of people will develop a bipolar disorder at some point in their lives.
Causes and risk factors
It is not known exactly what causes a bipolar disorder. As with other conditions that affect mood, such as depression, it is thought that people with a bipolar disorder have an imbalance of certain mood-affecting brain chemicals, such as serotonin and norepinephrine.
Research has shown that there is a genetic link to a bipolar disorder, meaning that you have an increased risk of developing the condition if you have a close family member who has it.
There are two main subtypes of a bipolar disorder: bipolar 1 disorder and bipolar 2 disorder. These differ on the severity of symptoms, especially with feeling high, which can be severe (known as mania) or much milder (known as hypomania).
Bipolar 1 disorder is usually diagnosed if a person experiences one or more episodes of mania and depression in their life. If these episodes are very severe, hospitalization may be required. Bipolar 2 disorder is diagnosed if a person experiences episodes of hypomania and milder forms of depression.
Signs and symptoms
People with a bipolar disorder have extreme mood swings that range from feeling extremely high, overexcited and energetic, to feeling very depressed and helpless.
During an episode of hypomania or mania, a person may experience:
- Difficulty sleeping;
- Very fast speech;
- Trouble concentrating, and;
- Reckless and impulsive behavior, such as quitting a job or overspending of money.
Some episodes of mania may be so severe that a person may experience symptoms of psychosis, meaning that they can no longer tell what is real and what is not.
During a bipolar depression, a person may experience:
- Feeling sad and/or hopeless, sometimes even feeling suicidal;
- Reduced appetite;
- Extreme tiredness, and;
- Difficulty sleeping, or sleeping too much.
Stress can be a trigger for bipolar episodes. The pattern of mood swings can be different for each person with the disorder. Some people may experience mainly highs, while others may experience more depressive moods. These moods may last for days, weeks or months at a time. If a person experiences more than four episodes within a year, their condition is called rapid-cycling bipolar disorder.
Methods for diagnosis
Diagnosing a bipolar disorder can be difficult, as there is no precise medical test that can confirm whether you have the condition. A diagnosis is usually made by a specialist (psychiatrist). To work out if you have a bipolar disorder, they will consider details about your symptoms and medical history.
You may also be required to have certain medical tests to rule out any other medical conditions that could be causing your symptoms.
Types of treatment
There is no cure for a bipolar disorder. It is a long-term condition that usually requires lifelong treatment, which generally involves medication, psychotherapy and support from family and friends.
Mood stabilizers are medications that are used to prevent or treat mania. Mood stabilizers can be taken with or without antidepressants and may take up to a week before they start working. Common mood stabilizers used to treat a bipolar disorder include:
- Lithium carbonate;
- Sodium valproate;
- Carbamazepine, and;
A bipolar disorder may sometimes be treated with medications called antidepressants. These help to control mood by restoring the balance of chemicals in the brain, such as serotonin and norepinephrine. If antidepressants are taken without mood stabilizers, they may trigger episodes of mania. Some of the common types of antidepressants prescribed to treat a bipolar disorder include:
- Selective serotonin re-uptake inhibitors (SSRIs);
- Serotonin and noradrenaline re-uptake inhibitors (SNRIs), and;
- Monoamine oxidase inhibitors (MAOIs).
These medications generally need to be taken for at least two weeks before any improvement in symptoms can be seen. Medication may also need to be continued for a time, even after the symptoms have gone, to prevent them from returning. When stopping antidepressant medication, the dose usually needs to be reduced gradually over time to avoid any withdrawal responses.
Like with most medications, some people may experience some side effects when taking antidepressants. Some common side effects include nausea, dizziness, tiredness and sexual dysfunction. Some antidepressants can have more serious side effects if they are taken with certain other medications or herbal remedies, or when combined with alcohol. Your doctor will work with you to find the medication that is best for you.
Very rarely, some antidepressants may increase suicidal thoughts and the risk of suicide. The risk is highest in the first week after starting antidepressant treatment, or when the dose of antidepressants is changed. If a person experiences suicidal thoughts, it is important to contact a doctor immediately.
Psychotherapy is sometimes referred to as 'talking therapy' and describes the process of treating a mental illness by applying different psychology techniques that can improve people's understanding of their condition and the various ways that it can be managed. Psychotherapy treatments for a bipolar disorder may include cognitive behavioral therapy, family-based therapy and group therapy.
Some people with a bipolar disorder may need to be hospitalized during a bipolar episode if they are at risk of harming themselves or others.
Having the support of close family and friends or attending a support group with other people who have also experienced a bipolar disorder may help people to understand and manage their condition.
Electroconvulsive therapy (ECT) is a procedure that is sometimes used to treat severe cases of bipolar depression. This procedure is performed in a hospital, under a general anesthetic. It involves passing a small amount of electric current through the brain. Depending on the severity of the condition, this procedure may be performed a few times a week for several weeks. It can work quickly to relieve symptoms and improve mood. Some people may experience some short-term memory loss for a few days or weeks after having treatment.
If left untreated, a bipolar disorder can affect many aspects of everyday life. The most serious complications of a bipolar disorder include suicidal thoughts and attempts at suicide or self-harm. This generally occurs during the depressive phase of the condition. If a person experiences suicidal thoughts, it is important to contact a doctor immediately.
There is currently no cure for a bipolar disorder. It is a long-term condition that usually requires lifelong treatment to effectively manage and improve the symptoms.
If you or someone you know needs help, please call or visit:
National Suicide Prevention Lifeline. Website: Lifeline Call: 1-800-273-8255
We can all help prevent suicide. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
- Mitchell P.B. (2013) Bipolar disorder. Australian Family Physician 42:616-619.
- Murtagh J. MD. (2011). John Murtaghs General Practice (5th Revised edition.). North Ryde N.S.W.: McGraw-Hill Medical Publishing.
FAQ Frequently asked questions
What is bipolar disorder?
Bipolar disorder is a condition that affects a person's mood. While everyone has mood swings from time to time, someone with bipolar disorder can have extreme mood swings that range from feeling high or overexcited to feeling low and depressed.
What causes bipolar disorder?
It is not known exactly what causes bipolar disorder. As with other conditions that affect mood, such as depression, it is thought that people with bipolar disorder have an imbalance of certain chemicals in the brain that affect mood. There is a genetic link …
What are the symptoms of bipolar disorder?
The main symptoms of bipolar disorder are extreme mood swings that range from feeling extremely high or overexcited and energetic, to feeling very depressed and helpless. The mood of feeling very high is sometimes referred to as mania. During a …
What is the difference between depression and bipolar disorder?
Depression and bipolar disorder are both conditions that affect mood. The main difference between them is that people with depression feel sad or miserable most of the time, while people with bipolar disorder have extreme mood …
What is mania?
Mania is a mood that can occur in bipolar disorder. It is the feeling of having an abnormally elevated mood. During a manic episode, a person may feel overexcited and have excess energy, and engage in reckless behavior. Sometimes mania may be so severe that a person can no …
What is manic depression?
Bipolar disorder was once called manic depression. The term manic describes the elevated mood that occurs in bipolar disorder, where a person feels extremely high, and overexcited. Depression refers to the low mood that people experience as part of a bipolar …
How is bipolar disorder diagnosed?
Diagnosing bipolar disorder can be difficult, as there is no single medical test that can confirm the condition. A diagnosis is usually made by a psychiatrist. To work out if a person has bipolar disorder, the psychiatrist will usually collect a detailed …
How is bipolar disorder treated?
Bipolar disorder is a long-term condition that usually requires lifelong treatment, which can involve medication and support programs. Medication used to treat bipolar disorder is usually very effective in preventing bipolar episodes. Support from close …
How common is bipolar disorder?
Bipolar disorder is a relatively common condition. In Australia, it is thought that around 1% of the population are thought to be affected at some point in their lives.