Bipolar Disorder

Bipolar Disorder (BD), previously known as manic depression, is a mental health condition involving intense periods of elevated (‘high’) mood (i.e. mania or hypomania) alongside depression. These mood changes are not the same as normal ‘ups-and-downs’. People experiencing mania often report feeling ‘on top of the world’; or having ‘racing thoughts’, and not being able to slow down.

In some cases, psychotic symptoms may be involved. Hypomania is a less severe form, where the ‘highs’ may not alter one’s functioning much, and no psychosis is experienced. These mania and depressive periods tend to cause personal distress or impair work, social, or daily functioning. People with BD can have periods of stable mood, where they do not have any symptoms.

Prevalence of BD

Approximately 2% of people worldwide meet criteria for BD. Most will experience symptoms before the age of 25. As BD typically involves periods of mania and depression, it is not uncommon to receive an initial diagnosis of depression, only to be later diagnosed with BD.

At times, individuals may underreport mania/ hypomania symptoms as these can feel pleasant. This can make getting appropriate treatment challenging.  

Possible causes

The exact causes of BD are unknown, but there is some indication that a combination of genetics, psychological, and environmental factors are involved. As such, traumatic or stressful life events may increase the likelihood of BD. Persons with BD sometimes report being highly ambitious, or having impulsive personality traits. 

Symptoms of BD

One person with BD may present quite differently from someone else. Possible symptoms include:

  • Mania/hypomania
  • Elevated mood or increased energy levels
  • Feeling persistently irritable
  • Grandiose ideas or inflated self-esteem
  • Reduced need for sleep
  • Greater amount and/or volume of speech
  • Racing thoughts
  • Significant distractibility
  • Physical agitation or restlessness
  • Reckless behaviours (e.g. spending sprees, irresponsible driving, or sexual indiscretions)

Treatment options

Effective treatments for BD often involve a combination of mood stabilisers (e.g. lithium) and psychological interventions, such as cognitive-behavioural therapy (CBT), or interpersonal and social rhythms therapy (IPSRT). Social support and lifestyle changes may be helpful as well.