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Bipolar disorder: key facts


What is bipolar disorder?Bipolar Disorder

Bipolar disorder is a condition in which your mood can swing very high, or very low, for weeks or months. It used to be called Manic Depression.

Your mood can be:

  • low with intense depression and despair
  • high or ‘manic’ with elation, over-activity or anger
  • a 'mixed state' with symptoms of depression and mania.

Bipolar disorder is less common than depression. It affects about 1 person in a 100.

What causes bipolar disorder?

  • It seems to run in families, so genes are involved. Genetic causes are less common in the elderly.
  • There may be a physical problem with the brain systems which control mood.
  • Stress can trigger episodes.

How does it feel to have bipolar disorder?

 Depression Mania
 
  • Feelings of unhappiness that don't go away
  • Agitation and restlessness
  • Loss of self-confidence
  • Feeling useless, inadequate and hopeless
  • Thoughts of suicide
  • Not able to think positively or hopefully
  • Can't make decisions
  • Can't concentrate, lose interest
  • Can't eat, lose weight
  • Can't sleep properly, wake early in the morning
  • Go off sex
  • Avoid other people
 
  • Very happy and excited
  • Feel more important than usual
  • Full of new and exciting ideas
  • Move quickly from one idea to another
  • Full of energy
  • Don't want to sleep
  • More interested in sex
  • Make unrealistic plans
  • Very overactive, talking quickly
  • Irritable with other people who can't go along with your mood and ideas
  • Spending more money
  • Lose insight and be unaware of how 'unwell' you are

In a severe mood swing, you can have psychotic symptoms. 

  • When depressed, you may believe that you are evil or guilty, that you are worse than anybody else, or even that you don't exist.
  • When manic, you may feel that you are on an important mission or that you have special powers and abilities.
  • You might also experience hallucinations - when you hear or see something that isn’t there.  

Treatment

  • Treating a high: lithium, antipsychotics and sodium valproate are the medications most commonly used.
  • Treating depression: antidepressants should be used carefully as they can make people go high. It's best to stop them as soon as the depression goes away.
  • Psychological treatments: these can also help. Methods include:
    • education: learning about the condition and how to control it
    • mood monitoring: you learn to notice when your mood is starting to change
    • strategies: to stop you mood going out of control
    • Cognitive Behavioural Therapy (CBT) for depression.

Self help

  • Learn to spot the early warning signs so you can get help early.
  • Find out as much as you can about bipolar disorder.
  • Be aware of how stress affects you.
  • Have at least one person that you can rely on and confide in - someone who can warn you if you think you are not well.
  • Balance your life and work, leisure, and relationships.
  • Do things that you enjoy and that give your life meaning.
  • Don't stop medication suddenly.
  • You may find it useful to keep a diary to record your daily mood.
  • You may want to write an ‘advance directive’ with your doctor and family to say how you want to be treated if you become unwell again.
  • Try to eat a healthy diet and to sleep well.
  • If you drink alcohol, stick to the safe limits. 

Helping someone else

  • When someone is depressed, it can be difficult to know what to say. They see everything in a negative light. Listen and try to be patient and understanding. 
  • During mania, the person will appear to be happy, energetic and outgoing. But the excitement of any social situations will risk sending their mood even higher and their doing things that are out of character for them. Try to steer them away from parties or heated discussions. Persuade them to get help.
  • In between mood episodes, find out more about the condition. Go to appointments with them (if they are willing). Make sure you give yourself space and time to recharge your batteries.

For more in-depth information see our main leaflet: Bipolar Disorder

This leaflet reflects the most up-to-date evidence at the time of writing.

Produced by the RCPsych Public Education Editorial Board.

Series Editor: Dr Philip Timms

Reviewed by Dr Ros Ramsay

© January 2014. Due for review: January 2016. Royal College of Psychiatrists. You can link to, download, print, photocopy and distribute this leaflet free of charge. But you must not change it or repost it on a website.

For a catalogue of public education materials or copies of our leaflets contact: Leaflets Department, The Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB. Telephone: 020 7235 2351 x 2552

Charity registration number (England and Wales) 228636 and in Scotland SC038369.

 

Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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