According to an NHS Digital report, 1.6 - 2.4% of people in the UK will be affected by bipolar disorder at some point in their lives. Although it can be an all-encompassing and afflicting condition, with proper treatment the illness does not necessarily stand in the way of a person’s ability to lead a rich and fulfilling life.
However, like many mental health conditions, bipolar disorder is largely misunderstood. Given the lingering stigma that still clouds debates around mental health, a lack of proper education on the topic can cause added distress for individuals living with it. It’s time to debunk the myths, lay down the facts and open up a much-needed dialogue on this common condition.
What is bipolar disorder?
Formerly called manic depression, bipolar disorder is a mental disorder that causes extreme mood swings from high (mania) to low (depression). The low periods might be treated with mood stabilisers and antidepressants such as fluoxetine, alongside talking therapies. High periods, on the other hand, are commonly managed using medication like antipsychotics.
Who does it affect?
Bipolar disorder can occur at any age, although the onset of the condition is most common between the ages of 15 and 19 - very rarely developing after the age of 40. Bipolar disorder does not discriminate, and men and women from all backgrounds can develop the condition.
What are the symptoms of bipolar disorder?
The high and low moods associated with bipolar disorder are often so extreme that they can disrupt everyday life. These two extremes - mania and depression - can be so far removed from one another that the potential symptoms of bipolar disorder can be separated into two distinct states.
Symptoms of mania
- Feeling overly happy and energetic
- Disconnected, racing thoughts
- Inappropriate social behaviour
- Inappropriate elation or euphoria
- Inappropriate irritability
- Psychosis-like symptoms
Symptoms of depression
- Prolonged low mood or sadness
- Feelings of worthlessness and helplessness
- Low self-esteem
- Feelings of guilt
- Lack of energy
- Having suicidal thoughts
Individuals with bipolar disorder can fluctuate between these two groups of symptoms (known as episodes), causing great emotional and physical distress.
Hypomania is a less severe form of mania, with symptoms including inflated self-esteem, being overly sociable, doing everything to excess, restlessness, and irritability. However, there are usually no symptoms of psychosis and a person might be able to continue with daily activities. If moods of hypomania frequently switch to depression and then back to hypomania, this is known as bipolar II (pronounced bipolar two) disorder.
To differentiate it from bipolar disorder, depression without mania is sometimes referred to as unipolar because the mood stays at one emotional state or ‘pole’.
What causes bipolar disorder?
Unfortunately, the exact causes of the illness are unknown, although it’s believed that a complex mix of physical, environmental and social factors can trigger the condition. Extreme stress, post-traumatic episodes and other problems in life are thought to contribute, as are chemical and genetic factors.
As a result, many often pose the question: can antidepressants cause you to develop bipolar disorder? The answer to this is no: neither medication, drugs or alcohol can cause bipolar disorder. However, some antidepressants can potentially trigger symptoms of the condition such as mania or hypomania.
It’s worth noting that if an individual develops either mania or depression it does not necessarily mean they will go on to develop clinically diagnosed bipolar disorder.
Is bipolar disorder genetic?
To an extent. The condition has been known to run in families, and a family history of bipolar disorder seems to be a strong risk factor. However, most family members of someone with bipolar disorder will not develop the condition. Up until now, no bipolar gene has been discovered, and the causes appear to stem from a mixed bag of environmental factors and genetic predispositions.
Is there a cure for bipolar disorder? Research has not yet discovered a cure for bipolar disorder, although the condition can be managed through a combination of psychiatric medication (such as antipsychotics and mood stabilisers) and psychotherapy. Long-term effects of the illness can be reduced through such treatment, and an early diagnosis significantly increases the effectiveness of a treatment.
Treatment for bipolar disorder
A number of treatments are available for bipolar disorder that allow individuals affected by the illness to live as normal a life as possible. Such treatments include:
- Medication such as lithium carbonate (commonly known as lithium) to minimise the effects of mania, hypomania, and depression. These are called mood stabilisers and are taken daily on a long-term basis.
- Medication to address the effects of mania and depression when they occur.
- Learning to recognise the triggers that can lead to the onset of either mania or depression, and then to act accordingly.
- Psychological treatment. This can encompass talking therapies such as cognitive behavioural therapy (CBT) or counselling, which provide you with advice on how to deal with the practical aspects of living with the condition and how to better manage your social relationships.
- General lifestyle advice - such as regular exercise, improved diet and getting a good night’s sleep. Positive activities that provide you with a sense of achievement are also highly recommended.
These treatments are not mutually exclusive, and the best way to manage your condition is through a combination of different treatments and therapies. The treatment your GP suggests will depend on the severity of your symptoms.
Bipolar disorder is a serious condition, and many people with the illness struggle to cope.
According to the NHS, studies have shown that as many as 25-50% of people with bipolar disorder attempt suicide at least once. If you are feeling suicidal, talk to your GP or counsellor. Alternatively, you can call Samaritans any time on 116 123.
However, sticking to treatment and getting good care can help reduce the severity of the symptoms and help you get on with your life. Remember, your bipolar does not define you.
For more on bipolar disorder, the mental health charities Mind and Bipolar UK are helpful resources. Time to Change also has a great collection of inspiring blogs and personal stories that document how people with bipolar disorder cope with their condition.
Clinically reviewed by Alistair Murray MRPharmS: 21/2/18
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