What is bipolar?

Bipolar (previously known as manic depression) is a serious illness that can cause you to experience periods of depression (‘’lows’’) lasting weeks or months, alternating with bouts of mania (otherwise known as ‘highs’), which can vary in duration. Your mood is otherwise perfectly normal for months or even years.

If you experience mania but do not have the accompanying depressive episodes, it is still called bipolar. The pattern of mood swings in bipolar can vary widely, with some people only experiencing a couple of episodes in their lifetime. For others, it is more often. These mood swings are much more intense and prolonged than everyday life's typical ups and downs, often disturbing routine and making daily tasks impossible.

What are the symptoms of bipolar?

Episodes of depression and mania can often last for several weeks or months. Still, if you have the following symptoms for at least two weeks, you should see your GP.

Symptoms of depression

• You are feeling sad, hopeless or irritable most of the time.
• You’re tired and lacking energy despite appropriate rest.
• You have a loss of interest and enjoyment in everyday activities.
• You have feelings of emptiness or worthlessness.
• You are feeling pessimistic about everything.
• You might have thoughts of suicide.

Symptoms of mania

• You feel 'high,' 'on top of the world,' 'better than usual,' 'overjoyed.'
• You feel unusually angry or agitated.
• You are overactive, restless and easily distracted.
• You feel like your mind is racing and can't 'switch off.'
• You talk fast and skip from one topic to another.
• You have loads of energy and don’t feel like you need as much sleep.
• You are more impulsive and have poorer judgement.

You may also have:

• Increased interest in pleasurable activities: new ventures, sex, alcohol, drugs, music, art or religion.
• Behaviour that is demanding, pushy, insistent, domineering or provocative.
• Delusions (false ideas) or hallucinations (visions or voices) that usually relate to bold ideas about creativity, religion, sex, politics or business. These types of symptoms are known as psychosis or a psychotic episode.

It is often the case that someone in the manic phase will not recognise the changes in themselves, creating difficulties with the people closest to them.

How is bipolar diagnosed?

Depending on how you experience these mood states and how severely they affect you, your doctor may refer you to a psychiatrist who specialises in mental health problems. If your illness puts you at risk of harming yourself, your GP will arrange an appointment immediately.

A mental health professional, such as a psychiatrist, will assess you by asking questions about your symptoms, frequency of symptoms, medical background, and family history. They may also run other tests to rule out other conditions. You can only be diagnosed with bipolar by a mental health professional, such as a psychiatrist – not by your GP. Support is usually also provided by other mental health professionals, such as a community psychiatric nurse.

Treatment

Bipolar cannot be cured, but there are treatments that can help manage it. A mental health specialist will work with you to create a treatment plan. This may include:

Self-help

There are things that you can do and put into place to help manage your condition.

It is best practice for you to develop your wellness recovery action plan (WRAP) so that you can identify effective personal coping strategies that you can use when you feel that you need to. For more info on WRAP, click here.

Psychotherapy or Counselling

This may help you come to terms with the illness and provide support and guidance for you and your family. It can help you spot relapses and get help earlier. Cognitive Behavioural Therapy may help with the depressive side of bipolar. However, psychotherapy does not control or stabilise bipolar.

Medication

Medication is the primary treatment for bipolar, and the mood stabiliser Lithium works for 75% of people. Alternatives are also available, and you may need a combination of drugs, e.g. antidepressants during the depressed phase or antipsychotic medicines if you have hallucinations or delusions. Medication helps manage your symptoms, and most psychiatrists would recommend a mood stabiliser to those who have a strong chance of further episodes.

Continue your medication as prescribed. Stopping medication is the most common reason for relapse. A typical course of antidepressant medication would be to take the drug for at least six months AFTER you feel better. Consult your doctor before changing or stopping your medication.

We have a close relationship with Bipolar UK. Their website contains more useful information for managing bipolar.