Mental health: bipolar affective disorder
Bipolar affective disorder,
also known as manic depression, is a mood disorder in which the
sufferer experiences marked mood swings which are beyond what most
These extremes of mood may include the lows of depression as well
as the highs of a very elated mood (known as mania). The number and
frequency of these periods of depression and mania vary from person
Between one and two percent of the population suffer from
bipolar affective disorder at some point in their lives. Some
people will experience just one or two episodes, whereas others
will have many episodes of depression or mania.
It is a serious condition but can be helped with the right
What causes bipolar affective disorder?
The causes of bipolar affective disorder are not well
understood. As with any mental illness, differences in
people's genetic makeup can make them more vulnerable to develop
bipolar affective disorder. Stressful events, illness or lack of
support can trigger individual episodes of mania or depression.
the symptoms of mania?
Mania is typically a period of a week or more where a person
feels abnormally good, high, excited, hyperactive or irritable.
This can be so extreme that the sufferer loses contact with reality
and starts to believe strange things, have poor judgement and
behave in embarrassing, harmful or even dangerous ways. This may be
- an elevated mood beyond what is normal for the
- an overwhelming sense of wellbeing and self-importance
- increased energy and overactivity
- increased speech, often rapid and louder than usual
- a reduced need for sleep
- loss of inhibitions with possible inappropriate and impulsive
- the expression of grand, over-optimistic ideas and plans
- an increase in sexual thoughts, feelings and behaviours
- risk-taking behaviour, including financially, sexually or
In severe cases sufferers may develop 'psychotic' symptoms of
delusions and hallucinations.
What are the symptoms of a major depressive
A depressive episode is when you have either a depressed mood or
the loss of interest or pleasure in nearly all activities lasting
for at least two weeks. Symptoms include:
- lack of interest in day-to-day life
- unusual levels of fatigue and exhaustion
- no appetite or an increased appetite with changes in body
- feeling worthless or guilty
- difficulty concentrating.
the types of bipolar disorder?
Bipolar affective disorder is not one single disorder. Instead,
there are four distinct types.
Bipolar I disorder is marked by experiencing
one or more manic episodes or mixed episodes and often one or more
major depressive episodes. Each depressive episode can last for
several weeks or months, alternating with intense symptoms of mania
that can last just as long. Between these extremes, there may be no
symptoms at all.
Bipolar II disorder is marked by experiencing
one or more major depressive episodes, along with at least one
hypomanic episode. Hypomanic episodes have symptoms similar to
manic episodes, but are not as severe. Between episodes, there
might be periods of normal functioning.
Cyclothymic disorder is a chronic fluctuating
mood pattern which involves periods of hypomanic symptoms and
periods of depressive symptoms. The symptoms do not have to be
severe enough to be labelled as mania or depression - it is a
milder form of bipolar disorder in which the symptoms are less
severe, less regular and don't last as long.
Bipolar disorder not otherwise specified
is when the symptoms don't fit any other type, it is a treatable
disorder, but it is not as regular or as clear-cut as the other
types and experiences vary more widely from person to person.
Symptoms may be as severe as the other types, but not last as long,
or may be too far apart to be classified as cyclothymic disorder,
or there may be recurrent hypomanic episodes without depressive
All these four types of bipolar disorder have the potential to
seriously disrupt someone's work, school, social or personal life.
Thankfully, they are also all treatable.
Depressive episodes are treated in the same way as other
episodes of depression. This includes psychological therapy and
antidepressant medication. Episodes of mania are usually
treated with antipsychotic medication (e.g. chlorpromazine and
If the episodes of either mania or depression are severe enough to
place the person at risk, or to endanger the lives of others, they
may need to be admitted to hospital in order to be treated.
Often, during acute episodes of illness, mood-stabilizing
medicines are used such as lithium, sodium valproate
(Epilim), carbamazepine (Tegretol) and olanzapine
(Zyprexa).These are also used for longer-term preventive
therapy, the aim of which is to prevent relapses.
These medications treat the symptoms, not the cause, and are
also used in cases where a brain injury leads to extremes of mood
that are not classed as a mental illness.
disorder in everyday life
Learn to recognize the warning signs. Episodes of both mania
depression have early-warning signs, such as feeling sluggish,
tearful or hopeless (depression) or being impulsive or caustic to
others (mania). Also learn to recognize triggers, and avoid them
Set routines and keep to them. Changes in patterns such as
sleeping and eating, and stressful events, are often triggers for
manic episodes and should be avoided where possible.
Make sure that you take your medication according to your
doctor's instructions, and if it isn't working talk to your doctor
about this rather than modifying the dosages yourself.
Keep a mood diary, which will help to identify triggers, warning
signs and helpful strategies.
Avoid any mood-altering chemicals that are not prescribed for
you. This includes caffeine in coffee and tea, alcohol, and
nicotine in tobacco. Exercise regularly. Regular physical exercise
helps with most psychiatric illnesses.
Find relaxation methods that work for you. Guided imagery,
taking a bath or yoga are some techniques that may help. Find
someone you can trust to talk to. This might be your GP, a
counsellor, friend or family member. They should be someone who
will help you work through emotions or fears and be able to provide
emotional support when needed.
Join a support group. Many people with mood disorders find that
support groups or internet forums provide them with most of their
social and emotional support.
for bipolar disorder
Like diabetes or heart disease, Bipolar Disorder is often a
long-term illness that must be carefully managed throughout a
Episodes of mania and depression typically recur across the life
span. Between episodes, most people are free of symptoms, but as
many as one third of people have some residual symptoms. A small
percentage of people experience chronic unremitting symptoms
Without treatment, however, the natural course of bipolar disorder
tends to worsen. Over time a person may suffer more frequent (more
rapid-cycling) and more severe manic and depressive episodes than
those experienced when the illness first appeared. But in most
cases, proper treatment can help reduce the frequency and severity
of episodes and can help people with bipolar disorder maintain good
quality of life.
References and further information