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Bipolar disorder

Bipolar is a mental health condition where you experience extreme mood swings of manic ‘highs’ followed by depressive ‘lows’. Find out more about the symptoms and signs of bipolar.

What is bipolar disorder?

Usually referred to as ‘bipolar’, you may also hear people talking about bipolar affective disorder or its old name, manic depression.

Whatever you call it, bipolar describes how your mood can fluctuate between mania when you feel high and depression when you feel low. These are more intense than having mood swings as the emotions are extreme and can last for weeks at a time or even longer. Some people also experience psychotic symptoms.

Bipolar disorder symptoms

Episodes of mania and depression are different for everyone, but they are often extremely disrupting to your daily life and can leave you feeling overwhelmed.

You may not be fully aware that you’re in a manic phase during the time, and afterwards, you might feel shocked at how you behaved.

During a manic phase, you may:

  • Feel happy, euphoric or ‘high’

  • Be excited and energetic

  • Have lots of new ideas and plans

  • Feel invincible, confident and self-important

  • Talk very quickly

  • Have a racing mind and be easily distracted

  • Experience delusions, sometimes seeing and hearing things that aren’t there

  • Behave in ways that you wouldn’t usually, like spending lots of money on things you don’t need or doing things that are risky or harmful

During a depressive phase, you may:

  • Feel sad, upset and hopeless

  • Lack energy or motivation

  • Find it hard to concentrate or remember things

  • Have low self-esteem and doubt yourself

  • Lose your appetite

  • Have sleeping problems

  • Lose interest in the things you usually enjoy

  • Self-harm or have suicidal feelings

  • Experience delusions, sometimes seeing and hearing things that aren’t there, although this is more common in the manic phase

Episodes of bipolar disorder

Bipolar episodes aren’t the same for everyone – some people have more manic episodes and others have more depressive ones. It’s also possible to experience both states simultaneously, known as ‘mixed state’.

Many people have periods where they feel ‘normal’ in between episodes, but some don’t. If you repeatedly swing from high to low with no feelings of normality in between, it’s called ‘rapid cycling’.

What causes bipolar?

The exact cause of bipolar is unknown, but experts believe that several different factors can increase your risk of developing the condition.

A chemical imbalance in the brain – an imbalance in neurotransmitters (the chemicals that control the brain’s functions) is thought to be linked to the condition.

Childhood trauma – traumatic events, sexual or physical abuse and neglect in childhood can affect your ability to control your emotions as an adult.

Family history – there’s no evidence of a single gene that’s responsible for bipolar, but your risk of developing bipolar is higher if you have a family member with the condition. Experts put this down to the shared ’environmental’ factors (or the type of lifestyle you lead) that can trigger bipolar.

Stressful triggers – it’s thought that stressful life events, like the death of someone you love, abuse, or the breakdown of a relationship, can trigger the symptoms of bipolar.

How is bipolar diagnosed?

You can only be diagnosed by a mental health professional, like a psychiatrist. But first, you’ll need to talk things through with a doctor, who can get an idea of the symptoms you’re experiencing and refer you to a specialist if needed.

It can be daunting to talk to a doctor about how you’re feeling. To help you feel more prepared, it can help to write down some notes about your symptoms before you go. Doctors sometimes ask you to keep a diary of your moods to help them understand your symptoms better. You could take this along if you’ve already started one. It might also help to bring a friend along for moral support.

If you’re referred to a specialist, they may ask you questions like:

  • What symptoms you’ve experienced, and how long you’ve had them

  • How you feel before an episode

  • How many episodes you’ve had, and how long they usually last

  • If you’ve ever harmed yourself or had thoughts about it

  • Your family history

  • Your medical background

You might need to have blood tests to see if there’s an underlying health issue causing your mania-like symptoms. For example, an underactive or overactive thyroid.

Treatment for bipolar disorder

Usually, a combination of talking therapy and medication is used to treat bipolar, but the exact treatment will depend on the type of episodes you’re experiencing.

Treatment may include:

Mood stabilisers – taken daily on a long-term basis to help control episodes of mania and depression

Antidepressants – to treat depression Antipsychotic medication – to treat more severe episodes of mania where behaviour is disturbed

Talking therapies – like cognitive behavioural therapy (CBT) to look at your thoughts, feelings and behaviour, and interpersonal therapy to help address your relationships with others

Hospital treatment – in severe cases, you may need treatment in a hospital if there’s a danger that you might hurt yourself or others - but this is rare.

Learning to manage bipolar

With the right treatment, the severity of episodes usually improves within a few months. Most people can live a much more normal life.

Other aspects of your treatment aim to give you an active role in your recovery. These might involve learning to understand what triggers an episode of depression or mania and following self-management programmes.

Changes to your lifestyle, like improving your diet and sleep and getting more exercise, could also be recommended and can be a positive way for you to take some personal control over your wellbeing.

Reviewed by:

Dr Rhianna McClymont

Lead GP at Livi

Last updated: