People with bipolar disorder (previously called manic-depressive illness or manic depression) experience a cycle of mood swings between depression and mania (elation). A less severe form of mania is termed hypomania. Both the manic and depressive phases vary widely in intensity and duration. People with bipolar disorder often spend more time in the depressive phase of illness than the manic or hypomanic phase.
Common symptoms of bipolar disorders are (1):
- Experiencing an elevated, expansive or irritable mood for at least one week
- Rapid changes in mood between depression and mania, or a mixture of both
- Irritability or anger
- Feeling excessively good about the self (inflated self esteem)
- Exaggerated ideas about how important one is (grandiosity)
- Difficulty concentrating, paying attention and remembering things
- Easily distracted or impulsive
- Having many ideas or thoughts at the one time (flight of ideas)
- More talkative or having pressured speech
- Problems with work, social or family life
- Increased goal-directed activity
- Involvement in pleasurable or risky activities that have the potential for serious negative consequences (eg, excessive spending, increased sexual activity)
- Increase in impulsivity
- Decreased need for sleep
- Changes in energy levels and appetite
Onset, prevalence, and burden of bipolar disorders in young people
At least one in every 100 people will experience bipolar disorder at some time during their lives. In Australia, it is estimated that approximately 1.8% of males and 1.7% of females have had bipolar disorder in the previous 12 months (2). In young Australians aged 16-24 years, it is estimated that approximately 3.2% of males and 3.6% of females have had bipolar disorder in their lifetime (3).
Bipolar disorder is the ninth leading contributor to the burden of disease and injury in Australian females aged 15-24 years, and the tenth leading contributor for males of the same age (3).
Overall, about 50% of people who develop bipolar disorder will do so by the time they are in their early to mid 20s (4). Bipolar disorder in young people may sometimes be misdiagnosed as depression. Australian researchers have found that from the average age of symptom onset (17.5 years), there was a delay of approximately 12.5 years before a diagnosis of bipolar disorder was made (5).
A number of factors are known to increase the likelihood that a person will develop bipolar disorder (6). These include:
- Genetic vulnerability (for example, bipolar disorder in other family members)
- Physiological or biological factors including complications during gestation or birth, or abnormal regulation of daily (circadian) rhythms
- Psychological factors including a childhood history of physical or sexual abuse
- Stressful life events
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
2. Slade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., & Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australasian Psychiatry, 43(7), 594-605.
3. Australian Institute of Health and Welfare 2011. Young Australians: their health and wellbeing 2011. Cat. no. PHE 140 Canberra: AIHW
4. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602.
5. Berk, M., Dodd, S., Callaly, P., Berk, L., Fitzgerald, P., de Castella, A.R., & Kulkarni, J. (2007). History of illness prior to a diagnosis of bipolar disorder or schizoaffective disorder. Journal of Affective Disorders, 103(1-3), 181-186.
6. Berk, M., Conus, P., Lucas, N., Hallam, K., Malhi, G. S., Dodd, S., Yatham, L., Yung, A., & McGorry, P. (2007). Setting the stage: from prodrome to treatment resistance in bipolar disorder. Bipolar Disorders, 9(7), 671-678