Most people who develop bipolar disorder will have experienced some symptoms by the age of 25
Normal feelings vs. bipolar disorder
It’s normal to experience a range of emotions and feelings in your life. How you feel is affected by the things going on around you, your friends or family, stressful events, or sometimes by nothing at all. Ups and downs or changes in mood are normal and generally don’t cause too many problems.
If you have mood changes that are more severe than normal, last more than a few days, or lead to changes in your behaviour then it’s important to talk to someone and get help.
What is bipolar disorder?
Bipolar disorder is a type of mood disorder in which people have times of low mood (major depression) and times of ‘high’ or elevated mood (mania or hypomania).
These episodes (changes) usually last at least a week and affect the way a person thinks, feels and acts. The symptoms can interfere with relationships, activities and day-to-day living. Most people who develop bipolar disorder will have experienced some symptoms by the age of 25.
The experience of bipolar disorder is different for everyone. Some people have only one or two episodes and then never have another one, while others have several episodes close together. Some people have years without symptoms between episodes of becoming unwell. Often a depressive episode (or episodes) occurs before a manic episode is experienced.
What is a manic episode?
A manic episode is a period of constant and unusually elevated (‘high’) or irritable mood and a noticeable increase in energy or activity. This generally lasts at least one week and leads to a range of difficulties in a person’s daily life.
When someone is having a manic episode they may experience a combination of:
Elevated mood – feeling euphoric, ‘high’ or ‘on top of the world’, or very irritable
Less need for sleep – sleeping very little without feeling tired
More energy, activity and drive – having lots of projects or plans, walking long distances, being always ‘on the go’
Racing thoughts and rapid speech – thoughts jumping around from topic to topic, speech that is difficult for others to follow
Being disinhibited – engaging in high-risk behaviours that are out of character and potentially harmful, including sexual risk-taking, driving too fast, abusing alcohol or other drugs, or spending large amounts of money
Inflated self-esteem – ranging from uncritical self-confidence to grandiose beliefs (e.g. believing they have special powers or talents)
Psychotic symptoms – not being in touch with reality and having hallucinations, delusional ideas, or disorganised thinking and speech
Whether these experiences are pleasant or frightening some people may be reluctant to get help. They may not believe that they are unwell or that they need treatment. They may also be feeling very suspicious and/or confused, making it hard for them to trust others.
What is a hypomanic episode?
A hypomanic episode is a milder form of mania that lasts for at least four days.
The symptoms are less severe and there are no psychotic symptoms. Hypomanic episodes may be enjoyable as the person can experience more confidence and an elevated mood. Some people will manage to keep functioning without any significant difficulties but others will progress to experience a full manic episode. Even if hypomanic symptoms are not distressing it is important to let a mental health professional know about them.
What is a depressive episode?
A depressive episode is a period of lowered mood, with changes in thinking and behaviour that lasts for at least two weeks.
Typical symptoms of depression include:
Feeling in a low mood - sadness, irritability, tearfulness
Losing interest in enjoyable activities
Changes in appetite and weight – eating more or less than usual, gaining or losing weight rapidly
Changes in sleeping patterns – trouble falling or staying asleep, or sleeping much more than usual
Lowered energy and lack of motivation
Feelings of hopelessness and worthlessness
Poor concentration and memory problems
Thoughts about suicide
Types of bipolar disorder
There are two main types of bipolar disorder: bipolar I (‘bipolar one’) and bipolar II (‘bipolar two’). An additional form of bipolar disorder is cyclothymia, which is a milder version of the disorder.
A person with bipolar I disorder will have had at least one episode of mania. Usually the mania is so severe that they will need admission to hospital to keep them safe. They will usually have experienced depression at some time as well.
A person with bipolar II disorder will have had at least one episode of hypomania (the less severe form of mania) as well as an episode of depression. Depressive episodes can be severe and the uncertain mood that individuals experience can have a major effect on their lives.
A person with cyclothymia (or cyclothymic disorder) experiences changes in mood that are less severe than those in bipolar I or II. Even though the symptoms may be less severe, it can have a significant impact on an individual’s functioning.
Getting help for bipolar disorder
A proper diagnosis from a health professional, a local general practitioner (GP) or a psychiatrist is important for you to get the right treatment. Getting professional treatment when problems begin helps to limit the impact of bipolar on the things you want to do in your life, like finishing school, moving out of home, and getting a job. Treatment can also reduce the risk that you will have problems with your mood in the future.
Treatment usually involves a combination of medication and psychological therapies. Your GP or psychiatrist can help you to find a medication that works for you. Psychological therapies can help you to understand your mood patterns, manage negative thoughts and feelings, and develop a plan to avoid becoming unwell in the future.
These strategies usually include:
Having regular patterns of sleeping and eating
Looking after your overall health; getting regular exercise and eating healthy food
Learning to manage stress
Avoiding alcohol and other drugs
Keeping in contact with friends and supportive people in your life
Getting a good balance of rest and activities
Learning to recognise ‘warning signs’ that you may be becoming unwell
Where to get help
GP’s and mental health professionals can give you helpful information about your mental health and arrange the treatment you need.
To find a health professional that you trust and feel comfortable with contact your local community health centre or headspace centre, or perhaps ask a trusted friend, teacher or family member about where to find help. Remember that it can take time to find the right treatment as every person is different and responds in different ways. Be patient and make sure you talk to your health professional about how things are going so that they can support you in the best possible way.
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