Bipolar Disorder
Bipolar disorder (sometimes called manic depression) refers to a group of conditions characterised by cycles of extreme low and high mood.
The periods of low mood are referred to as ‘depressive episodes’. The periods of high mood are referred to as ‘manic’ or ‘hypomanic’ episodes.
While everyone experiences fluctuations in mood, the episodes of high and low mood experienced in bipolar disorder significantly impact on the person’s relationships, work or education, and day-to-day life.
Bipolar disorder can look quite different in different people. For some people, episodes can last for three to six months and occur every few years while others may experience shorter but more frequent episodes over the course of one year.
In Australia, approximately 2.2 per cent of the population has a form of bipolar disorder. Symptoms usually start in early adulthood and for most people the disorder is a lifelong diagnosis; however, with appropriate treatment and support, bipolar disorder symptoms can be well managed and individuals are able to maintain a good quality of life.
There are a number of bipolar and related disorders.
Bipolar I disorder
Bipolar I disorder is characterised by one or more manic episodes (which last at least one week). Episodes of either depression or hypomania may also occur prior to or following a manic episode. Due to the severe nature of these symptoms, people with bipolar I disorder may require hospitalisation during an episode.
Bipolar II disorder
Bipolar II disorder is characterised by both hypomanic and depressive episodes but unlike bipolar I disorder, no manic episodes are experienced. Hypomania represents a change to the person’s usual functioning (noticeable by others) but is not, by definition, associated with impairment. Although bipolar II disorder is less severe than bipolar I disorder in terms of symptoms, it can be more chronic as depressive symptoms are often more frequent and longer-lasting
Cyclothymic disorder
Cyclothymic disorder is characterised by persistent and unpredictable changes in mood but without the extreme highs and lows of bipolar I and II disorder, with episodes of shorter duration.
Bipolar disorder is characterised by episodes of mania or hypomania and episodes of depression.
Mania and hypomania
Mania and hypomania are unusual and persistent periods of elevated mood (‘highs’) and increased activity or energy which may also involve:
- exaggerated self-esteem or feelings of grandiosity
- reduced need for sleep
- rapid thought and speech, which is often difficult to follow
- high distractibility
- increased activity
- risky, impulsive or inappropriate behaviour
- agitation, restlessness, and feeling on edge.
The core features of mania and hypomania are almost identical. However, manic episodes are more severe and last longer (episodes last at least seven days), cause severe problems in the person’s relationships or work life, can lead to highly risky behaviours, and may involve psychotic experiences such as delusions and hallucinations. Due to the risks associated with a manic episode, hospitalisation is often necessary.
Hypomania is described as a milder form of mania as it is shorter in duration (at least four days), there are no psychotic features, and the severity of symptoms does not require hospitalisation.
Depression
Depressive episodes are characterised by one or both of the following:
- feelings of sadness, emptiness or low mood that lasts for most of the day, nearly every day
- loss of interest or pleasure in almost all activities, even those usually enjoyed.
These symptoms are experienced most of the time for at least two weeks, along with several other symptoms over the same period that include:
- changes to appetite and sleep
- worry and negative thinking (e.g., hopelessness, guilt)
- agitation and restlessness
- fatigue or loss of energy
- thoughts about suicide
- trouble concentrating or making decisions.
Treatment involves addressing lifestyle factors and coping skills which may increase the person’s capacity to better manage difficulties, take their medications as prescribed, reduce their symptoms and their impact and improve quality of life. The psychologist may also suggest involving a supportive family member or friend to assist in the understanding of the person’s situation and to support treatment.
Our Psychologists are trained and qualified professionals, skilled in diagnosing and treating a range of mental health concerns. In treating bipolar disorder, our psychologist will work as part of a team of professionals, including a GP and/or psychiatrist, as medication is usually an important part of treatment.