Bipolar disorder is a serious condition. People with bipolar disorder experience unusual and extreme changes of mood, from very happy and active to very sad, hopeless and dull, and back again. ‘Normal’ states of mood may occur between these two extremes.
The ‘up’ stage is called mania or hypomania, while the ‘down’ state is depression.
Mood swings can occur rarely or several times a year. Most people experience some emotional symptoms between mood swing episodes, but not everyone does.
If left untreated, bipolar disorder can lead to poor performance at work or in school, damaged personal relationships, and even suicide.
Bipolar disorder often starts in late adolescence or early adulthood, but it can affect people of all ages. It may also occur during pregnancy or as the seasons change. Once a person gets it, it usually lasts lifelong.
Bipolar disorder is diagnosed by a combination of physical examinations and mental health evaluations by qualified professionals.
What causes bipolar disorder is yet to be clearly ascertained, but there may be several factors at play, including:
Physiology. People with bipolar disorder appear to have brains that are physically different from those of others.
Genetics. Bipolar disorder is more common in people who have a direct relative (a sibling or parent) with bipolar disorder.
Not everyone with a physically different brain or a direct relative with bipolar disorder develops the condition. Periods of high stress and substance abuse are risk factors that may trigger the first bipolar episode.
Signs & Indications
A person with bipolar disorder exhibits different signs during each phase of the illness. Here are a few:
Mania and hypomania
While the symptoms of mania and hypomania are the same, these are two distinct types of episodes. Mania is the more severe and causes noticeable problems in school, at work, and in interpersonal relationships. Mania may also trigger psychosis and require hospitalisation.
Here are some of the signs to watch out for.
- Manic and hypomanic episodes may include a person feeling or being:
- Abnormally joyous, nervous, or fidgety
- Increased activity, agitation, or energy
- Exaggerated sense of self-confidence and well being
- Reduced need for sleep
- Unusually talkative
- Thoughts racing
- Easily distracted
- Poor, short-term or impulsive decision-making (for example, a spending spree, extremely reckless driving, taking sexual risks)
Major depressive episode
Major depressive episodes can be so severe that they cause difficulty in day-to-day activities and interactions. An episode may include:
- Depressed moods
- Loss of interest or taking no pleasure in nearly all activities
- Significant changes in weight (loss or gain) or appetite
- Sleeping too much or too little
- Constant fatigue or lack of energy
- Feelings of worthlessness or guilt
- Inability to think, concentrate or make decisions
- Thinking about, planning or attempting suicide
Symptoms in children and teenagers
Bipolar disorder in young people can be difficult to identify: behavioural changes may be a normal part of growing up, the outcome of stress or trauma, or signs of another mental health problem.
While children and teenagers may experience distinct major depressive, manic or hypomanic episodes, the pattern varies from that of adults, and moods can shift rapidly during a single episode. Some young people may go for long periods without any problematic signs between episodes.
The most prominent sign of bipolar disorder in children and adolescents includes severe mood swings that are unlike their usual mood swings.
Despite experiencing extremes of mood, people with bipolar disorder often don’t recognise how much their lives and the lives of their loved ones are disrupted by their emotional instability. In addition, the cycles of euphoria can make people more productive and creative.
Unfortunately, every manic episode is followed by a major depressive episode that can leave the person depressed, exhausted and perhaps in serious trouble from the impulsive actions taken during the manic phase.
People with bipolar disorder often have other health conditions that need to be treated concurrently to prevent them from worsening bipolar disorder or interfering with treatment efficacy. These include anxiety disorders, eating disorders, ADHD, substance abuse and physiological problems like heart disease, obesity and thyroid problems.
A combination of medication and psychotherapy with a professional experienced in treating bipolar disorder works best to control symptoms.
If you have been diagnosed with bipolar disorder, you can help prevent minor symptoms from becoming full-blown manic or depressive episodes by:
Being alert for warning signs. You may have identified a pattern to what triggers your bipolar episodes. Call your physician or mental health advisor as soon as you feel the onset of the pattern, and ask friends and family to watch for those signs too.
Stay away from intoxicants. Consuming alcohol and recreational drugs can worsen your symptoms and make them more likely to recur.
Take your medication. Always take your medication exactly as your physician advises, on time and in the right dose. Stopping or reducing dosage can cause withdrawal effects that may make your symptoms worse or recurring.
Suicidal thoughts and behaviour occur frequently among people with bipolar disorder.
If you or someone you know is having suicidal thoughts – or has made a suicide attempt – seek help immediately. Learn more about the warning signs and never ignore them. They are appeals for help from someone who is in pain.
If you think someone is in immediate danger, do not leave them alone. Stay with them, and call the emergency services, the nearest hospital or a suicide helpline.
Seek treatment immediately if you feel worthless or are thinking of ending your life.