Bipolar Explained

Please note that this article has been put together by reproducing information from various different sources. The reason I have not used a single source is because different sources explain different areas in easier to understand ways, and I want this article to be as simple as possible. Sources are provided when information from that particular source ends.



What is bipolar disorder?

Bipolar disorder is sometimes called bipolar affective disorder, and used to be called manic depression. In this condition you have periods where your mood (affect) is in one extreme or another:
  • One extreme is called depression, where you feel low and have other symptoms.
  • The other extreme is called mania (or hypomania if symptoms are less severe), where you feel high or elated along with other symptoms.
The length of time you spend in each extreme can vary. It is usually for several weeks at a time or longer. Bipolar disorder is very different from the mood swings that moody people have which last a few minutes or hours.

You can have any number of episodes of highs and lows throughout your life. In between episodes of highs or lows there may be gaps of weeks, months or years when your mood is normal. However, some people swing from highs to lows quite quickly without a period of normal mood in between.
(Source: patient.co.uk)



The two poles

Depression

The depression phase of bipolar disorder is often diagnosed first. You may initially be diagnosed with clinical depression before having a future manic episode (sometimes years later), after which you may be diagnosed with bipolar disorder.
During an episode of depression, you may have overwhelming feelings of worthlessness, which can potentially lead to thoughts of suicide.
If you're feeling suicidal or having severe depressive symptoms, contact your GP, care co-ordinator or local mental health emergency services as soon as possible.

Mania

During a manic phase of bipolar disorder, you may feel very happy and have lots of ambitious plans and ideas. You may spend large amounts of money on things you cannot afford and would not normally want.
Not feeling like eating or sleeping, talking quickly and becoming annoyed easily are also common characteristics of this phase.
You may feel very creative and view the manic phase of bipolar as a positive experience. However, you may also experience symptoms of psychosis (where you see or hear things that are not there or become convinced of things that are not true).
(Source: NHS)



(The rest of this article has been taken from leaflets produced by Bipolar UK and refers on many occasions to the mood scale.  The mood scale can be found at the bottom of the page)





Different types of bipolar:

The majority of individuals are diagnosed with bipolar disorder. However some medical professionals may explain your illness in terms of a particular categorisation.

Bipolar I

Individual’s mood swings move across the mood scale encompassing both manic episodes and depression.
Untreated, manic episodes generally last three to six months.
Depressive episodes last rather longer – six to 12 months - without treatment.

Bipolar II

Individuals experience a prevalence of depression. Likely to have more than one episode of severe depression, and the majority of individuals with Bipolar II will experience hypomania (6 to 8 on the mood scale) rather than extreme manic episode (8 to 10 on the mood scale). See scale at bottom


Mixed State

Symptoms of mania and depression are present at the same time, which may result in agitation, trouble sleeping and significant change in appetite, psychosis and suicidal thoughts.

Rapid Cycling

This occurs when individual’s mood swings change faster. More than four mood swings happen in a 12-month period. Rapid Cycling affects around one in ten people with bipolar, and can happen with Bipolar I and II.

Cyclothymia

Individuals experience mood swings but at a much lower level. Symptoms must last for a period of at least two years, with no period longer than two months in which there has been a stable state and no mixed episodes. Although individuals diagnosed with cyclothymia are on the bipolar spectrum, the relative mildness of the mood swings means you are not diagnosed with bipolar. However cyclothymia can develop into bipolar.


Psychosis

Sometimes severe mania (8 to 10 on the mood scale) or depression (2 to 0 on the mood scale) is accompanied by periods of psychosis. Psychotic symptoms include hallucinations and delusions. See scale at bottom
(Source: Bipolar UK)




Bipolar – The Facts


  • 1% to 2% of the population experience a lifetime prevalence of bipolar disorder. Recent research suggests as many as 5% of the population are on the bipolar spectrum.
  • Bipolar also has a huge impact on family and friends.
  • On average it takes 10.5 years to receive a correct diagnosis for bipolar in the UK and before bipolar is diagnosed there is a misdiagnosis an average of 3.5 times.
  • Compared to other health problems, treatment of bipolar is still badly affected by misunderstanding and stigma.
  • Bipolar affects every aspect of your life and your relationships. Family and friends can all be put under stress. This is why you need to get a correct diagnosis, accept treatment and start to learn how you can adapt your lifestyle to cope with the ups and downs.
(Source: Bipolar UK)



If I experience mood swings does that mean I have bipolar?


No, everyone has good and not so good days. We all have mood swings. However to put this in perspective, the Bipolar UK mood scale is from 0 to 10. Those of us who do not have bipolar will experience mood swings between 4 and 6 on the mood scale. If you have bipolar, your mood swings go above stable levels anywhere between a 6 and 10. With bipolar when you experience depression it falls below 4 to as low as suicidal depression of 0. See scale at bottom

Hypomania (6 to 8 on the mood scale). See scale at bottom
Someone experiencing hypomania can seem very self confident and euphoric but may react with sudden anger, impatience or irritability for the slightest reason. They may become easily distracted, more talkative or challenging. They may become more reckless than usual, which might mean errors of judgement, sometimes involving spending too much money or taking on more than they can cope with.

Mania (8 to 10 on the mood scale). See scale at bottom
Someone experiencing mania may not recognise it is happening. Incoherent, rapid or disjointed thinking or being easily distracted are some symptoms. Other symptoms may include verbal aggression, paranoia and hallucinations affecting vision or perception. 6 Grandiose delusions or ideas can occur where the sense of identity and self have been distorted by the illness. Sometimes the term psychosis (losing touch with reality) is used to describe these symptoms.

Depression (4 to 0 on the mood scale). See scale at bottom
Most people with bipolar will experience severe depression at some time. Usually this will follow a period of mania or hypomania. For some people depression is more likely to occur during the winter months. Common symptoms experienced during depression include: feelings of emptiness or worthlessness (as opposed to sadness), loss of energy and motivation for everyday activities, pessimism and negativity. Thoughts of death and suicide are also common symptoms.
(Source: Bipolar UK)



Is there a cause and is there a cure?


Although much progress has been made in understanding bipolar disorder and how it can be managed, research has still not led to either a consensus on the cause or a cure. Some research suggests that there is, if not a known genetic link, then certainly an inherited predisposition to developing bipolar disorder. It is also known that stressful life events may often precede an episode of mania, hypomania or depression. As our understanding of the function of the brain increases, more insights and more effective medication can be developed. This is why Bipolar UK works in partnership with research organisations.
(Source: Bipolar UK)



Treatment


The majority of people with bipolar can effectively manage their illness through a combination of different approaches including medication.

There are a number of mood stabilising medications commonly prescribed for bipolar. Many people find these medications, taken singly or in combination, help stabilise their mood cycles.


‘Talking therapies’ such as cognitive behavioural therapy and counselling can often be useful and used to help recovery. GPs and consultants can make referrals to local practitioners. Learning about self management is an invaluable way of learning to manage mood swings and help lessen the severity of episodes.  
(Source: Bipolar UK)



The Bipolar UK Mood Scale


Click image to enlarge
(Source: Bipolar UK)