About Bipolar Disorder
Bipolar disorder (formerly called manic depression) is a condition experienced by approximately 2% of people that is characterised by episodes of mania. Mania is an emotional state of heightened reality during which the person may feel extraordinarily energetic, optimistic, self-confident and productive. Persons experiencing mania can often go days without sleeping, busily planning grandiose schemes or indulging in exorbitant shopping sprees (sometimes spending millions of dollars.) Many people experiencing bipolar alternate between periods of mania and deep depression. These mood swings can cycle over the course of months or years.
In everyday life we all experience ups and downs. Bipolar disorder, sometimes referred to as manic-depression, is a disorder where there are extreme shifts in mood.
Elevated, expansive or irritable mood, lasting at least a week or being very disruptive to daily functioning. During this period at least 3 of the following symptoms (4 if mood is irritable) are seen:
a) Inflated self-esteem or unrealistic belief in one’s abilities or power
b) Decreased need for sleep
c) More talkative than usual or need to keep talking
d) Jumping from one idea to another or racing thoughts
e) Distractibility, can’t concentrate very well
f) Increased energy
g) Excessive involvement in activities without regard for risks such as buying sprees or sexual indiscretions
Depressed (sad/empty/irritable) mood or loss of interest or pleasure and at least four of the following symptoms have been present during the same two weeks:
a) Fatigue or loss of energy
b) Can’t sleep or sleeps too much
c) Marked decrease or increase in appetite; significant weight loss when not dieting, or significant weight gain
d) Feelings of worthlessness or helplessness or excessive guilt
e) Slowed down or lethargic or very restless
f) Can’t concentrate and/or more indecisive than usual
g) Recurrent thoughts about death or suicide
Psychosocial interventions address stressful triggers of bipolar disorder and problems that can occur after episodes. Psychosocial treatments may be individual, group or family based. They can be helpful in providing support and information, and assisting in the development of effective coping skills. They can provide assistance both to people with bipolar disorder and their families. Psychosocial interventions that are commonly used include cognitive
behavioural therapy (CBT), psychoeducation, family therapy and interpersonal and social rhythm therapy.
Genetic factors
In terms of genetic vulnerability, on average, there is an 8% risk of a person's first-degree relatives (parents, children, siblings) having bipolar disorder compared to 1% in the general population. Scientists are trying to find
what genes may contribute to bipolar disorder and when they do, more precise diagnosis and treatments may be available.
Chemical Imbalance
Bipolar disorder is thought to occur when there is a problem with the production and breaking down of certain brain chemicals such as adrenaline, dopamine, acetylcholine, serotonin, and GABA. Research also suggests people with mood disorders (such as bipolar) have problems with the production of certain hormones that influence brain function. Mood stabilisers prescribed for bipolar disorder target these imbalances. Brain imaging studies suggest there may be certain differences in particular areas of the brain when comparing people with and without bipolar disorder. Scientists are still trying to work out how to refine these techniques and what these differences mean.
Stress
A mixed episode involves at least one week when the person experiences some symptoms of both manic and depressive episodes nearly every day. Sometimes the person experiences rapid mood swings (happy, sad, irritable); they can’t sleep, their appetite is affected, they are restless or uptight and may have delusions and suicidal thinking. These symptoms cause significant disruption to daily living. The person may need to be admitted to hospital.
Hypomania is similar to mania, only milder and although this means the person is able to carry out their normal daily activities, the changes in behaviour are obvious enough to be noticed by others. The symptoms must last for at least 4 days to be classifed as hypomania.
Bipolar I
This is a type of bipolar disorder that involves one or more full manic or mixed episode(s). Often the person has had one or more major depressive episodes as well.
Bipolar II
This type of bipolar disorder involves both one or more episodes of hypomania and one or more episodes of major depression.
Cyclothymic disorder
This refers to a pattern involving hypomanic symptoms and mild depressive symptoms that have been happening for two years
or more. Although 'milder' than Bipolar I or II, the symptoms of Cyclothymic Disorder are still severe enough to cause difficulties in work, education, employment and relationships.
Rapid cycling
within a 1-year period, they are said to have a bipolar pattern which is "rapid cycling".
Beyond Blue Bipolar fact sheet