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Information About Bipolar

Bipolar disorder is a mental health condition that affects your moods, which can swing from 1 extreme to another. It used to be known as manic depression.
Symptoms of bipolar disorder
People with bipolar disorder have episodes of:
  • depression – feeling very low and lethargic
  • mania – feeling very high and overactive
Symptoms of bipolar disorder depend on which mood you're experiencing.
Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks (or even longer).
Depression
You may initially be diagnosed with clinical depression before you have a 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, go to your nearest A&E as soon as possible.
If you're feeling very depressed, contact a GP or your care co-ordinator or local mental health crisis team as soon as possible.
You could also call NHS 111 for an immediate assessment.
If you want to talk to someone confidentially, call the Samaritans, free of charge, on 116 123. You can talk to them 24 hours a day, 7 days a week.
Or visit the Samaritans website or email [email protected].
Mania
During a manic phase of bipolar disorder, you may:
  • feel very happy
  • have lots of energy, ambitious plans and ideas
  • spend large amounts of money on things you cannot afford and would not normally want
It's also common to:
  • not feel like eating or sleeping
  • talk quickly
  • become annoyed easily
You may feel very creative and view the manic phase of bipolar as a positive experience.
But 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.
Living with bipolar disorder
The high and low phases of bipolar disorder are often so extreme that they interfere with everyday life.
But there are several options for treating bipolar disorder that can make a difference.
They aim to control the effects of an episode and help someone with bipolar disorder live life as normally as possible.
The following treatment options are available:
  • medicine to prevent episodes of mania and depression – these are known as mood stabilisers, and you take them every day on a long-term basis
  • medicine to treat the main symptoms of depression and mania when they happen
  • learning to recognise the triggers and signs of an episode of depression or mania
  • psychological treatment – such as talking therapy, which can help you deal with depression, and provides advice about how to improve your relationships
  • lifestyle advice – such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, as well as advice on improving your diet and getting more sleep
It's thought using a combination of different treatment methods is the best way to control bipolar disorder.
Help and advice for people with a long-term condition or their carers is also available from charities, support groups and associations.
This includes self-help and learning to deal with the practical aspects of a long-term condition.
Find out more about living with bipolar disorder
Bipolar disorder and pregnancy
Bipolar disorder, like all other mental health problems, can get worse during pregnancy. But specialist help is available if you need it.
Find out more about bipolar disorder in pregnancy
What causes bipolar disorder?
The exact cause of bipolar disorder is unknown, although it's believed a number of things can trigger an episode.
These include:
  • extreme stress
  • overwhelming problems
  • life-changing events
  • genetic and chemical factors
Who's affected
Bipolar disorder is fairly common, and 1 in every 100 people will be diagnosed with it at some point in their life.
Bipolar disorder can occur at any age, although it often develops between the ages of 15 and 19 and rarely develops after 40.
Men and women from all backgrounds are equally likely to develop bipolar disorder.
The pattern of mood swings in bipolar disorder varies widely. For example, some people only have a couple of bipolar episodes in their lifetime and are stable in between, while others have many episodes.


Bipolar disorder is characterised by extreme mood swings. These can range from extreme highs (mania) to extreme lows (depression).

Episodes of mania and depression often last for several weeks or months.

Depression
During a period of depression, your symptoms may include:

  • feeling sad, hopeless or irritable most of the time
  • lacking energy
  • difficulty concentrating and remembering things
  • loss of interest in everyday activities
  • feelings of emptiness or worthlessness
  • feelings of guilt and despair
  • feeling pessimistic about everything
  • self-doubt
  • being delusional, having hallucinations and disturbed or illogical thinking
  • lack of appetite
  • difficulty sleeping
  • waking up early
  • suicidal thoughts
Mania
The manic phase of bipolar disorder may include:

  • feeling very happy, elated or overjoyed
  • talking very quickly
  • feeling full of energy
  • feeling self-important
  • feeling full of great new ideas and having important plans
  • being easily distracted
  • being easily irritated or agitated
  • being delusional, having hallucinations and disturbed or illogical thinking
  • not feeling like sleeping
  • not eating
  • doing things that often have disastrous consequences – such as spending large sums of money on expensive and sometimes unaffordable items
  • making decisions or saying things that are out of character and that others see as being risky or harmful
Patterns of depression and mania
If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.

Between episodes of depression and mania, you may sometimes have periods where you have a "normal" mood.

The patterns are not always the same and some people may experience:

  • rapid cycling – where a person with bipolar disorder repeatedly swings from a high to a low phase quickly without having a "normal" period in between
  • mixed state – where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood
If your mood swings last a long time but are not severe enough to be classed as bipolar disorder, you may be diagnosed with a mild form of bipolar disorder called cyclothymia.

Living with bipolar disorder
Bipolar disorder is a condition of extremes. A person with bipolar disorder may be unaware they're in the manic phase.

After the episode is over, they may be shocked at their behaviour. But at the time, they may believe other people are being negative or unhelpful.
Some people with bipolar disorder have more frequent and severe episodes than others.
The extreme nature of the condition means staying in a job may be difficult and relationships may become strained. There's also an increased risk of suicide.
During episodes of mania and depression, someone with bipolar disorder may experience strange sensations, such as seeing, hearing or smelling things that are not there (hallucinations).
They may also believe things that seem irrational to other people (delusions). These types of symptoms are known as psychosis or a psychotic episode.



The exact cause of bipolar disorder is unknown. Experts believe there are a number of factors that work together to make a person more likely to develop it.

These are thought to be a complex mix of physical, environmental and social factors.

Chemical imbalance in the brain
Bipolar disorder is widely believed to be the result of chemical imbalances in the brain.

The chemicals responsible for controlling the brain's functions are called neurotransmitters, and include noradrenaline, serotonin and dopamine.

There's some evidence that if there's an imbalance in the levels of 1 or more neurotransmitters, a person may develop some symptoms of bipolar disorder.

For example, there's evidence that episodes of mania may occur when levels of noradrenaline are too high, and episodes of depression may be the result of noradrenaline levels becoming too low.

Genetics
It's also thought bipolar disorder is linked to genetics, as it seems to run in families.

The family members of a person with bipolar disorder have an increased risk of developing it themselves.

But no single gene is responsible for bipolar disorder. Instead, a number of genetic and environmental factors are thought to act as triggers.

Triggers
A stressful circumstance or situation often triggers the symptoms of bipolar disorder.

Examples of stressful triggers include:

  • the breakdown of a relationship
  • physical, sexual or emotional abuse
  • the death of a close family member or loved one
These types of life-altering events can cause episodes of depression at any time in a person's life.

Bipolar disorder may also be triggered by:


  • physical illness
  • sleep disturbances
  • overwhelming problems in everyday life, such as problems with money, work or relationships.

If your GP thinks you may have bipolar disorder, they'll usually refer you to a psychiatrist, a doctor who specialises in mental health problems.

If your illness puts you at risk of harming yourself, your GP will arrange an appointment immediately.

Specialist assessment
You'll be assessed by the psychiatrist at your appointment. They'll ask you a few questions to find out if you have bipolar disorder. If you do, they'll decide what treatments are most suitable.

During the assessment, you'll be asked about your symptoms and when you first experienced them.

The psychiatrist will also ask about how you feel leading up to and during an episode of mania or depression, and if you have thoughts about harming yourself.

The psychiatrist will also want to know about your medical background and family history, especially whether any of your relatives have had bipolar disorder.

If someone else in your family has the condition, the psychiatrist may want to talk to them. But they'll ask for your agreement before doing so.

Other tests
Depending on your symptoms, you may also need tests to see whether you have a physical problem, such as an underactive thyroid or an overactive thyroid.

If you have bipolar disorder, you'll need to visit your GP regularly for a physical health check.

Advanced directives
If you're diagnosed with the condition, it's important to talk to your psychiatrist so you're fully involved in the decisions about your treatment and care.

But a person is sometimes not able to make an informed decision about their care or communicate their needs, especially if their symptoms become severe.

If this happens, it may be possible to draw up an advance decision. An advance decision is a set of written instructions that state what treatments and help you want (or do not want) in advance in case you cannot communicate your decisions at a later stage.

Your GP or psychiatrist can give you further help and advice.
 
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