Understanding & Recognising Bipolar Disorder

Did you know that bipolar disorder can start for the first time after childbirth? It is more common than once thought.

What is bipolar disorder?

• There are several types.
• At least 2% of the population suffer from bipolar disorder.
• A recent study also found that a further 2.4% suffered from a spectrum of bipolar-type mood disorders.

Bi – means two. Polar – is like the North and South poles which are at the opposite ends of the earth, it’s like the opposite extremes of something.

Bipolar mood disorder is when a person suffers from an episode of either mania or hypomania (see below).

If they have had one or more of these episodes it is called bipolar disorder (even though it might only be the manic pole that is evident).

Usually depressive episodes also occur, hence the two poles: mania/hypomania and depression.

For 75% of women, their first episode is a depression so at this stage they (and their treating doctor) don’t know if it is what we call unipolar depression or whether it might be the first sign of bipolar disorder. (However there are some clues – see Depression below).

Mania

• The main feature of mania is a sense of being revved up or energised.
• There is usually an over-inflated sense of confidence or excessive planning.
• Mood is often said to be elevated but actually the person may feel awful (dysphoric is the technical name). A manic person may be bubbling with joy and enthusiasm or highly irritable.
• Thoughts are often sped up with lots of different ideas.
• Speech can be quite fast or ‘pressured’.

• Because of feeling overconfident, less cautious, and over-friendly, many people do things they later regret or feel embarrassed about, e.g. ringing friends in the middle of the night, buying expensive or unnecessary things, beginning ventures they can’t manage.
• Sexual interest can be heightened and lead to problems.
• The need for sleep is reduced significantly, sometimes very markedly – and yet the person seems to have energy the next day.
• These symptoms may become severe and psychotic symptoms develop, e.g. a woman may believe that she is ‘earth mother’ to all the worlds’ children, or that she is the best singer in the world or that her ideas for business will make her a millionaire by Christmas.

Hypomania

Hypo – means less of something.

Hypomania is a less marked form of mania.

It is not severe enough to result in a person needing hospitalisation, but nevertheless, it can be very disruptive for a person – particularly in their relationships.

Both mania and hypomania can go on for weeks or even months.

Mixed mood states

This occurs when there is a mixture of the symptoms of depression and mania/hypomania occurring in the same day.

It can be very confusing both for the sufferer and those around them.

It can be very difficult for a doctor to recognise (and diagnose). It can appear like an agitated depression. In fact there is a lot of debate among psychiatrists about the overlap of these conditions

It is a state that needs proper assessment and treatment.

Causes

Bipolar disorder runs in families – there are powerful genetic components to the disorder, but people with no family history of bipolar disorder can also develop it. The reasons for this are not clear.

Childbirth is more likely to trigger an episode of bipolar disorder than anything else.

In a person susceptible to bipolar disorder a number of other factors may also act as a trigger. Examples of this include:

• Sleep deprivation – not surprisingly having a baby often leads to this
• Stress
• Physical illness
• Certain medications including antidepressants
• Certain illicit drugs
• Travelling across time zones

Treatment

The biggest block to good treatment is resistance to accepting the diagnosis. This is often a big problem because there are still many people who are ignorant about mental illness and for them there is a stigma attached to it.

A wide range of treatments are useful for bipolar disorder. These include:

• Bio-social rhythms (keeping certain regular routines).
• Medication.
• Stress reduction.
• ‘Talking therapies’.

Usually a combination of these treatments is needed.

It is important for the family to be involved in treatment decisions.

The information and advice found on this website is shared with permission from PADA. PADA aims to reflect current medical knowledge and practice, however, this is not a substitute for clinical judgment and individual medical advice. The website authors accept no responsibility for any consequences arising from relying upon the information provided.

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