What is bipolar disorder?
Bipolar disorder is a particular type of depression, and is also known as manic depression.

People with bipolar disorder experience extreme mood swings, fluctuating between periods of intense depression and mania (elated, overactive, excited or ‘high’). They can also have periods of normal mood in between these episodes.

About 1 in every 100 people develops bipolar disorder at some stage in their lives, and males and females are equally at risk. Bipolar disorder usually first occurs in the mid-teenage years and twenties, but can affect anyone.

What are the symptoms of bipolar disorder?
The symptoms will vary according to whether the person is feeling depressed or manic.

During a period of depression, which lasts for at least two weeks, the person may have a number of the following symptoms:

• an unusually sad mood that does not go away;
• loss of enjoyment and interest in activities that used to be enjoyable;
• tiredness and lack of energy;
• loss of confidence in themselves or poor self-esteem;
• feeling guilty when they are not really at fault;
• wishing they were dead;
• difficulty making decisions and concentrating;
• moving more slowly or becoming agitated and unable to settle;
• having difficulty sleeping or sleeping too much;
• unusual weight loss, or for some people unusual weight gain.

During a manic episode, people usually have feelings of elation (extreme
happiness or feeling ‘high’), or irritability, or both. Mania can lead to difficult or harmful situations and can also be very frightening for the person and those close to them.

The symptoms of mania include:

• appear elated, overconfident, on top of the world or invincible;
• have increased energy and be excessively active;
• be extremely talkative, talk very rapidly or jump from one topic to another;
• be full of extreme ideas or delusions, such as a belief that they are superhuman, especially talented or an important religious figure;
• take very little sleep over an extended period of days;
• lack inhibitions and take risks they wouldn’t usually take, for example spending money extravagantly or being unusually sexually active;
• be irritable, particularly if others disagree with unrealistic plans or ideas;
• lack insight, believing their delusions are real.

Sometimes, during severe episodes of depression or mania the person may experience psychotic symptoms (See the section on Psychosis for more information).

During an episode of intense depression, a person might experience intense guilt or feel that they are ‘worse’ than everybody else. During periods of mania, psychotic symptoms are likely to involve more grandiose (extravagant) delusions, for example they may believe that they are on an important mission or have special powers/abilities. The person may also experience hallucinations where they see, hear, smell, or taste things that are not there.

It is important to remember that these are only some of the more common symptoms of depression and mania and not everybody will experience all of them.

What causes bipolar disorder?

• The exact cause of bipolar disorder is not fully understood but a number of factors may be involved:
• people who have a parent, brother or sister with bipolar disorder are more likely to develop the disorder and this suggests that genetics are involved;
• stressful life events may also bring on or trigger the illness in vulnerable people;
• research has also shown that there are changes to brain chemistry during such episodes.

If you are concerned about bipolar disorder speak to your GP or other health professional.

For further information visit the Royal College of Psychiatrists website.