Bipolar disorder

Bipolar disorder is a mental health problem that involves recurring episodes of extreme mood.1 In England in 2014, 2% of adults screened positive for bipolar disorder2 which is similar to estimates of lifetime prevalence from other countries.3

Symptoms

Bipolar disorder is characterised by recurring episodes of extreme or overwhelming mood.

The symptoms of bipolar disorder will depend on which type of extreme mood (referred to as depression and mania) is experienced and may not be the same for everyone, or for every episode.4

Symptoms of depressive episodes can include:4

  • Feeling sad, hopeless or irritable most of the time
  • Lacking energy and appetite
  • Loss of interest in everyday activities
  • Difficulty concentrating or remembering things
  • Feelings of emptiness, worthlessness, guilt or despair
  • Experiencing hallucinations or illogical thoughts
  • Difficulty sleeping

Symptoms of manic episodes can include:4

  • Feeling full of energy
  • Feeling self-important or full of ideas and plans
  • Feeling easily distracted, irritated or agitated
  • Eperiencing hallucination or illogical thoughts
  • Lack of desire to sleep or eat
  • Making decisions or saying things that are out-of-character and that can be risky or harmful

Episodes can often last for several weeks or months with periods of less extreme mood in between. The pattern of cycling between episodes of depression and mania can change over time and between individuals.

There are several different types of bipolar disorder based on the different patterns of cycling and the severity of manic and depressive moods. More information on the different types of bipolar disorder can be found on Mind’s website here.5

Causes

There are many different factors that can contribute to the development of mental health problems like bipolar disorder. These factors include biological influences (for example, genetics)6 and psychological or social factors (for example, experiences of trauma7 and stressful life events such as relationship breakdown or financial difficulties 89).

While bipolar disorder can affect anyone, regardless of age or background, rates may be higher among particular groups such as: young adults, those who are unemployed or in receipt of benefits, and those who live alone.2 These relationships may be ‘bidirectional’, which means that stressful circumstances (like unemployment or financial difficulties) may be a risk factor for developing bipolar disorder, but they may also occur because of difficulties managing bipolar disorder symptoms.9

Getting Support

There are a range of approaches for treatment and management of bipolar disorder, and the most appropriate method will vary depending on the type of bipolar, whether you are currently experiencing depression or mania, and individual preferences and circumstances.

Psychological Therapies:

This involves working through thoughts, feelings, and behaviours with a clinical psychologist or other mental health professional in regular sessions over a set period of time. Some common therapies for treatment and management of bipolar include:10,11

Cognitive Behavioural Therapy (CBT) which helps to teach strategies for recognising how your feelings, thoughts, and behaviour influence each other and works to build strategies for changing these patterns.

Interpersonal Therapy (IPT) which focuses on your relationships with others and how your thoughts, feelings, and behaviour are affected by your relationships and vice versa.

Medication:

Your GP or healthcare provider can discuss different medication options to manage symptoms of bipolar disorder. There are several medications (often called ‘mood stabilisers’) that can be used to help manage mood swings. It is important to discuss with your healthcare provider which one would be most appropriate for you and your circumstances.1

For more information about medication for bipolar, visit the NHS website.

Longer-term & self-management:

This can involve working with healthcare professionals to learn to monitor your mood and recognise the triggers of depression and mania. They may help you to develop a crisis or risk management plan, so you know how to manage any early warning signs. This may often involve family members or close friends, so they are also aware of how to recognise and support you with any early signs of distress.11

Longer-term management of bipolar disorder can also involve checking in regularly on your physical health as well as your mental health, and making sure that you get regular exercise, good quality sleep, and maintain a healthy diet.1,11

Other Approaches

There may be other treatments or approaches available that are not outlined here. If you are considering support for bipolar, we recommend getting in touch with your healthcare provider to discuss which approach may be best for you.

Further Information and Resources

Date Last Updated

This page was last updated on 24/05/2019

References

  1. NHS. (2019). Health A-Z: Bipolar Disorder. Retrieved from: https://www.nhs.uk/conditions/bipolar-disorder/
  2. Marwaha, S., Sal, N., & Bebbington, P. (2016). ‘Chapter 9: Bipolar disorder’ in McManus, S., Bebbington, P., Jenkins, R., Brugha, T. (eds) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. Retrieved from: https://digital.nhs.uk/data-and-information/publications/statistical/adu...
  3. Merikangas, K.R., Jin, R., He, J.P., et al. (2011). Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Archives of General Psychiatry, 68(3), 241-251. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/21383262
  4. NHS. (2019). Health A-Z: Bipolar Disorder Symptoms. Retrieved from https://www.nhs.uk/conditions/bipolar-disorder/symptoms/
  5. Mind. (2018). Bipolar Disorder: What types of bipolar are there? Retrieved from: https://www.mind.org.uk/information-support/types-of-mental-health-probl...
  6. Gatt, J.M., Burton, K.L.O., Williams, L.M., & Schofield, P.R. (2015). Specific and common genes implicated across major mental disorders: A review of meta-analysis studies. Journal of Psychiatric Research, 60(1), 1-13. doi: 10.1016/j.jpsychires.2014.09.014. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/25287955
  7. Palmier-Claus, J.E., Berry, K., Bucci, S., Mansell, W., & Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. British Journal of Psychaitry, 209(6), 454-459. DOI: 10.1192/bjp.bp.115.179655. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/27758835
  8. Horesh, N., & Iancu, I. (2010). A comparison of life events in patients with unipolar or bipolar disorder and controls. Comprehensive Psychiatry,21: 157-164. doi: 10.1016/j.comppsych.2009.05.005 Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20152296
  9. Hosang, G.M., Korszun, A., Jones, L., Jones, I., McGuffin, P., & Farmer, A.E. (2012). Life-event specificity: bipolar disorder compared with unipolar depression. The British Journal of Psychiatry, 201: 458-465. doi: 10.1192/bjp.bp.112.111047. Retrieved from: https://pdfs.semanticscholar.org/5fbb/bd946aca3944ceb84a02c290b5ca902cb3...
  10. Mind. (2018). Bipolar Disorder: What treatments can help? Retrieved from: https://www.mind.org.uk/information-support/types-of-mental-health-probl...
  11. NICE. (2014). NICE Clinical Guidance – Bipolar disorder: assessment and management. Retrieved from: https://www.nice.org.uk/guidance/cg185/chapter/1-Recommendations