Bipolar Disorder is a mood disorder characterised by periods of heightened elation, commonly known as manic episodes, followed by periods of low mood, known as depressive episodes.
When experiencing a manic episode, a person often does things that are risky or extreme, which they would not normally do. Such behaviours can include going on spontaneous shopping sprees or holidays, embarking on creative projects, gambling away life savings, and engaging in unsafe driving and sex. Some manic episodes may have psychotic features, such as delusional thoughts about possessing special powers. The symptoms of a manic episode consist of:
- Feeling optimistic and heightened
- Being very irritable
- Unrealistic perception of one’s abilities
- Limited sleep, but increased energy
- Talking very rapidly
- Increased thoughts (moving from one idea to the next)
- Very impulsive
- Impaired judgement
- Reckless activity
- Delusions and hallucinations (in extreme cases)
Commonly, after a manic episode has subsided, a person must then come to terms with its aftermath. This often results in the person slipping into a depressive state. The symptoms of a depressive episode include:
- Feeling sad, hopeless or deflated
- Lack of pleasure from activities
- Loss of energy
- Physical and mental deflation
- Irregular sleeping patterns
- Problems with concentrating
- Feelings of guilt
- Suicidal thoughts
The effects of Bipolar Disorder differ from person to person, with some having normal periods of stable living, and small bouts of depressive and manic episodes at times. Others can be stuck in a never-ending cycle of depressive and manic episodes.
There are three types of bipolar disorder, which include Bipolar I Disorder, characterised by at least one manic or mixed episode. Bipolar II Disorder is characterised by hypomania (a less extreme form of manic episode) and depressive episodes. Finally, there is Cyclothymia, a milder form of Bipolar Disorder involving a two year period where the person has experienced some symptoms from both depressive and manic Bipolar states that do not meet the full criteria for either a manic or depressive episode.
According to the Black Dog Institute (2013), the lifetime risk for suicide for people with bipolar disorder is 15% – representing 12% of all Australian suicides, with around 25% of people with bipolar disorder attempting suicide throughout their life.
How common is Bipolar Disorder?
According to the Black Dog Institute, around 1% of Australians are likely to receive a diagnosis of Bipolar I Disorder in their lifetime, and around 5% are likely to be diagnosed with Bipolar II Disorder, with rates higher in women.
What causes Bipolar Disorder?
The cause of Bipolar Disorder, like many mood disorders, is believed to be a combination of factors including genetic (inherited), physiological (chemicals within the brain) and environmental (e.g. upbringing, life stressors). Many believe that bipolar is a genetically heritable condition that manifests only if triggered by environmental factors such as stress, lack of sleep, substance abuse and seasonal changes.
How is Bipolar Disorder treated?
The methods that are often used to treat Bipolar Disorder include psychological therapy, education about the disorder, lifestyle management, medication, and seeking social and family support.
With psychological therapy, clients, along with a psychologist, will assist the client in identifying the links between uncomfortable feelings they have, and problematic coping strategies they may be using. Together they will also aim to repair relationships that may have been damaged because of the disorder, and engage in activities that may assist in regulating mood, such as stress management, and establishing routines for diet, exercise and sleep.
As a significant part of the aetiology of Bipolar Disorder involves imbalanced brain physiology, medications that assist in stabilising moods are an important part of treatment. Part of the role of a psychologist is to work alongside psychiatrists and GPs in ensuring clients continue to take their medications and to monitor any unpleasant side effects, such as weight gain and lethargy.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, D.C.: American Psychiatric Association.
Black Dog Institute. (2013). Why GPs Need to Know About Bipolar Disorder. Retrieved from: http://www.blackdoginstitute.org.au/healthprofessionals/bipolardisorder/overview.cfm
Black Dog Institute. (2015). Facts and figures about mental health and mood disorders. Retrieved from: http://www.blackdoginstitute.org.au/docs/Factsandfiguresaboutmentalhealthandmooddisorders.pdf