People with bipolar mood disorder experience recurrent episodes of depressed and elated moods. Both can be mild to severe. The term ‘mania’ is used to describe the most severe state of extreme elation and overactivity. Some people with bipolar disorder do not experience depressive episodes-only the episodes of elation and excitement.
What is bipolar disorder?
Bipolar disorder is the new name for what was called manic depressive illness. The new name is used as it better describes the extreme mood swings – from depression and sadness to elation and excitement – that people with this illness experience.
What are the symptoms of bipolar mood disorder?
Common symptoms include varying degrees of the following:
- Elevated mood – the person feels extremely high, happy and full of energy. The experience is often described as feeling on top of the world and being invincible.
- Increased energy and over – activity.
- Reduced need for sleep.
- Irritability – the person may get angry and irritable with people who disagree or dismiss their sometimes unrealistic plans or ideas.
- Rapid thinking and speech – thoughts are more rapid than usual. This can lead to the person speaking quickly and jumping from subject to subject.
- Lack of inhibitions – this can be the result of the person’s reduced ability to foresee the consequences of their actions. For example, spending large amounts of money, buying items which are not really needed.
- Grandiose plans and beliefs – it is common for people experiencing mania to believe they are unusually talented or gifted or are kings, film stars or prime ministers, for example. It is common for religious beliefs to intensify or for people with this illness to believe they are an important religious figure.
- Lack of insight – a person experiencing mania may understand that other people see their ideas and actions as inappropriate, reckless or irrational. However, they are unlikely to recognise the behaviour as inappropriate in themselves.
Many people with bipolar mood disorder experience depressive episodes. This type of depression can be triggered by a stressful or unhappy event, but more commonly occurs without obvious cause. The person loses interest and pleasure in activities enjoyed before. They may withdraw and stop seeing friends, avoid social activities and cease simple tasks such as shopping and showering. They are overwhelmed by a deep sadness, lose their appetite, subsequently lose weight, cannot concentrate and may experience associated feelings of guilt or hopelessness.
Some attempt suicide because they believe life has become meaningless or they feel too guilty to go on. Others develop false beliefs (delusions) of persecution or guilt, or that they are evil. For more information on depression and its treatment, see the Mental Health Information Brochure What is depression?
Most people who have episodes of mania and depression experience normal moods in between. They are able to live normal lives, manage household and business commitments and hold down a job. Everyone experiences mood swings from time to time. It is when these moods become extreme and lead to a failure to cope with life that medical attention is necessary.
What causes bipolar disorder?
Bipolar mood disorder affects two people in every hundred of the Australian population. Men and women have an equal chance of developing the disorder. It is most common in people in their twenties.
It is believed that bipolar mood disorder is caused by a combination of factors including genetics, biochemistry, stress and even the seasons.
Studies on close relations, identical twins and adopted children whose natural parents have bipolar mood disorder strongly suggest that the illness is genetically transmitted, and that children of parents with bipolar mood disorder have a greater risk of developing the disorder.
Mania, like major depression, is believed to be associated with a chemical imbalance in the brain which can be corrected with medication.
Stress may play a part in triggering symptoms, but not always. Sometimes the illness itself may cause the stressful event (such as divorce or a failed business), which may then be blamed for the illness.
Mania is more common in spring, and depression in early winter. The reason for this is not clear.
What treatments are available?
Effective treatments are available for depressive and manic episodes of bipolar mood disorder. For the depressive phase of this illness, anti-depressant medications are effective. Anti-depressants are not addictive. They slowly return the balance of neurotransmitters in the brain, taking 1-4 weeks to achieve their positive effects. Medication should be adjusted only under medical supervision, as some people may experience the onset of a manic phase.
It may be necessary to admit a person with severe depression to hospital for a time. When people are in a manic phase, it can often be difficult to persuade them that they need treatment. It may sometimes be necessary to admit the person to hospital if the symptoms are severe.
During acute or severe attacks of mania, several different medications are used. Some are specifically used to calm the person’s manic excitement; others are used to help stabilise the person’s mood. Medications such as lithium are also used as preventive measures, as they help to control mood swings and reduce the frequency and severity of depressive and manic phases.
Psychotherapy and counselling are used with medication to help the person understand the illness and better manage its effects on their life.
With access to appropriate treatment and support, most people with bipolar mood disorder lead full and productive lives.
Where to go for help
- Your general practitioner.
- Your community health centre.
- Your school or university counsellor
- Your community mental health centre.
For information on services, check the Community Help and Welfare Services and 24-hour emergency numbers in your local telephone directory.