Bipolar disorder is characterised by periods of extremes of mood. There are a number of types of bipolar disorder, with the most prevalent being Bipolar I and Bipolar II.
- Bipolar I involves extreme mood elevation (mania), and for the majority of people with Bipolar I they will also experience depression, although not everyone will experience low moods as well.
- Bipolar II encompasses hypomania, a less extreme level of mood elevation in comparison to the mania of Bipolar I. Bipolar II always involves periods of major depression.
Signs & symptoms
The defining feature of bipolar disorder is elevated mood. It involves elevated, expansive or irritable mood. This is combined with an increased in goal-driven activity or energy. For mania, these symptoms must last for a week (unless hospitalised), and for hypomania, it must last for 4 days. Other symptoms include:
- Exaggerated self-esteem or grandiosity
- A reduced need to sleep – feeling rested after only 3 hours sleep
- Talkative or pressure to keep talking
- Racing thoughts or ideas jumping from one topic to another
- Easily distracted
- Pursuing many goals at once
- Over involvement in activities that could have distressing consequences such as spending sprees, sexual indiscretions, poor business investments.
The 12-month prevalence rate for bipolar disorders is around 1.8%. There are equal numbers of men and women who experience bipolar I, however more females than males experience bipolar II. The onset of bipolar II is around the mid 20’s, which is a little later than the onset for bipolar I, whose onset is around 18 years.
Bipolar disorder is very much a biological disorder, and as such the first line treatment approach is medication, specifically with mood stabilizers.
- Antipsychotics may be used at times, however there is some controversy regarding the use of antidepressant medication with a risk they could switch a lowered mood into mania/hypomania. The efficacy-effectiveness gap that sees a high percentage of people with bipolar disorder experiencing relapses, even when taking medication as prescribed, has seen the increasing use of adjunctive psychosocial interventions. These are used in conjunction with medication and not as a replacement. Again there are a number of approaches used, with psycho-education (providing information about the disorder with some coping strategies), cognitive behaviour therapy, interpersonal social rhythm therapy (sticking to a flexible routine), some of the approaches of note.