Bipolar disorder

Bipolar disorder  Illnesses and conditions Mental health Bipolar disorder Bipolar disorder Introduction Symptoms Causes Diagnosis Treatment Living with bipolar disorder Introduction Bipolar disorder, formerly known as manic depression, is a condition that affects your moods, which can swing from one extreme to another. People withbipolar disorder have periods or episodes of: depression  feeling very low and lethargic mania  feeling very high and overactive (less severe mania is known as hypomania) Symptoms of bipolar disorder depend on which mood youre experiencing. Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks (or even longer), and some people may not experience a normal mood very often. Depression You may initially be diagnosed with clinical depression before having a future manic episode (sometimes years later), after whichyou may be diagnosed withbipolar disorder . During an episode of depression, you may have overwhelming feelings of worthlessness, which can potentially lead to thoughts of suicide . If youre feeling suicidal or having severe depressive symptoms, contact your GP, care co-ordinator or local mental health emergency services as soon as possible. If you want to talk to someone confidentially, call the Samaritans, free of charge,on 116 123. You can talk to them24 hours a day,7 days a week. Alternatively, visit the Samaritans website. Mania During a manic phase of bipolar disorder, you may feel very happy and have lots of energy, ambitious plans and ideas. You may spend large amounts of money on things you cant afford and wouldnt normally want. Not feeling like eating or sleeping, talking quickly and becoming annoyed easily are also common characteristics of this phase. You may feel very creative and view the manic phase of bipolar as a positive experience. However, you may also experience symptoms of psychosis , where you see or hear things that arent there or become convinced of things that arent true. Living with bipolar disorder The high and low phases of bipolar disorder are often so extreme that they interfere with everyday life. However, there are several options for treating bipolar disorder that can make a difference. They aim to control the effects of an episode and help someone with bipolar disorder live life as normally as possible. The following treatment options are available: medication to prevent episodes of mania, hypomania (less severe mania) and depressionthese are known as mood stabilisers and are taken every day on a long-term basis medication to treat the main symptoms of depression and mania when they occur learning to recognise the triggers and signs of an episode of depression or mania psychological treatmentsuch as talking therapy, which can help you deal with depression, and provides advice about how to improve your relationships lifestyle advicesuch as doing regular exercise, planning activities you enjoy that give you a sense of achievement, as well as advice on improving your diet and getting more sleep Its thought using a combination of different treatment methods is the best way to control bipolar disorder. Help and advice for people with a long-term condition or their carersis also availablefrom charities, support groups and associations. This includes self-help and self-management advice, and learning todeal with the practical aspects of a long-term condition. Find out more about living with bipolar disorder Bipolar disorder and pregnancy Bipolar disorder, like all other mental health problems, can get worse during pregnancy. However, specialist help is available if you need it. What causes bipolar disorder? The exact cause of bipolar disorder is unknown, although its believed a number of things can trigger an episode. Extreme stress, overwhelming problems and life-changing events are thought to contribute, as well as genetic and chemical factors. Whos affected? Bipolar disorder is fairly common and one in every 100 adults will be diagnosed with the condition at some point in their life. Bipolar disorder can occur at any age, although it often develops between the ages of 15 and 19 and rarely develops after 40. Men and women from all backgrounds are equally likely todevelop bipolar disorder. The pattern of mood swings in bipolar disorder varies widely between people. For example, some people only have a couple of bipolar episodes in their lifetime andare stable in between, while others have many episodes. Symptoms Bipolar disorder is characterised by extreme mood swings. These can range from extreme highs (mania) to extreme lows (depression). Episodes of mania and depression often last for several weeks or months. Depression During a period of depression, your symptoms may include: feeling sad, hopeless or irritable most of the time lacking energy difficulty concentrating and remembering things loss of interest in everyday activities feelings of emptiness or worthlessness feelings of guilt and despair feeling pessimistic about everything self-doubt being delusional, having hallucinations and disturbed or illogical thinking lack of appetite difficulty sleeping waking up early suicidal thoughts Mania The manic phase of bipolar disorder may include: feeling very happy, elated or overjoyed talking very quickly feeling full of energy feeling self-important feeling full of great new ideas and having important plans being easily distracted being easily irritated or agitated being delusional, having hallucinations and disturbed or illogical thinking not feeling like sleeping not eating doing things that often have disastrous consequences such as spending large sums of money on expensive and sometimes unaffordable items making decisions or saying things that are out of character and that others see as being risky or harmful Patterns of depression and mania If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa. Between episodes of depression and mania, you may sometimes have periods where you have a normal mood. The patterns arent always the same and some people may experience: rapid cyclingwhere a person with bipolar disorder repeatedly swings from a high to low phase quickly without having a normal period in between mixed statewhere a person with bipolar disorder experiences symptoms ofdepression and mania together; for example, overactivity with a depressed mood If your mood swings last a long time but arent severe enough to be classed as bipolar disorder, you may be diagnosed with cyclothymia(a mild form of bipolar disorder). Living with bipolar disorder Bipolar disorder is a condition of extremes.A person with the condition may be unaware theyre in the manic phase. After the episode is over, they may be shocked at their behaviour. However, at the time, they may believe other peopleare being negative or unhelpful. Some people with bipolar disorder have more frequent and severe episodes than others.The extreme nature of the condition meansstaying in a job may be difficult and relationships may become strained. Theres also an increased risk of suicide . During episodes of mania and depression, someone with bipolar disorder may experience strange sensations, such as seeing, hearing or smelling things that arent there (hallucinations). They may also believe things that seem irrational to other people (delusions). These types of symptoms are known as psychosis or a psychotic episode. Read more about living with bipolar disorder Causes The exact cause of bipolar disorder is unknown. Experts believe there are a number of factors that work together to make a person more likely to develop the condition. These are thought to be a complex mix of physical, environmental and social factors. Chemical imbalance in the brain Bipolar disorder is widely believed to be the result of chemical imbalances in the brain. The chemicals responsible for controlling the brains functions are called neurotransmitters and includenoradrenaline, serotonin and dopamine. Theres some evidence that if theres an imbalance in the levels of one or more neurotransmitters, a person may develop some symptoms of bipolar disorder . For example, theres evidence that episodes of mania may occur when levels of noradrenaline are too high, and episodes of depression may be the result of noradrenaline levels becoming too low. Genetics Its also thought bipolar disorder is linked to genetics, as the condition seems to run in families. The family members of a person with the condition have an increased risk of developing it themselves. However, no single gene is responsible for bipolar disorder. Instead, a number of genetic and environmental factors are thought to act as triggers. Triggers A stressful circumstance or situation often triggers the symptoms of bipolar disorder. Examples of stressful triggers include: the breakdown of a relationship physical, sexual or emotional abuse the death of a close family member or loved one These types of life-altering events can cause episodes of depression at any time in a persons life. Bipolar disorder may also be triggered by: physical illness sleep disturbances overwhelming problems in everyday life such as problems with money, work or relationships Diagnosis If your GP thinks you may have bipolar disorder, theyll usually refer you to a psychiatrist (a medically qualified mental health specialist). If your illness puts you at risk of harming yourself, your GP will arrange an appointment immediately. Specialist assessment Youll be assessed by the psychiatrist at your appointment. Theyll ask you a few questions to determine if you have bipolar disorder.If you do, theyll decide what treatments are most suitable. During the assessment, youll be asked about your symptoms and when you first experienced them. The psychiatrist will also ask about how you feel leading up to and during an episode of mania or depression, and if you have thoughts about harming yourself. The psychiatrist will also want to know about your medical background and family history, especially whether any of your relatives have had bipolar disorder. If someone else in your family has the condition, the psychiatrist may want to talk to them. However, theyll ask for your agreement before doing so. Other tests Depending on your symptoms, you may also need tests to see whether you have a physical problem, such as an underactive thyroid or an overactive thyroid . If you have bipolar disorder, youll need to visit your GP regularly for a physical health check. Treatment Treatment for bipolar disorder aims to reduce the severity and number of episodes of depression and mania to allow as normal a life as possible. Treatment options for bipolar disorder Treatment for bipolar disorder aims to reduce the length and severity of episodes. In some cases treatment can prevent bipolar episodes. Most people with bipolar disorder can be treated using a combination of different treatments. These can include one or more of the following: medication to prevent episodes of mania, hypomania (less severe mania) and depression  these are known as mood stabilisers and are taken every day on a long-term basis medication to treat the main symptoms of depression and mania when they occur learning to recognise the triggers and signs of an episode of depression or mania psychological treatment  like talking therapies, which help you deal with depression and provide advice on how to improve relationships lifestyle advice  such as doing regular exercise, planning activities you enjoy that give you a sense of achievement, and advice on improving your diet and getting more sleep Read more about living with bipolar disorder . Medication Several medications are available to help stabilise mood swings. These are commonly referred to as mood stabilisers and include: lithium carbonate anticonvulsant medicines antipsychotic medicines If youre already taking medication for bipolar disorder and you develop depression, you should speak to your healthcare professional. Learning to recognise triggers If you have bipolar disorder, you can learn to recognise the warning signs of an approaching episode of mania or depression. A community mental health worker, such as a psychiatric nurse, may be able to help you identify your early signs of relapse from your history. This may mean making some changes to your treatment. Your healthcare professional can advise you on this. Psychological treatment Most people find psychological treatment helpful when used alongside medication in between episodes of mania or depression. Pregnancy You should speak to your healthcare professional if you have bipolar disorder if youre trying to conceive or become pregnant. The National Institute for Health and Care Excellence (NICE) recommends that specialist mental health services work closely with maternity services. A written plan for managing the treatment of a pregnant woman with bipolar disorder should be developed as soon as possible. The plan should be drawn up with the patient, her partner, her obstetrician (pregnancy specialist), midwife, GP and health visitor. If you become pregnant while taking medication prescribed to treat bipolar disorder, its important that you dont stop taking it until youve discussed it with your healthcare professional. If medication is prescribed for bipolar disorder after the baby is born, it may also affect a mothers decision to breastfeed her child. Your pharmacist, midwife or mental health team can give you advice based on your circumstances. Living with bipolar disorder Although its usually a long-term condition, effective treatments for bipolar disorder , combined with self-help techniques, can limit the conditions impact on your everyday life. Staying active and eating well Eating well and keeping fitare important for everyone.Exercise can also help reduce the symptoms of bipolar disorder, particularly depressive symptoms. It may also give you something tofocus onand provide aroutine, which is important for many people. A healthy diet, combined with exercise, may also help limit weight gain, which is a common side effect of medical treatments for bipolar disorder. Some treatments alsoincrease the risk of developing diabetes, or worsen the illness in people that already have it. Maintaining a healthy weight and exercising are an important way of limiting that risk. You should have a check-up at least once a year to monitor your risk of developing cardiovascular disease or diabetes . This will include recording your weight, checking your blood pressure and having any appropriate blood tests. Read more information about losing weight and improving fitness Self-care and self-management Self-care Self-care is an essential part of daily life.It involves taking responsibility for your own health and wellbeing with support from the people involved in your care. It includes: staying fit and maintaining good physical and mental health preventing illness or accidents caring more effectively for minor ailments and long-term conditions People withlong-term conditions can benefit enormously from being helpedwith self-care.They can live longer, have less pain, anxiety, depression and fatigue, have a better quality of life, and be more active and independent. Self-management programmes Self-management programmes aim to help people with bipolar disorder take an active part in their own recovery so theyre not controlled by their condition. One course run by BipolarUK aims to teach people with bipolar disorder how to manage their illness. The programme includes information about: triggers and warning signs coping strategies and self-medication support networks and action plans maintaining a healthy lifestyle drawing up an advance decision complementary therapies action plans There are other courses, such as those run by Self Management UK , for mild to moderate mental health conditions. Coursessuch asthese help people who may feel distressed and uncertain about their bipolar disorder improve their own lives. Talking about it Some people with bipolar disorder find it easy to talk to family and friends about their condition and its effects. Other people find it easier to turn to charities and support groups. Many organisations run self-help groups that can put you in touch with other people with the condition. This enables people to share helpful ideas and helps themrealise theyre not alone in feeling the way they do. These organisations also provide online support in forums and blogs. Some useful charities, support groups and associations include: Bipolar UK Carers UK Mind Rethink Samaritans SANE Talking therapies are useful for managing bipolar disorder, particularly during periods of stability. Services that can help You may be involved with many different services during treatment for bipolar disorder. Some are accessed through referral from your GP, others through your local authority. These services may include: Community mental health teams (CMHT)  these provide the main part of local specialist mental health services. They offer assessment, treatment and social care to people withbipolar disorderand other mental illnesses. Early intervention teams these provide early identification and treatment for people who have the first symptoms of psychosis. Your GP may be able to refer you directly to an early intervention team. Crisis services  these allow people to be treated at home, instead of in hospital, for an acute episode. These are specialist mental health teams that deal with crises that occur outside normal office hours. Acute day hospital  these are an alternative to inpatient care in a hospital. You can visit every day or as often as you need. Assertive outreach teams  these deliver intensive treatment and rehabilitation in the community for people with severe mental health problems, providing rapid help in a crisis. Staff often visit people at home and liaise with other services, such as your GP or social services. They can also help with practical problems, such as helping to find housing and work, or doing your shopping and cooking. Avoiding drugs and alcohol Some people with bipolar disorder use alcohol or illegal drugs to try to take away their pain and distress. Both have well-known harmful physical and social effects and are not a substitute for effective treatment and good healthcare. Some people with bipolar disorder find they can stop misusing alcohol and drugsonce theyre using effective treatment. Others may have separate but related problems of alcohol and drug abuse, which may need to be treated separately. Avoiding alcohol and illegal drugs is an important part of recovery from episodes of manic, hypomanic or depressive symptoms, and can help you gain stability. Read more about alcohol misuse Money and benefits Its important to avoid too much stress ,including work-related stress. If youre employed, you may be able to work shorter hours or in a more flexible way, particularly if job pressure triggers your symptoms. Under the Equality Act 2010 , people are protected from discrimination in the workplace and in wider society. This can include people with a diagnosis of bipolar disorder or other mental illnesses. Arange of benefitsis available to people with bipolar disorder whocant work as a result of their mental illness. The Adult Disability Payment is managed by Social Security Scotland. Depending on your circumstances, you may qualify fromnon-devolved benefits from the UK Government . Want to know more? Care Information Scotland: Money Living with or caring for someone with bipolar disorder People living with or caring for someone with bipolar disorder can have a tough time. During episodes of illness, the personalities of people with bipolar disorder may change, and they may become abusive or even violent. Sometimes social workers and the police may become involved. Relationships and family life are likely to feel the strain. If youre the Named Person (as defined by theMental Health (Scotland) Act 2015) of a person with bipolar disorder, you havecertain rights that can be used to protect the persons interests. These include requesting that the local social services authority asks an approved mental health professional to consider whether the person with bipolar disorder should be detained in hospital (also known as sectioning). You may feel at a loss if youre caring for someone with bipolar disorder. Finding a support group and talking to other peoplein a similar situation might help. If youre having relationship or marriage difficulties, you can contact specialist relationship counsellors, who can talk things through with you and your partner. Want to know more? Care Information Scotland: Support for carers Relate: Relationship advice Dealing with suicidal feelings Having suicidal thoughts is a common depressive symptom of bipolar disorder.Without treatment, these thoughts may get stronger. Some research has shown the risk of suicide for people with bipolar disorder is 15 to 20 times greater than the general population. Studies have also shown that as many as 25-50% of people with bipolar disorder attempt suicide at least once. The risk of suicide seems to be higher earlier in the illness, so early recognition and help may prevent it. If youre feeling suicidal or youre having severe depressive symptoms, contact your GP, care co-ordinator or the local mental health emergency services as soon as possible. If you cant or dont want to contact these people, contact the Samaritans on 116 123. You can call them24 hours a day, seven days a week. Alternatively, visit the Samaritans website or email jo@samaritans.org . Self-harm Self-harm(sometimes called self-injury) is often a symptom of mental health problems such as bipolar disorder. For some people, self-harm is a way of gaining control over their lives or temporarily distracting themselves from mental distress. It may not be related to suicide or attempted suicide. Want to know more? Mind: Understanding self-harm National Self Harm Network Rethink: Suicide and self-harm Samaritans Recommended communities Online communities help you talk to people, share your experiences and learn from others. The SANESupport Forumallows people to share their feelings and provide mutual support to anyone with mental health issues, as well as their friends and family. SANE Support Forum Bipolar UK, a national charity, alsoruns an online discussion forum for people with bipolar disorder, their families and carers. Bipolar UK eCommunity Source: NHS 24 - Opens in new browser window Last updated: 04 April 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. 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