- Bipolar disorder causes people to experience extreme mood changes.
- These mood changes include periods of depression and periods of mania or hypomania.
- Many people living with bipolar can benefit from self-help strategies, medication, community support, and psychological therapies.
- A full and meaningful life is possible for people living with bipolar disorder.
What is bipolar disorder?
Bipolar disorder (once called manic depression) causes people to experience extreme changes in mood, thinking, energy and behaviour.
Everyone experiences mood swings, or times when we feel joyful or low. But people living with bipolar disorder experience more extreme types of mood changes, that can significantly impact on day-to-day life.
Many people living with bipolar disorder also experience other mental health issues, including anxiety disorders, substance use disorders, personality disorders, and attention-deficit hyperactivity disorder (1).
Symptoms of bipolar disorder
Bipolar and related disorders are characterised by periods of mania (extreme ‘highs’) and periods of depression (extreme ‘lows’). Symptoms usually first appear in late adolescence or early adulthood.
It is quite a diverse condition. Some people may only experience one episode of mania, but others experience more rapid cycles. Many people experience periods of normal mood in between episodes. Some people’s lives are affected significantly, but others experience only minor challenges.
There are three related presentations that share similar features (2):
- Bipolar I disorder: which involves at least one episode of mania.
- Bipolar II disorder: involving at least one episode of hypomania.
- Cyclothymic disorder: involving chronic, fluctuating mood changes, including hypomanic symptoms (but not a full period of hypomania).
Mania is a period of unusually elevated or irritable mood and activity, lasting at least one week. A manic episode is severe enough to cause difficulties in important areas of life, like work or relationships. Many people experiencing a manic episode need a stay in hospital.
A manic episode involves three or more of the following (2):
- Very high self-esteem, confidence, or sense of importance
- Needing less sleep
- Being very talkative
- Racing thoughts
- Being easily distractable
- Increased goal-directed activity, or agitation
- Risky behaviour or doing something reckless
Many people also experience symptoms of psychosis, such as hallucinations or delusions, during mania (1).
Hypomania is like a milder form of mania – it lies between a feeling of normal elation and mania. Hypomania also involves unusually elevated or irritable mood or activity, but it’s shorter (lasting at least four days). It also involves three or more of the symptoms listed above (2).
Hypomania involves a clear change in functioning but is less disruptive to a person’s life and does not require treatment or a stay in hospital.
Depressive episodes involve more than ordinary sadness. People with bipolar disorder may experience five or more of these symptoms over at least a two week period (2):
- Feeling depressed, sad, empty, hopeless, or agitated.
- A loss of interest or pleasure in activities.
- Significant weight changes.
- Sleeping too much or having trouble sleeping.
- Feeling slowed-down physically or agitated.
- Fatigue or lack of energy.
- Seeing things in a negative way, feeling worthless or guilty.
- Having difficulty concentrating or making decisions.
- Suicidal thoughts, planning, or attempts.
If you, or someone you know, are concerned about suicide and need to talk to someone right now, call Lifeline on 13 11 14 or Suicide Call Back Service on 1300 659 467. If life is in danger and you need help immediately, please call triple zero (000).
Causes of bipolar disorder
The causes of bipolar disorder are not fully understood. There seems to be a genetic link, meaning it can run in families. There are also neurological, biological, and environmental factors that contribute to the likelihood of developing bipolar disorder (1).
How common is bipolar disorder?
Around 2% of Australian adults experience bipolar disorder each year (3).
Managing life with bipolar disorder
People with bipolar disorder find different strategies helpful, such as:
- Learning more about bipolar disorder
- Establishing a support network of friends or family members
- Learning stress management techniques
- Looking after physical health, including getting regular physical health check-ups, improving sleep, exercising regularly, and avoiding drugs and alcohol
- Learning to recognise early signs of mania developing, such as a lack of sleep, an increase in energy, or racing thoughts (using apps to track mood and sleep can be helpful)
- Developing a wellness plan and sharing it with a support team
- Accessing peer support.
Treatment and support for bipolar disorder
Bipolar disorder is a long-term condition, meaning people may need support over time. Ideally, treatment and support decisions should be collaborative (4).
It’s a good idea to first talk to a GP. A GP can provide information and referrals for assessment, treatment and support options, and monitor physical health.
Treatment can usually occur in the community, though during episodes of mania, sometimes people may need an inpatient hospital stay. Treatment often involves working with mental health professionals such as psychiatrists, psychologists, and case managers. Treatment can have a range of goals, such as understanding more about bipolar disorder, preventing episodes of mania or identifying them early, and managing different areas of life like work, study, and relationships.
Medication is usually recommended (1). Certain medications called mood stabilisers can assist the brain to restore its normal chemical balance and help manage mood changes.
Psychological therapies can help manage symptoms of bipolar disorder, including cognitive behavioural therapy (CBT), family-focused therapy, dialectical behaviour therapy, and mindfulness-based CBT (1). Some people also benefit from electroconvulsive therapy (ECT). People living with bipolar disorder can also benefit from community support programs.
Help for family and friends
The family and friends of someone experiencing bipolar disorder need care and support too — it’s okay for family and friends to set boundaries, and to prioritise their own physical and mental health.
There are many other people out there who share similar experience, and many services designed to help carers of people with mental health issues. Check out our Guide for Families and Friends for more info.
Effective medical, community, and psychological treatment is available, and a person experiencing bipolar disorder can live a fulfilling life.
To connect with others who get it, visit our online Forums. They’re safe, anonymous, and available 24/7.