Mood disorders are a group of mental health issues that affect one’s emotional state. Amongst the mood disorders is bipolar disorder which, unlike depression, is a condition that causes intense shifts in a person’s mood, energy levels, thinking patterns, and behaviours.
What is bipolar disorder?
Bipolar disorder is actually an umbrella term which includes four separate types of mood disorder. All of these types of bipolar disorder involve mood instability or periods of low mood and elevated mood (known as mania or hypomania). Bipolar disorder used to be known as manic depression, but this highly stigmatised term was changed in 1980.
The two extremes of mood which are seen in people with bipolar disorders are depression and mania (or hypomania). During a bout of depression, a person will experience low mood, feeling sad or empty and being unable to gain pleasure from activities. Mania describes an episode of abnormally elevated mood, emotions, energy and activity levels.
In bipolar disorder, people will cycle between these different mood states at different frequencies and intensities, depending on the type of bipolar they have.
Bipolar disorder occurs in up to 2.5% of the population, but the prevalence is much higher among first-degree relatives of individuals who also have bipolar disorder.
What are the types of bipolar disorder?
The four types of bipolar disorder are:
- Bipolar I disorder: People with bipolar I disorder will have experienced one or more episodes of mania and may have had episodes of depression. However, these depressive episodes are not needed for a diagnosis. Some people with bipolar I disorder can have both depression and mania at the same time, and this is known as an episode with mixed features
- Bipolar II disorder: This form of bipolar disorder is often more difficult to diagnose, and whilst it causes cycles of mood instability like bipolar I, a person with bipolar II experiences hypomania instead of mania. Hypomania is a less severe form of mania, which isn’t as intense or disruptive as a manic episode.
- Cyclothymia: People with cyclothymia have a chronically unstable mood state. They may rapidly cycle between hypomania and mild depression over long periods of time.
- Other specified and unspecified bipolar and related disorders: This can occur when a person does not meet the criteria for the three bipolar disorder types above but has still experienced periods of clinically significant abnormal mood elevation.
What causes bipolar disorder?
The exact cause of bipolar disorder is yet to be identified. It is believed that several factors work together to make a person more likely to develop bipolar disorder. These may include:
- Chemical imbalance in the brain – brain chemicals that regulate our mood, such as serotonin and dopamine, may be involved
- Genetics – as bipolar disorder tends to run in families, there is likely a genetic reason for it to develop
- Triggers/risk factors – factors such as periods of high stress, the death of a loved one or another traumatic event may increase the risk of developing bipolar disorder
How is bipolar disorder diagnosed and treated?
Bipolar disorder will not get better on its own. Getting a diagnosis and treatment, however, can be an effective way to control the symptoms. A psychiatrist is required to diagnose bipolar disorder, and they do this by asking questions to understand your symptoms, such as when they first occurred and what other mental health issues you may have.
Treatment for bipolar disorder aims to reduce the frequency and severity of episodes of depression and mania. This allows people with bipolar disorder to lead as normal a life as possible. There are several medicines which are effective in treating the various types of bipolar disorder, including lithium, medicines usually used to treat epilepsy such as lamotrigine, and some medications used to treat schizophrenia such as quetiapine. Sometimes a combination of medicines is also effective.
Some people also find psychological treatment helpful when used alongside medicines for bipolar disorder. These can include psychoeducation (finding out more about what bipolar disorder is) and cognitive behavioural therapy (CBT), a talking therapy which is particularly useful for the depressive episodes of bipolar disorder. Importantly, learning to recognise the warning signs of an approaching episode of mania or depression is possible, and this may help someone with bipolar disorder prepare or get help.