What is it

Bipolar disorder is a condition described by extreme mood swings of ‘highs’ and ‘lows’.  The high moods are called mania or hypomania and the low mood is called depression. It is important to note that everyone has mood swings from time to time.  It is only when mood swings become extreme and interfere with social and occupational life that bipolar disorder may be present and a psychiatric assessment may be warranted.
 
There are two types of bipolar disorder, known as bipolar I and bipolar II.
 
Bipolar I
Bipolar I disorder is characterized by extreme mood swings including periods of mania or hypomania followed by depressive episodes.  It is considered a more serious condition in terms of symptoms, with people being more likely to experience mania, and having longer 'highs'.  Some people may also have psychotic experiences and be hospitalised, although this is not a requirement for diagnosis.
 
Bipolar II
Bipolar disorder II is diagnosed when a person experiences the symptoms of at least one major depressive episode and one hypomanic episode in their lifetime, with no psychotic experiences.  Hypomanic episodes tend to last a few hours or a few days, although impairment can often be as severe as in bipolar I disorder.
 
Individual differences in bipolar disorder
It is important to note that people can differ in the patterns of symptoms of bipolar they experience.  For example,

  • Sometimes people can experience a mixture of both highs and lows, or switch during the day, giving a mixed  picture.
  • Some people can experience daily mood swings, while others may have just one episode of mania once a decade.
  • It is not uncommon for people with bipolar disorder to experience normal moods in between their highs and lows, although many people experience some low level symptoms between episodes.
  • The onset of bipolar disorder usually occurs in the teens or early 20s.  Many people remain undiagnosed for many years.
  • With the correct treatment, the majority of people live normal and productive lives.
  • A number of factors may contribute to the development of bipolar disorder, including genetic factors and brain chemicals.  Up to 80% of people with bipolar disorder have genetic factors in their family.
  • Compliance with physical medications is an important component of treatment and long term mood stability.
  • Psychological therapies are valuable adjuncts to physical medications.
  • It is important to note that some people with bipolar disorder can become suicidal.  These people need to be taken seriously and treated immediately by a mental health service staff.  A link to Emergency Numbers, or to Depression?
 
What is Mania and Hypermania?
Mania includes a distinct period of persistently elevated, or irritable mood and increased goal-directed activity or energy, lasting a least a week and present most of the day.
During the period of mood disturbance and increased energy or activity, a person may experience three or more of the following to a significant degree, which represents a noticeable change from usual behaviour:
  • inflated self esteem or grandiosity,
  • decreased need for sleep,
  • more talkative than usual or pressure to keep talking,
  • flight of ideas or thought racing,
  • distracted by unimportant or irrelevant stimuli,
  • increase in goal directed activity,
  • excess involvement in activities that have a high potential for painful consequences (eg. spending sprees, sexual indiscretions, foolish business investments)
  • elevated mood is not due to the effects of a drug
In mania, the elevated mood is severe enough to cause a marked impairment in social or occupational functioning or necessitate hospitalization, whereas in hypomania elevated mood may not be severe enough to cause impaired social or occupational functioning, or hospital admission.
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What does it include

The aim of treatment is for people to achieve stability and to live successful and productive lives.  Treatment involves a combination of physical and psychological therapies which has been clearly demonstrated to be better than physical treatment alone.  Psychological treatments have been shown to be beneficial in monitoring moods, raising awareness of early warning signs of mood extremes, developing a wellbeing plan for maintaining wellness between highs and lows, and in preventing the occurrence of extreme mood swings.  Psychological therapies are also suitable to treat other conditions that may accompany bipolar disorder, such as problems with general anxiety and social phobias.

How can a psychologist help

Author

Tania Murray

If you require additional information, please call our office on 07 3256 6320. Our mental health focused reception staff will be only too happy to assist you with your enquiry about our service and can suggest the most suitable Psychologist for your concern.