Bipolar disorder: the two sides of the same coin

Bipolar disorder is a mental health condition where moods on opposite sides of the spectrum are experienced at extremes. In this article, a renowned consultant psychiatrist shares insight into this often misunderstood disorder.

What is bipolar disorder?

The condition used to be called manic-depressive disorder. The name “bipolar” can be broken down into “bi”, meaning “two”, and “polar” which comes from the Latin “polus” to mean the end of an axis, and refers to a state of being that is directly opposite another. The name describes how people with bipolar disorder veer between depression (low mood), and mania (high mood). These mood swings are called episodes, lasting between a few hours and up to months.

Bipolar disorder can be further broken down into two types, and they are categorised by how severe the high or low moods are.

The kinds of bipolar disorder

People with bipolar 1 will experience (or have experienced at least one) episodes of potent mania that will last at least a week. They will feel very happy, and excitable, and have a lot of energy. They may be restless and talkative, and take part in risky behaviours that can impact them physically, socially, or financially – for example, gambling and excessive spending, having an inflated ego, sleeping poorly, driving dangerously, or dramatically altering their appearance. It is possible for those in a manic episode to develop psychotic symptoms, like delusions and hallucinations. When not manic, they will likely exhibit signs of depression.

People with bipolar 2 will have more subdued periods of mania, that will not cause impairment to impulse control, risk aversion, or decision making. It may just look like a good mood. This is called hypomania. These periods will also not last as long as it does for those with bipolar 1. After a hypomanic period, people with bipolar 2 will more often experience heavy depressive episodes, where their mood will be low, and they will appear listless, isolate themselves, have low self-esteem, have a poor appetite, and may have suicidal thoughts.

What causes bipolar disorder?

Bipolar disorder can develop at any time, but the average age of onset is 25 years old. There is no known exact cause, but studies have shown there are subtle differences in structure and activity in the brains of those with bipolar disorder as compared to those without. Those who have immediate family with bipolar disorder are more likely to have it. Those who undergo an event of high stress or trauma, particularly in childhood, are more susceptible to developing bipolar disorder.

How is bipolar disorder diagnosed?

Bipolar disorder can often be mistaken for other conditions, so doctors should be thorough in order to diagnose it properly. Aside from a mental health evaluation and psychometric questionnaires, to diagnose bipolar disorder, a doctor may conduct:

• A review of a patient's medical history
• A blood test, as the symptoms may be caused by biological factors such as hyperthyroidism

To be diagnosed with bipolar disorder, a patient must have had at least one episode of mania or hypomania. If they haven’t experienced mania ever, then they have a different mental health disorder like chronic depression.

How is bipolar disorder treated?

Bipolar disorder management includes several strategies to help a patient stay in control of their actions and episodes.

Treatment plans can include:

• Talking therapies such as cognitive behavioural therapy
• Medications like antidepressants, antipsychotics, and mood stabilisers
• Community and support groups

For those who are in danger of harming themselves or others in a manic or depressive episode, hospitalisation may be required.

Bipolar disorder cannot be cured, so treatment for the condition is something the patient has to commit to.

If you are struggling with bipolar disorder, or another mental health condition, you can consult with a specialist today via Top Doctors.