Bipolar Disorder

What Is Bipolar  Mood Disorder?
Bipolar disorder, which used to be called manic depressive illness, is a disorder of mood, characterised by extreme mood swings. The mood swings are episodic:  in between episodes the person is usually completely well. Bipolar disorder is a neurobiological brain disorder and is strongly genetic.  A person fluctuates between high mood “mania” or “hypomania” and low mood “depression”.

What Is Mania?
Hypomania - Activity and thought speeds up, there is less need to sleep, mood is high, with a sense of well being but there is often irritation and intolerance towards other people. Ideas flow quickly and thought processes are relatively intact. The person feels well and in control - but may not see the consequences of his or her behaviour and may react angrily if confronted. Judgment is affected and people may become unable to make complex decisions. People may refuse medication or suggestions to seek help.  If hypomania is not treated, lack of sleep and high level of activity may lead to acute mania where thinking is disjointed and distorted. Hallucinations and delusions are common and may appear very real to the person. The person is usually not capable of looking after him/herself.
Delirious Mania - The person appears confused and bewildered and appears very disturbed. This stage often follows some days or weeks of not eating or sleeping, so the symptoms may be caused by poor nutrition and physical exhaustion. Without treatment, people can die in this stage of manic illness. This stage is often mistakenly diagnosed as a schizophrenic illness.

What Is Depression?
Depression is the opposite of mania. Thoughts are slower, mood is low and there may be feelings of sadness and emptiness. Thinking is difficult and it is hard to make decisions. The person may be incapable of or uninterested in performing everyday tasks. Sleeping is disturbed - it may be difficult to get to sleep with periods of wakefulness in the early hours of the morning followed by oversleeping into the late morning. The person may have an increase in or a complete lack of appetite. There is a decrease or loss of libido. Self-confidence is low and there is a generally pessimistic outlook regarding self and others.

Patterns of Bipolar Disorder
Bipolar disorder usually develops in adolescence and early adulthood. Stress is usually the trigger for early episodes of mood disorder but after a number of episodes, the episodes of mania or depression can develop without any obvious trigger.
Bipolar I - the person has episodes of mania and depression which are severe.
Bipolar II - the person has episodes of hypomania which generally do not disrupt normal activities. People often only seek help for the episodes of severe depression in this type of disorder.
Mixed States - sometimes mania and depression happen at the same time: the person may be laughing and crying at the same time or feel sad but driven to high levels of activity.
Rapid Cycling Disorder (4 or more episodes per year) - many more women than men develop rapid cycling moods after a number of years of mood disorder.

What are the Causes of Bipolar Disorder?
Bipolar mood disorder is thought to have a genetic component. In families where one person has manic depressive illness, there are often other family members who have episodes of depressive illness or hypomania. It is not known if there is a gene for bipolar disorder or if it is a vulnerability to severe mood swings that is passed on through families.

Other Possible Causes of Mood Swings
It is important to know that not all mood swings are caused by bipolar disorder.  Some of the possible causes may be some physical illnesses such as diabetes. Recreational drugs, alcohol and medications can have an impact on mood swings.  Mood swings can also be caused by viral or bacterial infection in the brain. If there is no history of mood disorder in your family then you should have a full physical check up to find out why you are having mood swings.

What Treatment is Available?
Treatment very often includes mood stabiliser drugs such as lithium carbonate, carbamazepine or sodium valproate.  Anti-psychotic medication may be used to stop manic symptoms and antidepressant drugs are used in the depressive phase of the illness.  Support, education and counselling may also help the person find ways of coping with the disorder and learn to recognise triggers for episodes of mood disorder.

Therapeutic Axis provides psychotherapy in Sydney and counselling in Sydney to persons affected by Bipolar Disorder.

Mental Health Association of NSW Inc