What is bipolar disorder?

Bipolar disorder used to be known as manic depressive disorder or manic depression. It's a serious mental illness, one that can lead to risky behaviour, damaged relationships and careers, and even suicidal tendencies - if it's not treated.

Bipolar disorder is characterised by extreme changes in mood (poles) - from mania to depression. Between these mood swings, a person with bipolar disorder may experience normal moods.

Bipolar disorder therapy

Along with medication, ongoing psychotherapy, or ‘talk’ therapy, is an important part of treatment for bipolar disorder. During therapy, you can discuss feelings, thoughts and behaviours that cause you problems. Talk therapy can help you to understand and ultimately master any problems that hurt your ability to function well in life. It also helps you to stay on your medication - and helps you to deal with effects of bipolar disorder on your social and work life. It can help you maintain a positive self-image.

Types of psychotherapy used to treat bipolar disorder include:

• Cognitive behavioural therapy. This focuses on behaviours that decrease stress and involves learning to identify and modify the patterns of thinking that accompany mood shifts.
• Interpersonal therapy. This involves relationships and aims to reduce strains that the illness may place upon them
• Psychoeducation. This helps you develop and understand the need for daily routines.

‘Manic’ describes an increasingly restless, energetic, talkative, reckless, powerful, euphoric period. Lavish spending sprees or impulsive risky sex can occur. Then, at some point, this high-flying mood can spiral into something darker - irritation, confusion, anger, feeling trapped.

‘Depression’ describes the opposite mood - sadness, crying, sense of worthlessness, loss of energy, loss of pleasure, sleep problems.

But because the pattern of highs and lows varies for each person, bipolar disorder is a complex disease to diagnose. For some people, mania or depression can last for weeks or months, even for years. For other people, bipolar disorder takes the form of frequent and dramatic mood shifts (rapid-cycling bipolar disorder).

‘There's a whole spectrum of symptoms and mood changes that have been found in bipolar disorder’, says Dr Michael Aronson, a clinical psychiatrist and consultant for WebMD. ‘It's not always dramatic mood swings. In fact, some people seem to get along just fine. The manic periods can be very, very productive. They think things are going great.’

The danger comes, he says, when the mania grows much worse. ‘The change can be very dramatic, with catastrophic results. People can get involved in reckless behaviour, spend a lot of money, there may be sexual promiscuity, sexual risks.’

The depressed phases can be equally dangerous: A person may have frequent thoughts of suicide.

If you or someone you know has thoughts of death or suicide, contact a health care professional, loved one, friend or call 999 immediately. 

Bipolar disorder and relationships

Bipolar disorder is equally difficult for families of those affected. The condition is the most difficult mental illness for families to accept, Aronson tells us. ‘Families can more easily accept schizophrenia, to understand that it is an illness. But when a person is sometimes very productive, then becomes unreasonable or irrational, it wreaks more havoc on the family. It seems more like bad behaviour, like they won't straighten up.’

If this sounds familiar - either for you or a loved one - the first step in tackling the problem is to seek medical advice. Whether it's bipolar disorder or another mood-related problem, effective treatments are available. What's most important is that you recognise the problem, and start looking for help.