Bipolar disorder (sometimes referred to as bipolar affective disorder) is a serious long-term mental health condition characterized by periods of depressed mood (depression) and elated mood and increased activity levels (mania or hypomania). In between these two states, many people with bipolar disorder will return to their baseline emotional state. Whilst most people will experience mood variations in response to daily stressors, depressed and manic episodes experienced in bipolar disorder differ from normal mood fluctuations in that they are more severe, long-lasting and can interfere with an individual’s work, relationships and/ or daily life. Bipolar disorder is estimated to affect approximately 1-2% of the population and most commonly first presents in early adulthood, however can affect people of all ages and genders. Bipolar disorder is considered to be a lifelong condition however research shows that with appropriate support individuals with bipolar disorder can live full and productive lives. 

 Individuals with bipolar I disorder will experience at least one manic episode. Mania is a period of unusually elevated and/or irritable mood and is accompanied by a significant increase in energy or activity. This episode usually lasts at least 1 week and is notably different to the individual’s normal mood or energy levels. When someone is experiencing manic symptoms, they may experience:

• Elevated mood: Feeling euphoric, invincible or increasingly agitated.
• Less sleep: Feeling a decreased need for sleep and rarely feeling tired.
• Increased energy and activity
• Racing thoughts, big ideas and rapid speech: Thoughts darting from topic to topic, speech that is difficult for others to follow
• Risk-taking behavior: Engaging in behaviours that are out of character. For example, spending large amounts of money, sexual risk-taking, engaging in drugs or alcohol or making significant life changes.
• Elevated self-esteem: Some people may experience uncharacteristically high self-confidence and/or grandiose beliefs.
• Psychotic symptoms: Manic episodes can increase an individual’s likelihood of experiencing psychosis whereby they may see and/or see things that are not there or believe things that are not true.

Individuals with bipolar II do not experience manic episodes but will experience periods of hypomania. Hypomania is less severe than mania and tends to have significantly less impact on an individual’s life and relationships. Hypomania may present as increased mood, self-confidence and productivity. Individuals may also present as unusually optimistic, exhibit decreased desire to sleep or seem somewhat hyperactive. Unlike mania, hypomania does not result in psychotic symptoms and does not typically result in significant adverse effects on the individual’s life. Conversely, many people with bipolar II may express enjoying periods of hypomania due to the associated optimism, confidence and elevated mood. Resultantly, individuals with bipolar II often first seek treatment following a depressive, rather than hypomanic, episode which can result in an initial misdiagnosis of depression.

Depressive episodes are a period of significant low mood that affect an individual’s every day life for two or more weeks. Whilst depressive symptoms are present in both bipolar I and II, evidence suggests that individuals with bipolar II may experience more severe depressive episodes that span over a more prolonged period of time. Symptoms of depressive episodes may include:

• Low mood, sadness, irritability or tearfulness
• Loss of interest in activities that were once deemed enjoyable
• Feelings of hopelessness or helplessness
• Decreased self-esteem
• Low energy and motivation
• Changes in appetite and sleeping patterns
• Poor concentration or issues with memory
• Thoughts of suicide and/ or suicide behaviors

Every person with bipolar disorder is different. Whilst research suggests that many people with bipolar disorder will have long periods without symptoms in between episodes, others may experience lingering symptoms. There are four primary types of bipolar disorder:

Individuals with bipolar I disorder will experience manic episodes that last at least one week or manic symptoms that are so severe that the individual requires hospital care. Manic episodes can, but do not always, result in symptoms of psychosis. Depressive episodes are also common and typically last two or more weeks.

Bipolar II is defined by the repeated pattern of depressive episodes that are severe in nature and often span across at least two weeks. Individuals with bipolar II do not experience manic episodes or psychosis. However, they may experience episodes of hypomania. Hypomania is not likely to have severe effects on the individual’s every-day life. 

BP-NOS is diagnosed when an individual exhibits symptoms of bipolar disorder but does not meet the criteria for either bipolar I or II. Symptoms must deviate from an individual’s baseline emotional state and behavior.

Cyclothymic disorder, sometimes referred to as cyclothymia, is defined by episodes of hypomania and mild depression. These cycles must be present for at least 2 years however episodes do not need to last 2 weeks or more. 

As no two people with bipolar disorder are exactly the same, treatment methods that are helpful to some people may not be for others. Doctors, counsellors and other helping professionals may work alongside you to find a treatment, or combination of treatments, which help to ease your symptoms. Common treatments for depression include:

• Medication to prevent episodes of mania and depression. These are known as mood stabilizers are taken every day over a prolonged period of time.
• Medication to treat the primary symptoms of mania and/or depression as they occur.
• Psychological treatments, such as talking therapies, which help individuals recognize triggers, identify the signs of episodes and process underlying causes for their condition.
• Lifestyle changes may be recommended to help to manage symptoms and reduce the risk of recurrence. These may include regular exercise, good sleep hygiene, a balanced diet and a healthy routine.