Bipolar Disorder: A Fact Sheet

Bipolar disorder is a mood disorder characterised by “mood swings” that alternate between periods of elevated disposition (mania) and periods of depression.  It affects men and women equally, occurring more often in people who have relatives with this disorder.  The condition usually appears between the ages of 15-25.

Bipolar disorder is also known as manic-depression or bipolar affective disorder.  There are two types of bipolar disorder.   The manic symptoms/hypomanic episodes are less intense in bipolar disorder II than those in bipolar disorder I.

The manic phase may last from days to months.  The symptoms include pervasive euphoria, agitation or irritation, inflated self-esteem or delusions of grandeur, little need for sleep, racing thoughts, hyperactivity and over-involvement in activities, poor temper control and general lack of self-control, impaired judgment, and reckless indulgent behaviour such as binge eating, sexual promiscuity, and spending sprees.

The depressed phase shows the opposite symptoms:  daily low mood or persistent sadness, fatigue or listlessness, loss of self-esteem, feelings of hopelessness and worthlessness or guilt, excessive sleepiness or inability to sleep, withdrawal from previously enjoyed activities, withdrawal from friends, loss of appetite and weight or overeating and weight gain, and persistent thoughts of death or suicide.

The shift between moods can be very abrupt.  Sometimes the two phases overlap, resulting in mixed symptoms occurring simultaneously or one after the other.  There is a high risk of suicide in bipolar disorder so it is very important to diagnose and treat this condition as soon as possible.

Treatment helps the patient function as best as possible between episodes and avoid the need for hospitalisation, reduces the frequency and severity of such episodes, avoids cycling between phases, and prevents self-destructive behaviour, including suicide.

The first line of treatment consists of drugs for stabilising mood.  The most common ones are carbamazepine, lamotrigine, lithium, and valproic acid.  Other medications may include anti-seizure, anti-psychotic, anti-anxiety, and antidepressant drugs.

Electroconvulsive therapy may be used to treat a manic or depressive phase that is resistant to medication.  Transcranial magnetic stimulation (TMS), which uses high frequency magnetic pulses that target affected areas of the brain, is usually the second-line of defense after ECT.

Medical treatment is often more effective in combination with certain forms of psychotherapy.  Among the most useful types of psychotherapy for treating bipolar disorder are psychoanalysis, psychodynamics, and cognitive-behavioural therapy.  Psychoanalysis and psychodynamics help clients understand the underlying origins of their condition.  Cognitive behaviour therapy is very helpful in treating adults and adolescents who tend to catastrophise events when depressed.  It helps them identify, stop, and replace thoughts that can lead to troubling conduct, including self-injurious behaviour, with affirmations that yield positive consequences.   The cognitive therapist literally encourages the client to think himself/herself into a state of wellness.  In young children, bipolar disorder may be more effectively treated with play therapy rather than talk therapy.  This is because children more freely and openly express their fears, emotions, and desires in play.

Psychotherapy also provides the benefit of a supportive and safe environment in which the clients can talk about how bipolar disorder affects them and their families.  The therapist/counselor also serves as a third party who can objectively monitor the clients’ mood states, assess their potential for self-injury, and track their progress.  The counsellor also helps motivate clients to maintain their bipolar medication and know when adjustments in the medical routine are required.  In addition, psychotherapy helps clients improve their coping skills in their social and occupational worlds so they can resist falling into the extreme mood states.

If you or someone you know may be suffering from bipolar disorder, Australia Counselling links you with professional counsellors and psychologists in Sydney, Canberra, Melbourne, Perth, Brisbane, Adelaide and country areas of Australia. Search under depression for counsellors and psychologists that focus in this area of practice in a location near you or use an advanced search to combine your location with counsellors that work with depression.