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WHAT IS BIPOLAR DISORDER?

It used to be known as 'manic depression', but now we more commonly refer to it as 'bipolar disorder' or sometimes 'bipolar affective disorder'. Bipolar describes an extreme set of mood swings (or episodes) that range from excitable, emotional, almost manic highs to depressively, deep lows, plateauing with stable, 'normal' moods in between.

The balanced, stable moods can last for weeks, months or even years. Equally, the length of the peaks and troughs can also vary. Typically each 'up' episode will last anywhere between 2 weeks or up to 5 months, whereas the depressive episode often lasts longer; usually for more than 6 months but less than a year (without treatment). Of course, these will vary from person to person and your experience will be different to someone else.

When it comes to defining mood, bipolar uses a mood scale. Whilst not definitive, it ranges from 0 - Severe Depression, which includes endless suicidal thoughts and feelings of hopelessness and guilt, up to 10 - Mania; the total loss of judgement with delusions and hallucinations thrown in for good measure. Numbers 4, 5 and 6 on the scale describe balanced moods, with no symptoms of either of the two extremes.

Whilst it does have dissociative features, bipolar is a long-term, disruptive, mood-affective disorder. It affects those with the condition (obviously), as well as their family and friends. It is best controlled by medication, via psychotherapy and some self-management lifestyle choices.

There are different categorisations of bipolar within the spectrum of the condition. These are:

  • Bipolar I - This is characterised by the change between manic and depressive 'episodes'. Some people do get depressive moods, but not all.
  • Bipolar II - This type is characterised by more depressive episodes, which alternative between those and periods of hypomania (rather than manic episodes).
  • Cyclothymia - Where the periods of depressive or manic moods are short lived and at a much lower level. The symptoms of cyclothymia (aka cyclothymic disorder) must last for a period of 2 years (at least), with an episode lasting no longer than 2 months, in which there has been a stable state and no 'mixed' state episodes (see below).
  • Rapid Cycling - When you get four or more 'episodes' a year; either manic, depressive or a mix of the two. This can also happen with Bipolar I and II.
  • Mixed States - Where the periods of depression and elation occur at the same time. This can often manifest itself as agitation, sleep disorder and changes in appetite.
  • Mania with Psychotic Symptoms - If your manic episodes have psychotic symptoms, then your symptoms may be more severe and develop into delusions and paranoia.
  • Depression with Psychotic Symptoms - As with those above, if your depressive episodes have some psychotic symptoms, then you may also experience hallucinations (visual and auditory) or delusions. Both this and the previous type can be much more distressing.

Because of these dramatic peaks and troughs, it can affect how those living with bipolar feel on a daily basis. We all know how much the way you feel, or the mood you're in, can impact on your day. We all go through it to some degree. When we're in a good mood, we're full of energy and can conquer the world, but when we're not so good, we barely want to get out of bed or engage with anyone. So imagine how you would feel if you had some really extreme high 'highs' and followed closely behind by really low 'lows' over and over again.

THE SYMPTOMS

Many people living with bipolar may notice the symptoms of the condition long before they are actually diagnosed. It's not uncommon for the illness to be treated (or defined) as 'depression', before later being re-diagnosed with bipolar. It can misdiagnosed a number of times before the correct diagnosis is given.

Only a psychiatrist can diagnose you with bipolar disorder and only after you've experienced the symptoms two or more times and undertaken a full psychiatric assessment.

As the descriptions suggests, the symptoms of bipolar are like having a fluctuating routine of very good and very bad moods. They can include:

  • Feeling good when things are going well, and more irritable when they aren't.
  • Having less energy and feeling tired more.
  • Talking quickly.
  • Jumping from one idea to another with thoughts racing through your mind.
  • Feeling better than usual about yourself.
  • Not want to take part in things you've previously enjoyed.
  • Making bad decisions.
  • Struggling to concentrate or becoming easily distracted.
  • Doing things out of character that may cause problems in your life, i.e. spending sprees, over use of drugs or alcohol, one-night stands or generally being more sexually promiscuous.
  • Being argumentative, aggressive or pushy.

WHAT CAUSES BIPOLAR DISORDER?

Bipolar affects just as many men as women, from any social or ethnic background. It affects 1 in every 100 adults. Most people will develop it by the time they're 30 years old, but it can also happen earlier or later in life.

Whilst we don't know much about what causes bipolar, there is evidence to suggest a genetic link. Bipolar tends to run in families, although just because there is no history of it in your family, doesn't mean you can't develop it (or vice-versa).

As with many mental illnesses, the cause is often a mixed bag of social, environmental and physical influences. Many people can trace their history of bipolar to a stressful life event they have experienced, like child birth (or death), a marriage or long-term relationship breaking down or serious financial problems.

Some researchers believe it develops as a consequence of trauma in childhood like abuse, neglect or the loss of a parent early in life. We may never know a clear reason for why bipolar develops.


If you live with bipolar, there may be some organisations on our Where To Turn pages that can help you. If not, and you know of one, please let us know and we'll look into it.

Also, if you'd like to share your experiences of living with the condition with our community, please take a look at our 'Men Tell' section.