Types of mood swing
Low (‘depressive’): intensely low, depressed, despaired
High (‘manic’): Extremely happy, elated, overactive, irritable. May develop grandiose delusional beliefs about yourself and your abilities
Hypomanic: Mood is high, not as extreme as mania
Mixed: Mixture of mania and depression
What is bipolar disorder?
Used to be called ‘manic depression’ - as phrase suggests: severe mood swings
Usually last several weeks to months, beyond usual ups and downs most people experience
How common is bipolar disorder?
About 1 in 50 adults will develop bipolar disorder at some point in their life
Usually starts between 15 and 25, rarely after 50
Types of bipolar disorder
Bipolar I: at least 1 manic episode lasting > 7 days, some people only manic episodes but most will also have depressive episodes, untreated mania usually lasts 3-6 months, untreated depression 6-12 months
Bipolar II: more than 1 episode of severe depression, mild manic episodes
Rapid cycling: 4 or more episodes in 12 months, about 1 in 10 people with bipolar
Cyclothymia: mood swings less severe but can last longer, can progress into full bipolar disorder
What causes bipolar disorder?
Similar ‘genetic risk factors’ in bipolar, severe depression and schizophrenia
Environmental risk factors can interact with genetic risk factors
No single cause
Parent with SMI - strongest RF, 1:3 chance
Depression
We all experience feelings of depression from time to time. It can even help us to recognise and deal with problems in our lives. In major depression / bipolar depression - feelings are much more intense, last for longer, makes it difficult or impossible to deal with normal life.
Depression: emotional changes
Feelings of unhappiness that don’t go away
Tearfulness
Losing interest in things
Unable to enjoy things
Restless, agitated
Losing self-confidence
Feeling useless, inadequate, hopeless
Irritable
Thinking of suicide
Depression: difficulties with your thinking
Can’t think positively or hopefully
Difficult to make simple decisions
Can’t concentrate properly
Depression: physical symptoms
Reduced appetite, weight loss
Hard to fall asleep, wake up very early and can’t fall asleep again
Tired
Constipated
Lose interest in sex
Depression: behaviour
Hard to start or finish things, even everyday chores
Cry a lot, or want to cry but can’t
Avoid other people
Mania
You feel intensely well, energetic and optimistic – so much so that it affects your thinking and judgement. You can start to believe strange things about yourself, make bad decisions, and behave in embarrassing, harmful and - occasionally - dangerous ways.
Make it difficult or impossible to deal with day-to-day life. Can badly affect relationships and work.
Isn’t so extreme: ‘hypomania’. Can still affect your judgement, and how you get on with other people.
Mania: emotional changes
Very happy and excited
Very irritable
Feeling more important than usual
Mania: thinking
Full of new and exciting ideas
Moving quickly from one idea to another, losing track of what you are trying to think about or explain
Hear voices that other people can’t hear
Mania: physical
Full of energy and more active than usual
Unable or unwilling to sleep
May be more interested in sex
Mania: behaviour
Making plans that are grandiose and unrealistic
Very active, moving around quickly
Behaving unlike normal self
Talking very quickly
Making odd decisions on the spur of the moment
Recklessly spending money
Over-familiar or recklessly critical of other people
Less inhibited in general
Psychotic symptoms
If very severe - may develop delusional ideas.
Manic episode - tend to be grandiose beliefs about yourself - that you are on an important mission / special powers and abilities.
Depressive episode – feel intensely guilty, that you are worse than anybody else, or even that you don’t exist.
Hallucinations - hear, smell, feel or see something, but there isn’t anything (or anybody) there to account for it.
Between episodes
Some people feel that they recover completely in between their mood swings but many do not.
Can continue to feel depressed and to have problems in thinking, even when you appear (to other people) to be better.
DVLA
An episode may mean that you have to stop driving for a while – you must tell the DVLA if you have bipolar disorder.
Medications
Keep your mood stable (prophylaxis)
Treat a manic or depressive episode.
