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What is Bipolar Disorder?

Bipolar disorder is a type of mood disorder where people experience lows (depression) and highs (mania, or hypomania). The lows in bipolar disorder are usually severe and are often related to melancholic depression.

During a high, people often report experiences such as: 

• Feeling elated, on top of the world –although sometimes this feeling may be unpleasant
• Feeling really attractive and very confident (increased self-esteem)
• Having more energy and needing less sleep 
• Talking more and faster than usual, sometimes very loudly and over other people
• Having racing thoughts  
• Having lots of plans and feeling capable of achieving anything
• Feeling like worries have vanished
• Saying or doing things that would normally cause embarrassment
• Alternately feeling happy, friendly and fun to be with, or irritable and aggressive with other people
• Doing things that are regretted later. For example, buying things or making commitments to things without thinking about the consequences
• At times, going too far with everything–arguments, drinking, drugs, showing off, shopping, gambling, fast driving, sex, …

There are two types of bipolar disorder:

Bipolar I disorder

Bipolar I disorder is the more severe condition. The highs (mania) are more extreme and longer, and people suffer from psychotic experiences such as delusions (fixed, false, irrational or illogical beliefs – like believing that they have special powers) or hallucinations (hearing, seeing, or sensing things that really aren’t there). 

Bipolar II disorder

Bipolar II disorder is considered to be less severe than bipolar I disorder because the highs (hypomania) are usually less extreme than those of bipolar I disorder. People with bipolar II disorder do not have psychotic experiences and the highs can last from only a few hours to a few days.

However, the depression can be equally as severe in both conditions. 

Other important points

• Bipolar disorder can start in childhood but more often starts in adolescence (when people are in high school)
• It is not known exactly what causes bipolar disorder, but biological factors (such as changes in brain chemistry) and stressful life events (such as the breakup of a relationship) are associated with its onset
• Getting the right treatment is important for people with bipolar disorder to get on with their lives 
• Occasionally people can experience a mixture of both highs and lows at the same time which is called a ‘mixed’ episode 
• People with bipolar disorder can experience thoughts of suicide or attempt suicide. Such thoughts need to be taken seriously so you should speak to your doctor or to an adult who can help you arrange to see your doctor
• It is important to realise that everyone has mood swings from time to time. It is only when these mood swings become extreme and interfere with usual activities, like going to school and relating to family and friends, that the diagnosis is made.

Treatment

How is bipolar disorder treated?

There are four important aspects to treatment: 

• Medication
• Education
• Counselling
• Wellbeing plans

Medication

Everyone is different and therefore the appropriate medications change from person to person. The usual types of medications used to treat bipolar disorder are antidepressants, mood stabilisers and antipsychotics. 
Read more detailed information about  bipolar disorder medications on the Black Dog Institute website.

Education

Learning about bipolar disorder helps you to move from feeling ‘controlled by’ it to feeling ‘in control of’ it. There are many great books to read including ‘Mastering Bipolar Disorder’ (Allen & Unwin) which includes personal stories from sufferers of bipolar disorder revealing what it feels like on the inside. Inspiring stories and wise advice are accompanied by tips from psychiatrists and information about latest research.
Also, you can watch the Black Dog Institute's Online Bipolar Disorder Education Program.
 

Counselling 

Counselling can help you come to terms with having bipolar disorder and help you learn to manage it successfully. It can also help you deal with other problems that you may be having about family and friends, body image or eating problems, study, career, etc. 

Wellbeing Plans

A wellbeing plan is a guide specially created by you and your health professional to help you manage your bipolar disorder.  It should identify the triggers and early warning signs that come before one of your highs or lows.  A trigger is what sends you into your high or low, for example your high might follow on from drinking too much alcohol, or studying long hours.  An early warning sign is an indication that you are about to have a high or a low.  For example, an early warning sign for a high may be the experience of ‘racing thoughts’, and for a low, ‘feeling worthless’.  Once you have identified your triggers you can avoid them and prevent further episodes.  If you are aware of early warning signs, you can take steps to prevent a full-blown high or low or you can make an appointment with your health professional to get further help.  As your triggers and warning signs change with time, your wellbeing plan will need to change as well.

Your wellbeing plan should also include daily monitoring, e.g. completing a daily mood chart where you can record your mood swings, medication changes, stresses, sleep patterns, etc.  Keeping a Daily Mood Graph can help you understand your triggers and early warning signs and can also be very helpful for your treating health professional.

Highs vs lows

As human beings we all experience a wide range of emotions and feelings. Remember, it is only when these moods become really extreme and interfere with activities, like school and relationships with family and friends, that the diagnosis is made. The following table compares the highs and lows of bipolar disorder.

Getting help

What should I do?

The first thing to do is to discuss how you’re feeling with someone you trust and feel comfortable with. You might also need to see your doctor. 

Sometimes people are embarrassed to go to their doctor about their mood problems. If you are worried about talking to your doctor remember that:

• Up to 1 in 4 people visiting their doctor may suffer from a mood disorder like depression and bipolar disorder

• Mood disorders are very common

• Doctors can prescribe medications and also offer non-medication treatments, such as counselling, or even refer you to a specialist psychologist or psychiatrist

• With the right treatment and support, you will definitely feel better and be able to get on with enjoying your life again

The most important thing is to talk to someone you trust and feel comfortable with. If you try one doctor and you don’t like their reaction, don’t give up! Make an appointment with another one and try again.

If you are feeling really down and cannot cope, speak to someone immediately, try one of these services:

• Lifeline: 13 11 14 (free call from landline)
• Kids Help Line: 1800 55 1800 (cost of a local call from landline)

Watch our interview with a psychologist to see what getting help can be like.