Bipolar disorder is a diagnosis given to someone who experiences extreme periods of low (depressed) and high (manic) moods.
What is bipolar?
Bipolar disorder used to be referred to as manic depression, and some people still use this term. It can sometimes be called bipolar affective disorder too.
High or 'manic' periods typically consist of:
- Feeling euphoric, excited, confident, ambitious or adventurous
- Having racing thoughts, a feeling of not being able to get their words out fast enough, difficulty concentrating on one thing
- Increased sex drive
- Excessive or extravagant spending
- Not feeling like eating or sleeping
- A feeling of being special, invincible or having enhanced physical and mental abilities
- In some cases, experiencing symptoms of psychosis such as hallucinations or delusions.
Low, or depressive periods share a lot of characteristics with depression. They usually include:
- Feeling down, hopeless, empty, upset or tearful
- Low self-esteem, lack of confidence, feeling guilty or worthless
- Tired, heavy, sluggish feelings. Lack of motivation and inability to enjoy things
- Feeling tense, frustrated, agitated
- Suicidal thoughts and feelings.
Some people also experience 'mixed' episodes, where they feel elements of both high and low moods.
The lows feel inescapable. It’s like walking through tar. You can see the end of the road, but it feels impossible to reach it - Amber
There are several different types of bipolar:
- Bipolar I: Mostly mania with some periods of depression (although some people do not have any).
- Bipolar II: A mixture of manic and depressive episodes.
- Cyclothymia: A mixture of manic and depressive episodes which are either not frequent enough or pronounced enough to require a Bipolar II diagnosis.
Only a psychiatrist can diagnose bipolar. They will make a diagnosis by asking questions about a person's thoughts and feelings. They may also ask about someone's family history.
When my brain fell into full blown psychosis – with delusions and grandiose thoughts, fearful thoughts about loved ones and being in danger and a complete change in rational perception – it ripped apart the fabric of my life and all I knew - Sarah
How common is bipolar?
It is difficult to know how common bipolar is as many people describe it in different ways and many will never receive a formal diagnosis. However, it is estimated around 2% of the population fits the criteria for a bipolar diagnosis.
What are some of the myths and misconceptions about bipolar?
Some people hold unhelpful beliefs about what bipolar means. For example, thinking of bipolar as being like having dual or split personalities or that it is just 'moodiness'.
These kinds of beliefs are extremely damaging as they can make people feel isolated and alone. They may also stop people from getting the help they need which means their mental health gets worse and are at increased risk of suicide.
I think the most difficult part about having a mental health problem isn't the actual illness itself, but the stigma that surrounds it and all the negative stereotypes in the media ... the misconceptions, the myths and just worrying about what people might think if they found out the truth - Mark
How does bipolar affect people's lives?
Bipolar can make life very difficult. It can disrupt home-life, work, relationships, finances and physical health. If someone has bipolar they will probably experience symptoms to varying degrees for much of their lives. This doesn't mean they will not be able to live full and healthy lives, however.
During times of high mood, someone might act in a way which seems strange to others. They might make risky decisions or spend money they can't afford. When someone returns to a 'normal' or depressed mood they can feel embarrassed, ashamed or regretful. The risky decision-making can also put them in danger.
I am ashamed of the violent words and actions that I have witnessed in myself and others, and would walk a thousand miles barefoot to take back some of the things I have said and done to those I care for when in the middle of a mixed state - Gregory
During times of low mood, people may withdraw from family, social or professional life. This can lead to them feeling lonely and isolated. People with bipolar can feel suicidal or take actions to end their lives.
I know that certain behaviours of mine have put strains on personal relationships and I can often isolate myself when I am going through a depressive episode. I can be extremely flaky, plans with me can often change at the last minute - Jade
How can I help someone with bipolar?
Learn about bipolar
There are lots of resources online which you can use to find out about bipolar . This may help you to understand what your friend or family member is going through and help you to feel more confident in offering support. Try starting with the Mind or Rethink Mental Illness websites.
Be patient and try not to judge
A person with bipolar may do and say things which seem strange to you, but try and understand that the way they are acting makes sense to them at the time, whether it's due to increased confidence, depression or psychosis.
The time I really began to notice how bad things were was when a friend of mine pointed out to me how dramatically my moods would shift - Joshua
Help them plan, and learn their triggers and warning signs
Most people have certain things that might trigger a particular mood, such as stress, or not getting enough sleep. It might be hard for them to recognise these signs when they are going through it themselves, so it might be helpful if together you can agree a plan for what to do if you think they are becoming unwell.
Ask them how you can help
Everybody is different and there is no single way to help someone experiencing bipolar. If you want to support a friend or loved one, one of the best things to do is ask them how.
Give them information about other types of support
Sometimes the support of friends and family is not enough. Letting them know about the support they can get from the NHS, private healthcare or organisations like Mind and Rethink Mental Illness can also be helpful.
As well as treatment provided by medical professionals, such as psychological therapies and medication, community based support related to lifestyle, education or social activities can also help someone stay well.
Remember you can’t force someone to get help. Repeatedly trying to do so before they are ready can actually do more harm than good.