Do you go through intense moods?
Do you feel very happy and energised some days, and very sad and depressed on other days? Do these moods last for a week or more? Do your mood changes make it hard to sleep, stay focused, or go to work?
Some people with these symptoms have bipolar disorder, a serious mental illness.
What is bipolar disorder?
Bipolar disorder is a serious illness that is also called manic-depressive illness. People with bipolar disorder go through unusual mood changes. Sometimes they feel very happy and ‘up’, and are much more active than usual. This is called mania or hypomania, depending on how elevated their mood and behaviour becomes. Equally, people with bipolar disorder can also feel very sad and ‘down’, and can be much less active. This is called depression. Bipolar disorder can also cause changes in energy and behaviour.
Bipolar disorder is not the same as the normal ups and downs everyone goes through. Bipolar symptoms are more powerful than that. They can damage relationships and make it hard to go to school or keep a job. They can also be dangerous. Some people with bipolar disorder try to hurt themselves or attempt suicide. But treatment is available. With help, people with bipolar disorder can get better and lead successful lives.
Who develops bipolar disorder?
Anyone can develop bipolar disorder. It often starts in a person’s late teens or early adult years. But children and adults can have bipolar disorder too. The illness usually lasts a lifetime.
What causes bipolar disorder?
Several factors may contribute to bipolar disorder, including genetics (the illness often runs in families) and/or abnormal brain structure and brain function. The causes of bipolar disorder aren’t always clear. Current research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.
What are the symptoms of bipolar disorder?
Bipolar mood changes are called ‘mood episodes’. People may have manic episodes, depressive episodes or ‘mixed’ episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two – sometimes longer. During an episode, the symptoms last every day for most of the day. Mood episodes are intense. The feelings are strong and happen along with extreme changes in behaviour and energy levels.
People having a manic episode may:
- feel very ‘up’ or ‘high’
- feel ‘jumpy’ or ‘wired’
- talk really fast about a lot of different things
- be agitated, irritable, or ‘touchy’
- have trouble relaxing or sleeping
- think they can do a lot of things at once and are more active than usual
- do risky things, like spend a lot of money or have reckless sex
People having a depressive episode may:
- feel very ‘down’ or sad
- feel worried and empty
- have trouble concentrating
- forget things a lot
- lose interest in fun activities and become less active
- feel tired or ‘slowed down’
- have trouble sleeping
- think about death or suicide
Can bipolar disorder coexist with other problems?
Sometimes people having very strong mood episodes may have psychotic symptoms. These are strong symptoms that cause hallucinations (when people believe things that are not real). People with mania and psychotic symptoms may believe they are rich and famous or have special powers. People with depression and psychotic symptoms may believe they have committed a crime or that their lives are ruined.
Sometimes behaviour problems go along with mood episodes. A person may drink too much or take drugs. Some people take a lot of risks, like spending too much money or having reckless sex. These problems can damage lives and hurt relationships. Some people with bipolar disorder have trouble keeping a job or doing well at school.
Is bipolar disorder easy to diagnose?
Some people have bipolar disorder for years before anyone knows. This is because bipolar symptoms may seem like several different problems. Family and friends may not see that a person’s symptoms are part of a bigger problem. A doctor may think the person has a different illness, such as schizophrenia or depression.
Also, people with bipolar disorder often have other health problems. This may make it hard for doctors to see the bipolar disorder. Examples of other illnesses include substance abuse, anxiety disorders, thyroid disease, heart disease and obesity.
How is bipolar disorder treated?
Right now, there is no cure for bipolar disorder, but treatment can help control symptoms. Most people can get help for mood changes and behaviour problems. Treatment works best when it is ongoing, instead of on and off.
- Medication. Different types of medication can help. People respond to medications in different ways, so the type of medication depends on the patient. Sometimes a person needs to try different medications to see which are best. Medications can cause side effects, and sometimes a person and their psychiatrist or GP may have to try a few medications at different dosages before they can find the best combination that has both maximum efficacy and minimal side effects. People with bipolar mood disorder sometimes default (stop taking) on their medication. A person should never stop taking a medication or alter the dose without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.
- Therapy. Different kinds of psychotherapy can help people with bipolar disorder. Therapy can help them change their behaviour and manage their lives. It can also help patients get along better with family and friends. Research has clearly demonstrated that CBT is an effective treatment for many people with bipolar mood disorder, both in terms of limiting the frequency and length of manic and depressive episodes, and also the degree of the highs and lows.
- Other treatments. Some people do not get better with medication and therapy. These people may try electroconvulsive therapy or ECT. Sometimes people take herbal and natural supplements, such as St John’s wort, 5HTP or omega-3 fatty acids. Some people may also require sleep medications during treatment. Always consult with your doctor before taking any supplement or medication.
How can I help myself if I have bipolar disorder?
You can help yourself by getting treatment and sticking with it. It takes time, and it’s not easy. But treatment is the best way to start feeling better. Here are some tips:
- Talk to your doctor about your treatment.
- Stay on your medication.
- Engage in psychotherapy such as CBT or psychoanalysis.
- Keep a routine for eating and sleeping.
- Make sure you get enough sleep.
- Learn to recognise your mood swings.
- Ask a friend or relative to help you stick with your treatment.
- Be patient about your symptoms. Improvement takes time.
How does bipolar disorder affect friends and family?
When a friend or relative has bipolar disorder, it affects you too. Taking care of someone with bipolar disorder can be stressful. You have to cope with the mood swings and sometimes other problems, such as drinking too much. Sometimes the stress can strain your relationships with other people. Caregivers can miss work or lose free time.
If you are taking care of someone with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job, and it might help your loved one stick to his or her treatment. Sometimes it can also be helpful to see a psychologist to help you with these stressors.
Bipolar Mood Disorder is a Prescribed Minimum Benefits (PMB) condition in South Africa, which means that if you are on a medical aid then (and irrespective of the quality of your medical aid plan) they need to grant you 15 outpatient psychotherapy sessions (at their normal rate).