Bipolar disorder

Bipolar disorder – also known as manic depression – is a mental disorder marked by extreme mood swings.

Characterised by periods of lethargy and depression, and then mania (when you feel euphoric and overactive), a person with bipolar disorder will experience extreme changes in mood, energy and behaviour.

While bipolar disorder’s causes are not known, experts believe it may be a combination of biochemical, genetic and psychological factors.

According to the South African Depression and Anxiety Group (SADAG), it affects about one percent of the population. While the disorder has been seen in children, the usual age of onset is late adolescence and early adulthood.

Bipolar disorder and alcohol are often linked. Up to half the people who have bipolar disorder reportedly also struggle with alcoholism.

What are its symptoms?

There are several types of bipolar disorder. They include bipolar I, bipolar II, cyclothymic disorder, mixed bipolar, and rapid-cycling bipolar disorder. All involve episodes of depression and mania to different degrees.

Mania symptoms:

  • Excessive happiness
  • Excitement
  • Irritability
  • Restlessness
  • Increased energy
  • Reduced need for sleep
  • High sex drive
  • Tendency to make grand, unattainable plans

Depression symptoms:

  • Sadness
  • Irritability
  • Loss of energy
  • Uncontrollable crying
  • Change in appetite
  • Increased need for sleep
  • Difficulty making decisions
  • Thoughts of death or suicide

Suicide is a very real risk for people with bipolar disorder, whether they’re in a manic or depressive episode — up to 10 to 15 percent of people with bipolar disorder reportedly kill themselves. However, treatment greatly lowers the risk.

How is it diagnosed?

There is no single bipolar disorder test, so a bipolar disorder diagnosis is usually made on the basis of the symptoms meeting several criteria. A multidisciplinary assessment with input from a psychiatrist and a GP may be necessary, in order to rule out other conditions that could be causing the symptoms.

During the assessment, the psychiatrist will ask you about your symptoms. He/she will also want to know about your medical background and family history, especially whether any of your relatives have had bipolar disorder.

If you do have bipolar disorder, you will need to visit your GP regularly for a physical health check.

What are your treatment options?

Treatment in the form of medication and counselling can be effective for most people with bipolar disorder. It cannot be cured but can be managed successfully.

Treatment with mood-stabiliser medicines such as lithium, anticonvulsants or antipsychotic medicines aims to keep the mood within normal limits, while the therapeutic benefits of psychological counselling also helps.

If it’s not diagnosed and treated, the impact of the illness can be devastating to the individual, their family and friends, according to SADAG.

About 85 percent of people who have a first episode of manic depression will have another. Maintenance treatment is therefore essential.

Can it be prevented?

As so little is understood about the causes of bipolar disorder, there’s no guaranteed way to prevent it. However, manic episodes can be controlled through medication.

Home treatment is also important in bipolar disorder. This includes:

  • Take your medication every day as prescribed
  • Get enough exercise
  • Avoid alcohol and illegal drugs
  • Limit caffeine and nicotine
  • Control the amount of stress in your life
  • Get enough sleep
  • Learn to recognise the early signs of your manic and depressive episodes
  • Ask for help from friends and family

For more info
The South African Depression and Anxiety Group

The accuracy of this information was checked and approved by physician Dr Thomas Blake in May 2015