Bipolar disorder, also known as manic depression, is a highly complex illness. It is a mental disorder that disrupts mood and behaviour and has consequences in all spheres of life, affecting family, relationships, and careers.
Bipolar disorder usually appears in adolescence or early adulthood. It affects both men and women.
Bipolar disorder causes individuals to go through mood cycles that shift from one extreme to the other. They typically experience three states: a high state (mania), a low state (depression), and a well state.
There are several types of bipolar disorder, which are distinguished by the frequency, duration, and intensity of the manic and depressive episodes. Often unrelated to life events, these episodes are interspersed with moments of well-being during which the individual feels "normal" and functions well.
The beginning of a manic episode is characterized by boundless energy and creativity. This state can quickly turn into a sustained period of extreme agitation.
Individuals experiencing a manic episode are not always happy or euphoric; they may be highly irritable, feel intense anger, or exhibit aggressive behaviour. A number of other symptoms may also be present:
- Trouble concentrating
- Rapid, loud, rambling speech
- Hallucinations, delusions
- Involvement in many activities (social, professional, academic, family)
- Exaggerated self-esteem, sense of grandeur
- Poor judgment, impulsiveness
- Risky, pleasure-seeking behaviour
- Reduced need for sleep
Depressive episodes often involve a constant state of intense sadness, despair, or frustration.
Individuals typically experience several of the following symptoms:
- Constant self-deprecation
- Difficulty making decisions
- Inability to concentrate
- Fatigue, weakness
- Restlessness or, conversely, low energy
- Health problems such as headaches, back pain, or stomach pain
- Change in appetite or weight
- Suicidal thoughts
- Loss of interest in daily activities
- Disturbed sleep (insomnia, hypersomnia)
- Symptoms of psychosis, such as hearing voices or having delusions
- Feelings of guilt or worthlessness
Manic and depressive symptoms sometimes occur at the same time, which is deeply painful for the individual.
Causes and triggers
What causes bipolar disorder is unknown. However, genetics have been shown to play a key role. Individuals are more likely to develop bipolar disorder if they have relatives with the condition.
While certain events (family problems, intense stress, periods of insomnia, taking medication or drugs, etc.) can trigger episodes of mania or depression, they cannot cause the disease.
To date, there is no cure for bipolar disorder, but the symptoms can be managed with medication and psychosocial treatment. In both cases, the main goal is to alleviate symptoms and minimize relapses.
Bipolar disorder is treated primarily with mood stabilizers, medications that reduce the abnormal mood swings caused by the illness. They must be taken continuously to be fully effective. Adjunctive medications may also be prescribed to treat specific problems (e.g., anxiety, insomnia) or to increase the efficacy of mood stabilizers.
Psychosocial treatment is usually suggested once an individual's symptoms are under control. It includes psychoeducation (learning about the disease), psychotherapy, and support groups. Psychotherapy involves speaking with a therapist and developing strategies to address problems related to the disease. Support groups allow individuals to share their experiences with other people who are dealing with the same illness.
When should I see a health care professional?
Speak with your health care provider in the following cases:
- You are experiencing psychological distress.
- Your symptoms are preventing you from functioning properly.
- Your social, professional, and family commitments and obligations have become a burden and you are no longer able to fulfill them.
- You are having suicidal thoughts.