If you have bipolar disorder you will experience extreme swings in mood – from periods of overactive, excited behaviour – known as ‘mania’ or ‘manic episodes’ – to deep depression. Between these severe highs and lows, you may have stable times.
Some people also see or hear things that others around them don't (known as having visual or auditory hallucinations) or have uncommon, unshared, beliefs (known as delusions).
Manic episodes
You may experience one or more of the following symptoms. However, it is unlikely that you will go through all of them. Symptoms may include:
- feeling euphoric – excessively ‘high'
- restlessness
- extreme irritability
- talking very fast
- racing thoughts
- lack of concentration
- having a lot of energy
- a reduced need for sleep
- a sense of own importance
- poor judgement
- excessive and inappropriate spending
- increased sexual drive
- risky behaviour
- misusing drugs or alcohol
- aggressive behaviour.
You may feel like you are a genius and that you are the only person in the world who can see it the right way.
Here are the different types of Bi Polar
- Mania with psychotic symptoms – if you experience mania with psychotic symptoms, you are likely to experience many of the symptoms listed under Manic episodes. Your symptoms might be severe and your sense of your own importance may develop into delusions. Suspicions may turn into delusions of persecution and you may feel convinced that others are out to get you.
- Depression with psychotic symptoms – with severe depression you may start hearing or seeing things that others don’t see and hear (hallucinations) and/or have beliefs that others don’t share (delusions). This can be very distressing. You may, for example, hear voices accusing you of being nasty and bad. Or you may be convinced that some terrible disaster is about to happen and that you are responsible for it.
- Bipolar I – characterised by manic episodes – most people will
experience depressive periods as well, but not all do. - Bipolar II – characterised by severe depressive episodes alternating with episodes of hypomania.
- Cyclothymic disorder – short periods of mild depression and short periods of hypomania.
- Rapid cycling – four or more episodes a year. These can be manic, hypomanic, depressive or mixed episodes.
- Mixed states – periods of depression and elation at the same time.
You may have very few bipolar disorder episodes, with years of stability in between them; or you may experience many more. Episodes can vary in both length and frequency from weeks to months, with varying lengths of time in between.
Mania usually starts suddenly and lasts between two weeks and four to five months. Depression often lasts longer, on average around six months. It can last longer, but usually less than a year.
Although you may cope very well in between episodes, you may still experience low-level symptoms in these relatively ‘stable’ periods, which can impact on your daily life.
Treatment and care for someone with Bipolar Dissorder
Your treatment and care should take into account your personal needs and preferences, and you have the right to be fully informed and to make decisions in partnership with your healthcare team. To help with this, your healthcare team should give you information you can understand and that is relevant to your circumstances. All healthcare professionals should treat you with respect, sensitivity and understanding and explain bipolar disorder and the treatments for it simply and clearly.
The information you get from your healthcare team should include details of the possible benefits and risks of particular treatments. You can ask any questions you want to and can always change your mind as your treatment progresses or your condition or circumstances change. Your own preference for a particular treatment is important and your healthcare team should support your choice of treatment wherever possible, but this does depend on your age. If you are over 16 you can give your own agreement; if you are under 16 and you fully understand all the information you may also be able to give your own agreement; but if you are too young, your parents or carers may also need to agree to treatment.
Your treatment and care, and the information you are given about it, should take account of any religious, ethnic or cultural needs you may have. It should also take into account any additional factors, such as physical or learning disabilities, sight or hearing problems, or difficulties with reading or speaking English. Your doctor or nurse should be able to arrange an interpreter or an advocate (someone who supports you in asking for what you want) if needed.
If you agree, your carers and relatives should have the chance to be involved in decisions about your care. Carers and relatives also have the right to the information and support they need in their roles as carers.
All treatment and care should be given with your informed consent. If, during the course of your illness, you are not able to make decisions about your care, your healthcare professionals have a duty to talk to your family or carers unless you have specifically asked them not to. Healthcare professionals should follow the Department of Health's advice on consent (www.dh.gov.uk/en/DH_103643) and the code of practice for the Mental Capacity Act. Information about the Act and consent issues is available fromwww.nhs.uk/CarersDirect/moneyandlegal/legal In Wales healthcare professionals should follow advice on consent from the Welsh Government (www.wales.nhs.uk/consent).
Most people with bipolar disorder receive most of their treatment from a psychiatrist and other specialist mental health professionals, although your GP will also play an important part in your treatment.
If your GP is or has been responsible for your treatment for bipolar disorder, you may be offered an appointment with a psychiatrist or other specialist if you move to a new practice. You should also be offered an appointment if your symptoms become a lot worse, if you are thought to be a risk to yourself or others, if treatment has not helped you, or if you have drug or alcohol problems.
Where possible, your care should be provided by the same healthcare professional(s) and you should have regular appointments. If you are being treated by a number of different healthcare professionals, there should be a clear plan about what each of them does to help you.
There are a number of treatments for adults with bipolar disorder, including:
drugs for an episode of mania.
long-term treatment to stabilise your mood and prevent episodes.
Some of the drugs used for long-term treatment are the same as those used for treating an episode of mania.
When planning your treatment, your doctor should discuss with you any treatment you have had before and your own preference for treatment. He or she should take into account how severe your symptoms are, what treatments have helped you in the past, and be aware of any other drugs you might be taking.
If you are a woman at an age where you could get pregnant, your doctor should talk to you about the risks involved and about contraception.
If you have had a manic episode or severe depression, your healthcare professional should meet with you again within 1 week of your first assessment. After that they should see you regularly, for example every 2–4 weeks in the first 3 months and then at longer intervals if the treatment is helping.
If you are over 65, you may be cared for by special services for older people. You should be given low doses of medication and your healthcare professional should ask you about any other illnesses or problems.
One of the most important things for everyone is staying healthy while having treatment.
Your healthcare professional should give you written information about staying healthy, and ways to cope with bipolar disorder. This should include the importance of sleeping well and having a regular lifestyle.
They should also discuss giving you extra help and support at particularly difficult periods in your life. This may include checking on your mood and general health and encouraging you to talk through difficulties with family and friends.
You and your healthcare professional should develop a plan that looks at things that can start your symptoms off and make them worse, and what to do if this happens.
If someone in your family has bipolar disorder, healthcare professionals should give you information about bipolar disorder and treatments that can help and they should be available in times of crisis. Doctors should also consider your needs, especially if you are under 18, and if you have your own problems and difficulties. You should be offered a regular assessment of your circumstances, needs and physical and mental health, and you may be offered treatment and support. You should also be told about any support groups for families and carers.
Here are a few helpful places
Depression Alliance, 0845 123 2320, www.depressionalliance.org
Bipolar UK, 020 7931 6480, www.bipolaruk.org.uk
Mind, 0300 123 3393, www.mind.org.uk
Rethink, 0300 5000 927, www.rethink.org
SANE, 0845 767 8000, www.sane.org.uk
And remember don't just suffer in silence, if you think you may have Bipolar, contact someone, ask a friend to get help or go to doctors, your not alone.
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