Bipolar disorder

What is bipolar disorder?

People with bipolar disorder experience extreme variations in mood and energy levels, which can include extreme highs, lows or ‘mixed’ states.

People with bipolar disorder have problems with their moods, experiencing extreme highs and lows. If you have bipolar disorder, you will experience periods or ‘episodes’ of highs known as mania or hypomania and usually, periods of depression.

You may also have problems with thinking and perception, which can include symptoms of psychosis. This can include thinking things that are not true (delusions) and seeing or hearing things that are not there (hallucinations).

Research suggests that bipolar disorder runs in families, and genes can influence whether someone develops the illness.

We also know that the brain systems involved in controlling our moods work differently in people with bipolar disorder.

Factors such as life stress, lack of sleep and recreational drugs can trigger mood episodes.

Bipolar disorder can cause a great deal of distress, but there is a lot that can be done to stay as well This includes lifestyle changes, medication and talking treatments.

If you have bipolar disorder, you will experience periods or ‘episodes’ of highs known as mania or hypomania and usually, periods of depression.

Some may also have problems with thinking and perception, which can include symptoms of psychosis.

This can include thinking things that are not true (called delusions) and seeing or hearing things that are not there (called hallucinations).

Bipolar disorder can cause many difficulties but there is a lot that can be done to stay well. This includes lifestyle changes, medication and talking treatments.

We are still learning about what causes bipolar disorder. Research suggests genetics play a role in whether someone develops the illness. We also know the brain systems involved in controlling our moods work differently in people with bipolar disorder.

Other factors can increase the risk of developing bipolar disorder such as trauma and use of recreational drugs.

For some people with bipolar disorder there are triggers for their mood episodes. Life stress or use of recreational drugs can trigger mood episodes. Change in usual sleep patterns could be a trigger or indicator of a mood episode.

Getting support

If you think you might have bipolar disorder you should first see your GP who will perform an initial assessment.

Depending upon the outcome of this, your GP will decide whether you need a referral to a primary care mental health worker, your local community mental health team (CMHT) or another service, depending on your needs.

If you are referred to your local CMHT you will receive a further detailed assessment, and they will work with you to plan the right treatments for you.

Treatments

For many people with bipolar disorder medication is a key part of staying well. There are many medications that can help.

Some work by preventing the extreme highs or lows caused by the condition; these are known as mood stabilisers and often need to be taken daily for long periods.

Other medications may then be used to treat episodes of high or low moods when they happen.

Different medications suit different people, and finding the best medication for an individual can take time, and trials of different medications and doses.

Talking treatments such as psychoeducation can also be helpful. This approach helps people to understand their illness, learn to recognise early warning signs of highs and lows and develop the skills needed to stay as well as possible.

Bipolar Education Programme Cymru, also known as BEPCymru, is one example.

A combination of medication and psychoeducation is often most effective.

Tips for people with bipolar disorder

  • The key things that are known to help in bipolar disorder are medications, education and following lifestyle recommendations with a focus on maintaining routine and balance.
  • It is crucial to take medication regularly as prescribed stopping and starting suddenly can make things worse.
  • There are many medications for bipolar and finding the one that works the best for you can take time.
  • Learn as much as you can about the condition and how to stay well. There are many bipolar disorder websites, self-help books and education groups.
  • Look after your physical health as well as your mental health. Sticking to a regular and sufficient sleep routine, eating healthily, avoiding recreational drugs and moderating your alcohol consumption can all help you to avoid becoming unwell.
  • Even if you are well now, you may have more episodes if low or high mood in the future. Try to have a plan in place in case you become unwell again. Find advice on advance decision making.
  • Talk to other people who have bipolar disorder. Their knowledge and experience can be helpful. Organisations such as Bipolar UK can help you to do this.

Tips for families, parents and carers

  • A loved one with bipolar disorder may need your help to stay well. Try to be open and understanding about their condition.
  • Ask them about their concerns and how you can help.
  • Talk to the mental health professionals who are looking after them. Don’t be afraid to ask questions and for advice.
  • Don’t assume that every small mood change or disagreement is related to the illness.
  • Have a plan for what to do if your relative becomes unwell in the future.
  • Learn as much as you can about bipolar disorder and possible treatments. There are useful links included in this leaflet and on ncmh.info, including a list of books on the subject.
  • Talk to others who care for people with bipolar disorder. They may have experienced similar situations and have useful tips. Organisations like Bipolar UK can help you to do this.

Our work with the Brain and Genomics Hub

We are working with the Brain and Genomics Hub to build a community of 600 people with lived experience of bipolar disorder.

The Brain and Genomics Hub is one of six new research hubs that make up the Mental Health Research Platform funded by UKRI.

The platform was established to accelerate progress towards new and more effective treatments for serious mental illness.

The Bipolar, Schizophrenia and Psychosis Research Initiative (B-Sprint) study from the Brain and Genomics Hub aims to go beyond diagnostic boundaries, to help identify ways to develop more targeted treatment approaches for people living with these conditions, and to improve how they are diagnosed.

Find out more about the B-Sprint study.

Resources

Piece of Mind podcast: Have your voice heard in mental healthcare decisions

Advance choice documents (ACDs) give people living with mental illnesses an opportunity to state their wishes and instructions about their treatment and care during future episodes of illness.

We chatted with Professor Tania Gergel about her work to raise awareness of this vital tool for people with severe mental illness.

Bipolar Education Programme Cymru (BEPC)

Bipolar Education Programme Cymru (BEPC) is a group educational programme which aims to improve participants’ understanding of bipolar disorder and also aims to provide benefits in terms of quality of life and experience of symptoms.

Find out more about BEPC and how to access it.

Websites