Bipolar Disorder

All of us experience lows and highs in life including some awesome days full of great memories as well as days that do not go well at all. Most days probably sit somewhere in between. Bipolar disorder is when a person experiences massive mood swings beyond what is normally expected. If you experience such mood swings, you are not the only one. Nearly one in every 55 Australians has bipolar disorder, according to a national survey . Mood swings in bipolar disorder typically include high episodes (i.e. periods of feeling exceptionally high), depressive episodes (i.e. periods of getting deeply depressed), and sometimes a mixture of both. This last one is called a mixed episode. To understand bipolar disorder, we should first know a bit more about these episodes. See the next couple of paragraphs.

High episodes may last from a few days to a few months during which you feel pumped-up, get unusually optimistic, become overactive, get very sociable, and don't need to sleep as such. It sounds great so far, but unfortunately, extreme highs can create significant problems. For example, a person may become careless due to overconfidence and over-optimism; may make rush decisions; may overspend money; drive recklessly; party a lot; and get into improper relationships. This may lead to massive debt, business failure, traffic offences, family problems, or unlawful behaviour. People with an elevated mood may become very opinionated; may not stand any objection; and therefore, get into frequent arguments with others. This may put the person and others at risk. High episodes are subdivided further into manic and hypomanic episodes. I will explain this a bit more later. 

There is also a flip side to high periods. People can rarely maintain a high mood for long. They eventually get mentally and physically exhausted; and slide down to deep depression that can last for many months. Depressive episodes are not any better. A depressed person usually feels unmotivated, tired, or absent-minded. They may miss work, withdraw from others, and leave tasks to pile up. Sometimes a depressed person may grow serious suicidal thoughts. Finally, people with bipolar illness may go through a mixed episode which includes a mixture of high and depressive symptoms at the same time. For example, depressed mood along with over-activity and restlessness.

Bipolar disorder can include any possible sequences of the above mood episodes. However, they are generally classified based on the severity of high episodes. The most severe form is bipolar one disorder. This includes manic episodes which are the most severe high episodes that you can get. Some people with manic episodes become delusional; and come to believe that they are truly special and have exceptional talents or powers. Their thoughts and speech become very fast and sometimes pretty jumbled. They typically tend to make rush decisions with grim consequences, or to get irritable and aggressive easily. People with manic episodes put themselves and others at great risk, and usually require hospitalisation.


Then, there is bipolar two disorder which is a milder form than bipolar one. In this disorder, high episodes are not as extreme as manic episodes and therefore, are referred to as hypomanic episodes. People with hypomanic episodes are typically euphoric, super-confident, energetic, talkative, irritable, and distractible. However, they do not get delusional and can be talked down. Their behaviour is typically not so concerning to warrant admission to hospital. Finally, cyclothymic disorder is the mildest form of all. Here, mood elevation and depression happen frequently but never reach the magnitude of bipolar one or two disorders.

Bipolar disorders are treatable. Please read Self-Help and Treatment

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You can read more about bipolar disorders at RANZCP.