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Bipolar disorder

About bipolar disorder

What is bipolar disorder?

Bipolar disorder is a mental illness that affects a person’s mood and energy levels.

Everyone has highs and lows, but people with bipolar have extreme ups and downs in mood. These mood changes can be distressing for them and other people. They can affect how they live their life, and even put them in risky situations. Between these mood swings, however, they feel and act normally.

People with bipolar disorder have times when their highs are extreme and they have too much energy. These highs are called ‘mania’ when severe, or ‘hypomania’ when less severe.

Most people with bipolar disorder also have times when they feel extremely down. They can feel hopeless, helpless or empty. This is called bipolar depression.

In the past, bipolar disorder was called ‘manic depression’.

Bipolar disorder is a lifelong condition, but with the right treatment the symptoms can be well controlled.

Types of bipolar disorder

There are two types of bipolar disorder: bipolar I disorder (bipolar one disorder) and bipolar II disorder (bipolar two disorder).

People with bipolar I disorder have mania, and most also have depression.

People with bipolar II disorder have hypomania and depression.

Doctors use these categories to help them choose the right treatment.

Symptoms of bipolar disorder

People with bipolar disorder have extreme highs (mania or hypomania) and most also have lows (bipolar depression).

Different people have these in different combinations. For example, people can have:

  • mostly mania/hypomania
  • mostly depression
  • depression followed by mania/hypomania
  • features of both at the same time (this is called 'mixed states').

Between these mood swings, however, they feel and act normally.

People with bipolar disorder usually have depression for much more of the time than they have mania or hypomania.

Bipolar is different for everyone, but a common pattern is that someone will have at least one episode of bipolar symptoms every few years, with each episode lasting for a few months.

Some people have 'rapid cycling' bipolar, which means they have at least 4 episodes per year.   

Mania and hypomania - symptoms
Depression - symptoms

What causes bipolar disorder?

There is no single cause of bipolar disorder. It can be caused by different things in different people.

We know that bipolar disorder changes how the brain works, and this causes symptoms of mental illness.

Some things that make it more likely that someone will develop bipolar disorder are:

  • having particular genes
  • stress while a child or teenager (e.g. trauma or illness)
  • using drugs.

There is still a lot about the causes of bipolar disorder that isn't yet well understood.

When someone already has bipolar disorder, their symptoms can be brought on by stress.

Who gets bipolar disorder?

Around 1 in every 100 people will have bipolar disorder (I or II) during their life.

It is seen in males and females, and in all countries and cultures.

For people with bipolar I, symptoms usually begin during their late teens, with depression.

For bipolar II, symptoms tend to start later, when the person is in their late 20s.

Getting help for bipolar disorder

Early medical care is vital to a good recovery. The sooner you get help, the more chance you have of getting the correct diagnosis and getting effective treatment and help to manage your problems.

Where to get help – Australia

  • Your GP (family doctor) – a GP can refer you to a public mental health service or a private psychiatrist, psychologist or private hospital clinic.
  • headspace – Australia’s National Youth Mental Health Foundation.
  • Your local mental health service – Assessment and treatment at public mental health centres is free.

Where to get help – New Zealand

  • Your GP (family doctor) – a GP can refer you to a public mental health service or a private psychiatrist, psychologist or private hospital clinic.
  • Your District Health Board.

More about first steps for getting help

How is bipolar disorder diagnosed?

Bipolar disorder is diagnosed based on a person’s symptoms and behaviour.

The diagnosis is usually made by a psychiatrist. Some GPs and clinical psychologists can also diagnose bipolar disorder.

To make a diagnosis, a doctor needs to spend time with the person so they can understand them and their symptoms. The doctor may not make a diagnosis right away. Sometimes they might want to see how the person goes over time, before making a diagnosis.

A medical check-up and tests are needed to make sure the symptoms are not caused by other medical conditions.

How is bipolar disorder treated?

Treatments for bipolar disorder include:

  • medications for mania, hypomania and depression
  • medication to stop symptoms returning
  • psychological treatments (talking therapies).

In some circumstances, electroconvulsive therapy (ECT) might be recommended.

You and your health-care team will work together to find the treatment that works best for you.

More about treatment of bipolar disorder

Recovery from bipolar disorder

Over time, a person with bipolar disorder can get to know their symptoms better, and learn how to stay well.

While there is no cure for bipolar disorder, it can be treated effectively with medication and psychological treatment and the symptoms can be well controlled. This means many people with bipolar disorder can live full lives. Many people with bipolar disorder have responsible jobs and successful careers.

Remember

  • People with bipolar disorder have unusual ups and downs in mood and energy, which can be extreme.
  • Treatments for bipolar disorder include medications, psychological treatment (talking therapy) and sometimes electroconvulsive therapy (ECT).
  • Bipolar disorder is a lifelong condition, but the symptoms can be well controlled. Most people with bipolar disorder live full, normal lives.
Last reviewed April 2017 © RANZCP | C1034V1

This is a general guide only, and does not replace individual medical advice. Please speak to your doctor for advice about your situation. The RANZCP is not liable for any consequences arising from relying on this information. Subject matter experts, people with lived experience of mental illness and carers all contributed to this fact sheet.