Insight into bipolar disorder

What is bipolar disorder?

Bipolar disorder is a disorder of mood. About one person in 100 is affected by manic depression. It can cause excessive swings of mood from extreme depression (a 'low') to elation and hyperactivity (a 'high' or hypomain). Mania is a severe 'high'. The moods associated with manic depression are much more pronounced than everyday ups and downs. No two people have exactly the same pattern of highs and lows and they do not necessary alternate between them.

For example, you can have several highs in a row. Some people may move from a high to a low very quickly (rapid cycling). The causes of bipolar disorder are not fully known. It is suggested there is a genetic component. There may also be biochemical factors and environmental causes. The good news is that mood disorders are among the most responsive to treatment.

What are the signs?

The condition can vary considerably between people. Common symptoms of low mood are the same as for depression in general:

• Disturbed sleep and tiredness
• Changes to appetite and weight
• Lack of concentration
• Morbid sadness, possibly with thoughts of self-harm or suicide
• Loss of confidence and selfnesteem
• Lack of energy or motivation, which may interfere with work or everyday activities

In a high, symptoms may be:

• Elevated mood, hyperactivity and irritability
• Inflated self-esteem, perhaps with delusions of being a special person
• Poor judgement, possibly including irrational spending or unwise relationships
• A sense that life has special meaning

The danger with a high is that you may not realise you are unwell until the symptoms become severe. It is possible to have high and low symptoms at the same time. This is called a 'mixed state'.

What next?

A range of support is available. Different resources may help you.

Medication
The majority of people with bipolar disorder are likely to need medication. Mood stabilisers, such as Lithium, Carbamazepine and Sodium Valproate are commonly prescribed. Anti-depressants (to control a low) and anti-psychotics (to control a high) are also often used where needed. Like all medicines, these may cause unwanted side effects. Your doctor or pharmacist can discuss this with you.

Self-help
There are a number of ways you can help yourself. You may find it helpful to:

• Keep a daily record of your feelings
• Learn to recognise early warning signs
• Talk to people - if you feel you cannot speak to those close to you, call a helpline or attend a self-help group. It may help to talk to others in the same situation as you
• Write down your preferences for future care and treatment and share this with others so they know how to help you.

Talking or psychological therapies
These involve talking and listening with a trained therapist, who will not judge you. They may be beneficial in helping you to understand and manage bipolar disorder, but for some people they arouse unpleasant emotions. This can be difficult to cope with. Your doctor can discuss this with you.

Complementary or alternative therapies
These cover a range of treatments. Many people with bipolar disorder have found therapies such as yoga, aromatherapy and massage helpful. However, any activity that relaxes you and makes you feel good about yourself can be beneficial. It is important you discuss complementary treatments with your doctor prior to use and that you advise him/her of the results.

Further help

NHS Cambridgeshire & Peterborough Talking Therapies
If you are registered with a GP in Peterborough, Cambridgeshire, Huntingdon or Fenland, you can access this service via self-referral or through your GP. Call 0300 300 0055. Lines are open from 9am to 5pm, Monday to Friday, excluding Bank Holidays. it offers a range of support to help you make changes in your life to improve your wellbeing and to help you cope with stress, anxiety and depression. This includes self-help reading materials, guided self-help (both over the telephone and face-to-face), one-to-one therapies.
To self-refer or for more information about the service, please see our webpage:   NHS Cambridgeshire & Peterborough Talking Therapies

First Response Service
If you or a loved one is in mental health crisis, you can call our 24-hour First Response Service on 111 (option 2). This service is for anyone, of any age, living in Cambridgeshire and Peterborough. Specially-trained mental health staff will speak to you and discuss with you your mental health care needs.
More information about getting help in a crisis is available on this webpage:  https://www.cpft.nhs.uk/helpinacrisis

The Samaritans
Dial 116 123 (24 hours a day, 7 days a week - free from any phone)
More information about the Samaritans can be found on its website here:  https://www.samaritans.org/

SANE
0300 304 7000 (lines open 6pm – 11pm, 365 days a year)
More information about SANE can be found on its website here: http://www.sane.org.uk/

Mind 
More information about anxiety can be found on Mind's website here: https://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/about-bipolar-disorder/

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