What is bipolar affective disorder?
Symptoms and treatment of bi-polar affective disorder
Bipolar affective disorder is also known as manic depression or bipolar depression. In its most typical form, the patient experiences uncontrollable mood swings, cycling between a ‘manic’ or ‘euphoric’ state and a depressed state.
While it’s often difficult to diagnose, bipolar affective disorder can be successfully controlled with medication and psychotherapy. In some cases, an initial period of hospitalisation may be required.
Symptoms of bi-polar affective disorder
Bi-polar depression actually describes a spectrum of disorders and the symptoms can be very different from one person to another. The frequency, duration and severity of the manic and depressed episodes can vary enormously – and different people may be either more ‘manic’ or more ‘depressive’.
Bipolar I disorder is characterised by severe manic episodes which may include psychotic or delusional behaviour. This disorder may or may not include depressive episodes.
Bipolar II disorder is characterised by severe depressive episodes – which may include suicidal feelings – as well as mildly manic episodes known as hypomania. Because it’s so hard to tell hypomania apart from simple happiness, this disorder can easily be diagnosed as clinical depression.
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Cyclothymia is a mild form of bipolar disorder, characterised by periods of hypomania (low-level mania) and mild depression. While cyclothymia does interfere with normal life, family and friends are likely to see the symptoms simply as part of the sufferer’s personality.
Bipolar Disorder NOS stands for Not Otherwise Specified and is a catchall category for bipolar disorders that don’t fit a specific subtype.
What are the causes of bipolar affective disorder?
Twin studies suggest a possible genetic cause of bipolar disorder, but it’s not understood how this works. But it seems that, if one is genetically predisposed to bipolar, a series of high-stress events such as childhood traumas, including abuse, make it more likely that symptoms will occur.
The actual symptoms seem to be chemically based. The classic mood cycles are caused by neurons (the brain’s messengers) being fired at a higher or lower rate than normal. However, less severe symptoms have more complex physical and chemical causes.
Diagnosing bipolar affective disorder
Unfortunately there is no physical test for bipolar. But because any single symptom of bipolar disorder could have an alternative cause, it’s important to rule these out. So testing for physical conditions such as thyroid problems, STDs and epilepsy may be carried out, and other mental disorders such as schizophrenia and drug-induced psychosis may be considered.
In the end, diagnosis usually requires a reported history of behaviour, ideally from the patient but also from a family member, friend, co-worker, nurse, social worker or clinician.
The importance of a professional diagnosis
Someone experiencing a severe manic phase is unlikely to be objective about their condition – they may be delusional or may see their state as being highly creative and productive. Non-specialists may also wrongly diagnose clinical depression if the ‘manic’ episodes aren’t that different from a normal state of happiness.
This is why an experienced specialist is so important to eliminate other possible conditions by getting the full picture from both the sufferer and other people involved.
Treatment of bipolar affective disorder
Hospitalisation may be required at first, especially if it’s necessary to control extreme manic behaviour, after which drop-in support or home visits will be required until the patient’s condition and medication regime is stabilised.
While the mood stabiliser, lithium, is the ‘gold standard’ of bipolar treatment, other drugs may be prescribed either as an alternative or as a complement to lithium. However, antidepressants are usually not prescribed for bipolar disorder.
Cognitive behavioural therapy, family-focused therapy and psychoeducation are all useful to help the patient deal with stress and negative emotions that may trigger bipolar episodes, and also to foster trust between the sufferer and their family.
How Clinical Partners can help
At Clinical Partners we offer confidential assessment, diagnosis and treatment for the whole depression spectrum. Simply call our clinical team in confidence on 0203 326 9160 and we will recommend the most suitable therapist for your needs. Read more about Bipolar and our treatment services.