From the Guidelines
Bipolar disorder is a complex mental health condition characterized by extreme mood swings, including manic and depressive episodes, that can significantly impact an individual's daily life and relationships.
Key Characteristics of Bipolar Disorder
- Mood swings: Bipolar disorder is marked by periods of mania or hypomania, which can include symptoms such as elevated mood, increased energy, and decreased need for sleep, as well as periods of depression, which can include symptoms such as low mood, loss of interest in activities, and changes in appetite or sleep patterns 1.
- Impact on daily life: Bipolar disorder can affect an individual's ability to function in daily life, including their relationships, work or school performance, and overall well-being 1.
- Comorbid conditions: Bipolar disorder often co-occurs with other mental health conditions, such as anxiety disorders, substance abuse disorders, and attention-deficit/hyperactivity disorder (ADHD) 1.
Treatment of Bipolar Disorder
- Medications: Traditional mood stabilizers, such as lithium and valproate, and atypical antipsychotic medications are commonly used to treat bipolar disorder, although the evidence for their effectiveness in children and adolescents is limited 1.
- Psychotherapy: Psychotherapies, such as cognitive-behavioral therapy and family-focused therapy, can be effective in helping individuals with bipolar disorder manage their symptoms and improve their functioning 1.
- Combination therapy: A combination of medications and psychotherapy is often the most effective treatment approach for bipolar disorder, as it can help individuals manage their symptoms and improve their overall quality of life 1.
From the Research
Definition and Characteristics of Bipolar Disorder
- Bipolar disorders are recurrent and sometimes chronic disorders of mood that affect around 2% of the world's population, encompassing a spectrum between severe elevated and excitable mood states (mania) to the dysphoria, low energy, and despondency of depressive episodes 2.
- Bipolar disorders are characterized by alternating episodes of mania or hypomania and depression, or mixtures of manic and depressive features 3.
- The illness commonly starts in young adults and is a leading cause of disability and premature mortality 2.
Types of Bipolar Disorder
- Bipolar I disorder is defined by the presence of a syndromal, manic episode, while bipolar II disorder is defined by the presence of a syndromal, hypomanic episode and a major depressive episode 4.
- Bipolar disorders can be markedly varied between and within individuals across their lifespan, making early diagnosis challenging and misdiagnoses frequent 2.
Prevalence and Impact
- Bipolar disorders substantially reduce psychosocial functioning and are associated with a loss of approximately 10-20 potential years of life 4.
- The mortality gap between populations with bipolar disorders and the general population is principally a result of excess deaths from cardiovascular disease and suicide 4.
- Bipolar disorders are leading causes of disability in young people, leading to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease 5, 6.
Diagnosis and Treatment
- Early and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression 5, 6.
- Careful clinical assessment remains the cornerstone of diagnosis, with the detection of hypomanic symptoms and longitudinal clinical assessment crucial to differentiate a bipolar disorder from other conditions 5, 6.
- Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary 5.
- Lithium is the gold standard mood-stabilising agent for the treatment of people with bipolar disorders, and has antimanic, antidepressant, and anti-suicide effects 4.