While everyone experiences fluctuations in mood, the episodes of high and low mood experienced in bipolar disorder significantly impact on the person’s relationships, work or education, and day-to-day life.
Bipolar disorder can look quite different in different people. For some people, episodes can last for three to six months and occur every few years while others may experience shorter but more frequent episodes over the course of one year.
In Australia, approximately 1.3% of the population has a form of bipolar disorder. Symptoms usually start in early adulthood and for most people, the disorder is a lifelong diagnosis; however, with appropriate treatment and support, bipolar disorder symptoms can be well managed and individuals are able to maintain a good quality of life.
There are a number of bipolar and related disorders.
Bipolar I disorder
Bipolar I disorder is characterised by one or more manic episodes (which last at least one week). Episodes of either depression or hypomania may also occur prior to or following a manic episode. Due to the severe nature of these symptoms, people with bipolar I disorder may require hospitalisation during an episode.
Bipolar II disorder
Bipolar II disorder is characterised by both hypomanic and depressive episodes but unlike bipolar I disorder, no manic episodes are experienced. Hypomania represents a change to the person’s usual functioning (noticeable by others) but is not, by definition, associated with impairment. Although bipolar II disorder is less severe than bipolar I disorder in terms of symptoms, it can be more chronic as depressive symptoms are often more frequent and longer-lasting.
Cyclothymic disorder is characterised by persistent and unpredictable changes in mood but without the extreme highs and lows of bipolar I and II disorder, with episodes of shorter duration.
Bipolar disorder is characterised by episodes of mania or hypomania and episodes of depression.
Mania and hypomania
Mania and hypomania are unusual and persistent periods of elevated mood (‘highs’) and increased activity or energy which may also involve:
The core features of mania and hypomania are almost identical. However, manic episodes are more severe and last longer (episodes last at least seven days), cause severe problems in the person’s relationships or work life, can lead to highly risky behaviours, and may involve psychotic experiences such as delusions and hallucinations. Due to the risks associated with a manic episode, hospitalisation is often necessary.
Hypomania is described as a milder form of mania as it is shorter in duration (at least four days), there are no psychotic features, and the severity of symptoms does not require hospitalisation.
Depressive episodes are characterised by one or both of the following:
These symptoms are experienced most of the time for at least two weeks, along with several other symptoms over the same period that include:
The psychologist takes time to develop an understanding of the potential factors relevant to understanding the client’s symptoms and concerns.
Treatment involves addressing lifestyle factors and coping skills which may increase the person’s capacity to better manage difficulties, take their medications as prescribed, reduce their symptoms and their impact and improve quality of life. The psychologist may also suggest involving a supportive family member or friend to assist in the understanding of the person’s situation and to support treatment.
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