Bipolar Disorder

Bipolar disorder is a mental health condition characterised by episodes of significantly elevated or irritable mood (mania or hypomania) alternating with episodes of depression. It is a lifelong condition that can be effectively managed with appropriate treatment.

• Manic or hypomanic episodes: elevated or irritable mood, decreased need for sleep, increased energy or activity, rapid speech, racing thoughts, and impulsive or risky behaviour
• Depressive episodes: persistent low mood, loss of interest in activities, fatigue, and changes in sleep or appetite, similar to major depression
• Episodes can vary in length and severity, with periods of relatively stable mood in between
• Severe manic episodes can include loss of touch with reality (psychosis) in some cases

• Believed to result from a combination of genetic, biological, and environmental factors affecting brain chemistry and function.
• Family history of bipolar disorder or other mood disorders increases risk.
• Episodes can be triggered or worsened by significant stress, sleep disruption, or substance use, though the underlying condition is not caused by these factors alone.

• Diagnosed through a detailed clinical history, including a careful assessment for past episodes of both elevated and depressed mood, ideally with input from family or close contacts who may have observed earlier episodes.
• It is important to distinguish bipolar disorder from other conditions, such as depression alone, since treatment approaches differ significantly.
• Assessment of current risk, including any thoughts of self-harm, is an essential part of every evaluation.

Mood-stabilising medicine is the cornerstone of long-term treatment, used to reduce the frequency and severity of both manic and depressive episodes, and is generally needed on an ongoing basis even between episodes.

Acute manic episodes, particularly severe ones, often require closer monitoring or hospital-level care, alongside medicine to bring the episode under control.

Depressive episodes in bipolar disorder are treated carefully, since some antidepressant medicines can trigger a manic episode if not used alongside a mood stabiliser.

Psychosocial support, including psychoeducation for the individual and family, helps with recognising early warning signs of an episode and supports long-term stability.

Regular follow-up and consistent medicine adherence are essential for long-term stability, as untreated bipolar disorder tends to have a relapsing course.

• Take mood-stabilising medicine consistently, even during periods of feeling well, and avoid stopping it without medical guidance.
• Maintain a regular sleep schedule, as sleep disruption can trigger episodes.
• Learn to recognise personal early warning signs of an emerging manic or depressive episode.
• Build a support network of family, friends, and health workers who can help identify early changes.
• Seek urgent support for any thoughts of self-harm, and encourage the same in a loved one showing these signs.