Bipolar disorder is the term used to describe mental health conditions characterized by both emotional highs and lows.
Although most of us will experience mood swings, those affected by bipolar can experience extreme forms of these feeling. There can be days or weeks of feeling depressed, and then a period of time of mania or euphoria.
The feelings can be overpowering for those affected, impacting greatly on their lives and relationships.
In the UK, around one in 100 people are diagnosed with bipolar disorder (formerly called manic depression).
The causes are unknown, but it could be influenced by chemical imbalances in the brain, genetics, childhood trauma or periods of extreme mental distress.
Bipolar disorder is further divided into different types – commonly types I and II.
Bipolar I tends to be characterized by at least on bout of mania that last for a week or more, which may or may not be accompanied by depression.
Type II is when a person experiences a major depressive episode (for at least a couple of weeks), followed by some days of milder mania (called hypomania). However, everyone’s experience of bipolar will be unique, and there is no typical experience.
Most of us know what constitutes depression, but the concept of mania can be harder to comprehend.
Mania can include inflated self-esteem or grandiosity; bouts of energy and over-activity, uncontrollable excitability and easy distractibility, and being more talkative than usual.
Mania can lapse over into more uninhibited risk-taking, aggression or psychosis.
Erratic behavior, such as splashing out lots of money on things you don’t really want, can also be on the spectrum of mania. You may say or do things that are inappropriate or out of character.
Hypomania is a less extreme form of mania. It can include the same feelings of over-confidence, euphoria, loss of social inhibitions and increased excitability, but tends to last for a shorter time.
It is these periods of mania and hypomania that differentiates bipolar from manic depression. However, the depression experienced with bipolar disorder will be similar – periods of feeling low, worthless, tearful, tired and lethargic.
For this reason, people are sometimes diagnosed with depression before later receiving a bipolar diagnosis.
‘Being bipolar can be an all-consuming challenge’
The late Carrie Fisher was a high-profile bipolar sufferer. In her 2008 book she explained why she felt moved to speak about the condition.
‘One of the things that baffles me (and there are quite a few) is how there can be so much lingering stigma with regards to mental illness, specifically bipolar disorder.
‘In my opinion, living with manic depression takes a tremendous amount of balls. Not unlike a tour of Afghanistan (though the bombs and bullets, in this case, come from the inside).
‘At times, being bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of. They should issue medals along with the steady stream of medication.’
‘Massive highs and miserable lows’
Another mental health advocate to live with the condition is the gay actor and broadcaster Stephen Fry. Diagnosed with the condition at the age of 37, he says the news provided some initial relief.
‘I’d never heard the word before, but for the first time I had a diagnosis that explains the massive highs and miserable lows I’ve lived with all my life.
‘That’s when I thought that everything would be OK, because I’d named the beast, I’d faced it. I was kidding myself.’
He says that living with bipolar continues to be a struggle, but he receiving treatment has helped him.
If you think you are experiencing the symptoms of bipolar disorder, there are many organizations that can offer advice. Speak to a medical practitioner or mental health services for support.
Treatment will often involved medication, such as mood stabilizers. It can also involve therapy and counseling to help you understand your condition and the associated highs and lows.
Health experts can also offer lifestyle advice, concerning exercise, stress management and getting enough sleep, and what to do when you recognize a depressive or manic episode starting.
Bipolar disorder will often combine different treatments to manage their condition.
LGBTI and bipolar
Although there is no known direct link between bipolar and being LGBTI, the impact of prejudice or discrimination can increase stress and symptoms.
Ash Rehn, a gay counselor and therapist in Sydney, Australia, points out, ‘Because we want people to accept us, we might find ourselves in the position of trying to please others. Trying to meet others expectations and sensing their judgment can put pressure on mood, so bipolar people need to take extra care of themselves.’
Organizations that can offer further information include:
If you are struggling with depression or contemplating suicide or self-harm, contact these helplines for help and support.