Bipolar Disorder

Bipolar disorder is characterised by recurrent manic or mixed episodes and usually depressive episodes as well. Mixed episodes may be difficult to diagnose, but include the simultaneous and/or rapidly alternating presence of symptoms of depression and mania. The most common picture of bipolar disorder involves repeated episodes of mania or depression, usually separated by periods of complete remission.

The key features of mania are outlined below:

  • Elevated mood (sometimes accompanied by irritability)
  • Grandiose ideas and inflated self esteem
  • Increased energy and activity
  • Racing thoughts
  • Rapid, pressured speech which may be unintelligible
  • Enhanced libido often leading to disinhibition and inappropriate sexual activity
  • Impaired judgement and impulsive behaviour including gross overspending
  • Decreased need for sleep
  • Increased creativity
  • Increased sociability
  • Impaired concentration and attention
  • Psychotic symptoms such as delusions or hallucinations

During the manic episode, judgement is impaired causing disruption in social and occupational functioning. Not only is the individual at risk of ruining his or her reputation with inappropriate and often bizarre behaviour; but he or she is also at risk of causing serious financial, legal, or physical harm. Insight into the illness may be poor thus making it difficult for the individual to accept the need for treatment.

(Ref: Management of Mental Disorders, World Health Organisation Collaborating Centre)