Bipolar disorder: Bipolar Affective disorder; Manic depression

Bipolar Affective disorder is a mental health disorder that affects men and women equally. It usually first develops between the ages of eighteen to twenty-four. The disorder is characterised by mood swings between mania (feeling of elation or euphoria) and depression. Where the manic aspect of Bipolar Affective disorder is milder and no admission to hospital is necessary, it is called Hypomania. There are usually periods of stable mood between episodes of Bipolar Affective disorder but in the 'rapid cycling' form of the disorder there may be few or no periods of stability between episodes. Occasionally, 'mixed' episodes occur, when symptoms of mania and depression can be observed at the same time.

The cause of Bipolar Affective disorder is not known but it is thought that genetic and environmental factors are involved. Stress factors may play a part in the further onset of the disorder in previously diagnosed individuals.

Periods of mania may develop quite rapidly over a period of a few days and last for a week or longer. Aspects of mania may include a number (usually three or four) of the following:

• Unreal ideas of an individual's importance;
• Need for less sleep than normal;
• Heightened energy;
• Increased talkativeness;
• Unrealistic new activities;
• Inappropriate behaviour;
• Distracted and agitated behaviour;
• Mood change affecting personal and work life;
• Risky behaviour leading to financial difficulties;
• Possible alcohol and drug related misuse.

In Bipolar Affective disorder the depressive period lasts for at least two weeks and includes at least five of the following:

• Constant low mood for most of the day and nearly every day;
• Sleep disturbance;
• Weeping and extreme sadness;
• Tiredness and lack of energy;
• Lack of interest in most activities;
• Inability to concentrate;
• Feelings of guilt, worthlessness and suicide;
• Appetite changes;
• Problems in affection and personal relationships.

A diagnosis of Bipolar Affective disorder type I describes an illness with one or more manic episodes or mixed episodes. Individuals often have one or more major depressive episodes.

Bipolar Affective disorder type II is characterised by the occurrence of one or more major depressive episodes accompanied by at least one hypomanic episode.

Treatment with medication is either preventative or symptomatic (treating episodes of mania and depression when they occur). Medication is usually with mood stabilising drugs such as Lithium which may also be taken in combination with other tranquilising or sedating drugs. Lithium can be taken as a long term preventative measure or a symptomatic medication.

Inheritance patterns
It is thought that an individual's genetic make up might be involved as there is a higher than average change of developing the condition if other members of the family are affected.

Prenatal diagnosis
None.

Medical text written May 2005 by Contact a Family. Approved May 2005 by Professor K Ebmeier, Professor of Psychiatry, University of Edinburgh, Edinburgh, UK and Chair, Bipolar Guideline Group, Scottish Intercollegiate Guidelines Network.

Further Online Resources
Medical texts in The Contact a Family Directory are designed to give a short, clear description of specific conditions and rare disorders. More extensive information on this condition can be found on a range of reliable, validated web sites and links to them are included in the CD-ROM version of this Directory. Further information on these resources can be found in our Medical Information on the Internet article.

MDF - THE BIPOLAR ORGANISATION

MDF - The Bipolar Organisation
Castle Works
21 St. George's Road
London SE1 6ES
Tel: 08456 340 540
Fax: 020 7793 2639
e-mail: mdf@mdf.org.uk
Web: http://www.mdf.org.uk

MDF is a National Registered Charity No. 293340, established in 1983. It is a national, user-led organisation which works to enable people affected by manic depression/bipolar disorder to take control of their lives. Services include: a network of self help groups for people with manic depression/bipolar disorder, their relatives and friends; a quarterly journal, Pendulum; publications and research papers; Self Management training programme; employment advice; travel insurance scheme; 24 hour Legal Advice Line; life assurance scheme; STEADY (the young person's self management programme); and bulletin boards and chat rooms. MDF aims to educate the public and professionals about manic depression and campaigns for greater research into methods of treatment.

Group details last confirmed February 2008.