What is bipolar disorder?
Bipolar disorder is a potentially serious psychiatric disorder, characterised by mania (a dramatic elevation in mood and energy) that is often followed by depression (which can last weeks, months or occasionally even years).
What is mania and hypomania?
Mania is a dramatic elevation in mood and energy. The intensity of mania can vary from mild (hypomania) to severe (mania).
Mania can lead to hospitalisations and sometimes includes psychotic symptoms, such as delusions and paranoia. However, less severe or ‘mild mania,’ termed hypomania, often doesn’t lead people to seek help. In fact, someone experiencing hypomania is unlikely to feel they need help at all - after all, who would think to seek help for high confidence, a mind bursting with fresh ideas and endless energy?
While hypomania can only sometimes be problematic enough for someone to seek professional assistance, it is often accompanied by its far more troubling cousin: depression. It is common that during these depressive episodes, people look towards seeking professional help, and the bipolar disorder is finally brought to light.
The mania and hypomania aspect of bipolar disorder is often accompanied by:
- Lesser need for sleep or an inability to sleep (insomnia)
- Racing mind
- Feeling as if you have consumed too much caffeine or taken an illicit substance, such as cocaine
- Extreme self-confidence and self-belief that is out of the ordinary
- Lack of control or a fear of losing control
- High creative output
- Being extremely talkative, often feeling unable to stop chatting
- Dramatically increased sex drive
- Behaving recklessly
- Having extravagant ideas that are unrealistic
- Behaving impulsively, for example booking a plane ticket last minute in search of an adventure
- Disregard for one’s safety, perhaps engaging in risky or irresponsible activities, such as gambling, spending sprees or unsafe sex
- Anxiety
- Delusions
- Hallucinations
- Paranoia
Bipolar disorder can come in many forms, and symptoms can vary substantially between people. Bipolar disorder is surprisingly common, with 2 in every 100 people diagnosed with the condition. You might even be familiar with some of the highly successful people known to have been diagnosed with bipolar, such as Kanye West, Stephen Fry, Mel Gibson, Frank Sinatra, Russel Brand, Mariah Carey, Selena Gomez, Sinéad O'Connor and even Winston Churchill.
Although all of these people admit to struggling with their symptoms, many have come out publicly to highlight the benefits of accessing professional help and education about the disorder. Here is a video of Stephen Fry, speaking to his younger self, highlighting the importance of seeking bipolar disorder treatment.
What are the different types of bipolar disorder?
There are four main types of bipolar disorder, but in reality, symptoms may not fall precisely into these categories:
Bipolar 1
Periods of both severe depression and mania
Bipolar 2
Periods of both severe depression and hypomania
Rapid cycling Bipolar
Either Bipolar 1 or 2, except episodes are shorter and occur more frequently (at least 4 episodes a year).
Cyclothymia
Periods of feeling low (mild depression) followed by periods of feeling energetic, excited and happy (hypomania).
Do I have BPD?
Borderline Personality Disorder (BPD) is marked by intense emotions, unstable relationships, and a strong fear of abandonment. If you often experience mood swings, feelings of emptiness, or impulsive behaviour, you might have BPD. It’s important to seek a formal assessment from a specialist, as BPD requires careful diagnosis and a comprehensive treatment plan. London Psychiatry Clinic offers expert support and tailored treatments to help manage BPD effectively.
What are the warning signs of bipolar disorder?
Here are some of the warning signs you may want to look out for if you or a loved one are suspicious that you may need bipolar disorder treatment:
- Knowing that something is just not quite right
- Random, extended fits of laughter for no apparent reason
- Feeling a lesser need for sleep
- Feeling elated, audacious or invincible
- Losing your appetite
- Feeling agitated, restless or uncomfortable in your skin
- Feeling like you’re losing control of your thoughts because they’re racing
What are the potential triggers of bipolar disorder?
We also encourage you to note potential triggers for your condition, some examples of which may be:
- Stress at work, home or school
- Conflict or socially upsetting circumstances
- A break-up or change in your romantic life
- Bereavement
- Lack of sleep
- Recreational drug use
- Prescribed medications that are not appropriate for your condition
Our approach to bipolar disorder treatment
Bipolar disorder is likely caused by a combination of genetics interacting with environmental risk factors. However, scientists still haven't been able to pinpoint the specific causes. The good news is that many people with the condition still live happy and successful lives, but finding the right bipolar disorder treatment approach and symptom management plan is crucial.
We have extensive experience in providing bipolar disorder treatment using a range of approaches, from medication to therapy. Treating bipolar disorder takes expertise and experience, as it is easy to misdiagnose someone with bipolar with either depression or psychosis, due to the changes in their symptoms over time. Receiving a diagnosis from a psychiatrist before moving ahead with medications is incredibly important in the case of bipolar disorder, as specific medications can worsen symptoms or trigger an episode, while other medications may only treat some of the symptoms.
At LPC we know that psychoeducation is essential for successful treatment of bipolar disorder. We encourage you to get to know the nature of your bipolar disorder patterns, so you learn to recognise the signs before an episode takes hold. These are specific to you, and no two people will have exactly the same set of warning signs, but they may be similar.
We follow the Maudsley Prescribing Guidelines for bipolar disorder, which recommends using both antipsychotics and mood stabilisers, with anti-anxiety drugs often being useful as an add-on to these medications. Specific medication will be prescribed depending on what type of bipolar disorder symptoms someone has (see below).
Research has even shown that certain medications work most effectively when they are taken in conjunction with another medication. For example, medications that are commonly prescribed together include lithium and an antidepressant, lithium and lamotrigine, or olanzapine and fluoxetine.
We also use other evidence-based methods that have been shown to improve or reduce symptoms of bipolar disorder. Some of these approaches are:
- Psychotherapy: Cognitive Behavioural Therapy (CBT), Interpersonal Therapy
- Psychoeducation: providing education and advice on how to recognise triggers and manage symptoms to individuals with bipolar, as well as their families/partners
- Stress management: mindfulness, meditation, or self-care activities
- Exercise plans
By taking control of your condition under the guidance of our experienced professionals, there is no reason that a diagnosis of bipolar disorder should hold someone back from what they want to achieve.
We understand therapy can be daunting for some, which is why we offer online therapy so you can speak to our experts in the comfort of your own home. Our online therapy services also mean that no matter where you are in the world, we can help you.
Patient success stories
I am 26, I was 24 when I was diagnosed with type 1 bipolar disorder. Becoming sick at this point of my life was very discombobulating. I was very ignorant about bipolar disorder and therefore disorientated when it came to understanding my mania and depression.
Since I have started feeling better and that depression flip switched off, I have been regularly speaking to Dr Alameda. I really feel appreciative of his holistic care, having a talented psychiatrist helping me stabilise and prevent me from relapsing this year.
I would also like to mention how brilliant Jennifer and Kirsty (Dr Pertusa and Dr Alamada’s secretaries) have been, they have an amazing bedside manner and I enjoy their phone calls. - Jenna, 28
FAQs: Mania
What is mania?
Mania is a period of excessively high mood or energy, usually associated with bipolar disorder, and formerly known as manic depression. Mania can last for days, weeks, or months. Generally, mania is followed by a period of low mood and depression. It is important to treat it as a way to mitigate the potential consequences of the manic episode and reduce the risk or intensity of the depression if it happens.
What are the different types of mania?
There are two types of mania, mania, and hypomania. Hypomania is a less severe form of mania but with a similar rise in energy and mood. This is often seen in Bipolar II disorder.
You can learn more about our approach to bipolar disorder treatment in adults (not currently live on website).
What are the symptoms of mania?
A person with mania can experience any of the following symptoms:
- Higher than normal energy levels
- Sleeping fewer hours than usual for several days in a row but still feeling very well
- Feeling restless and unable to stay still
- Being easily distracted from simple tasks
- Being extremely talkative and unable to stay on point during a conversation, also known as pressured speech
- Having lots of new ideas, plans, and thoughts
- A racing, busy mind that is hard to tame
- Embarking on multiple new projects with no realistic capacity to finish them
- Increased sexual drive
- Behaving in an overly familiar way, and in a way that is out of character
- Actively engaging in dangerous or risky behaviours, such as impulsive sex
- Spending far more money than usual or gambling
- Throwing or giving away personal belongings
- Psychotic symptoms such as increased self-esteem, feeling grandiose, and/or having very high confidence
What does mania feel like?
Mania is a different experience for everyone. Here are some of the most common feelings felt during a manic episode:
- Feeling invincible or indestructible
- Feeling as if you are hyper aware and hyper focused
- Feeling as if everything is important, every idea, every conversation
- A desire to feel stimulated both physically and mentally
- Endless energy even with little sleep or appetite
- Overly excited and unable to consider the consequences of your actions
- Feeling extremes of emotion, for example, anger, or irritation
- Unable to put the brakes on your thoughts and decisions
- Feeling more creative and perceptive
- Feeling as if you can multitask
- Confused and forgetting details such as how you got somewhere, what you have done or said
Depressive symptoms can also be experienced during mania. Feelings of sadness and hopelessness may accompany the feelings noted above.
If you are experiencing hypomania you may feel like you are simply ‘happy’. You have the energy and motivation to do what you have wanted to do for some time but have not been able to due to an ongoing depressive episode. Though this may feel normal, it is still important to reach out for help as, without treatment, hypomania can develop into mania or depression.
CTA
What does mania or a manic episode look like?
During a manic episode, the affected individual is unlikely to recognise that there is a problem, even if those around them are trying to convince them there is. This often makes it very difficult to help the person. Even people who have been diagnosed with bipolar disorder and have experienced manic episodes in the past may not be able to recognise the symptoms of mania when they experience another episode.
How long does mania or a manic episode last?
Mania can last anything from one week to several months, with the average being around three and a half months. Hypomania lasts at least four days. The sooner mania is treated, the better as it rarely will go away on its own.
When mania is ending, a feeling of slowing down is experienced. More sleep and a better appetite are good signs that the mania is ending. Feeling ashamed or embarrassed by actions and behaviour during a manic episode is normal.
Once the mania has ended, there may be a return to a normal mental state or there can be an onset of depression. Mania can come back and this is most often seen in Bipolar I Disorder.
What causes mania?
The exact causes and mechanisms of mania are unknown. It is thought to be a combination of biological (genetic), psychological and social factors (environment). Causes will be different for everyone.
What triggers mania?
Taking or withdrawing from some medications, including recreational drugs, may trigger mania or hypomania. It is important to discuss any medication changes with your doctor.
There are also some physiological conditions that mimic mania which is why it is so important to reach out and get help as soon as possible.
Can mania lead to psychosis?
No mania does not lead to psychosis. Psychosis is a group of symptoms that can be experienced during mania.
How is mania treated?
Mania is treated with one or a combination of interventions. Psychotherapy, Cognitive Behavioural Therapy (CBT), and medications can be used.
View our team of specialists who treat mania.
Are mania and psychosis the same?
No, mania and psychosis are not the same things. Think of mania and depression at two ends of a mood spectrum. Psychosis and psychotic episodes can occur as symptoms of either depression or mania.
