March 29th, 2021

Understanding Bipolar Disorder

By Dan Whale

  • Bipolar

Bipolar disorder is something that all of us have heard of, but it affects more people than you might think. 1% - 2% of the UK population have a diagnosis of bipolar disorder and recent research suggests that as many as 5% may be on the bipolar spectrum.

As today is National Bipolar Awareness Day, we thought it might be useful to provide some information on what bipolar disorder is and why it’s so commonly misdiagnosed. Our Clinical Director Dr Nicky Hartigan specialises in bipolar disorder and she has also shared some of her thoughts on psychological interventions for the condition.

What is bipolar disorder?

Bipolar disorder is a condition which primarily affects mood. People with bipolar can spend days, weeks or even months with a significantly elevated mood known as mania, whilst spending similar periods of time with very low mood - depression.

Mood swings are of course part of life, but for those with bipolar, these peaks and troughs go to extremes which can make day-to-day functioning more challenging. For some, they can experience these extremes with periods of stable mood in between, but others may swing more rapidly between very high and very low mood. It’s also possible to experience both mania and depression simultaneously.

It’s important to note that mania is not the opposite to depression - it’s not a constant state of happiness. It would be more accurately described as being very highly energised, which can cause impulsive and sometimes reckless behaviour and intense feelings of restlessness. Mania can also be associated with unusual thought processes and grandiose ideas, which can be experienced as distressing, intense and overwhelming.

Bipolar disorder has two subtypes, bipolar I and bipolar II. Bipolar I disorder is diagnosed when a person has experienced at least one episode of mania that lasts longer than 1 week; the majority of people (around 90%) will also have periods of depression. Bipolar II disorder is diagnosed when a person has had at least 1 period of significant depression and at least 1 period of hypomania (similar to mania, but milder).

Why is bipolar disorder so commonly misdiagnosed?

On average it takes 9.5 years for someone to be diagnosed with bipolar disorder. This is in part due to bipolar sharing symptoms with other conditions such as depression and anxiety, which means it can be overlooked.

However, some studies suggest that in recent years this may have been reversed. An increased awareness of the condition, along with other possible factors, has resulted in bipolar disorder now being overdiagnosed.

This highlights the importance of getting an assessment with a specialist in mood disorders if you or a loved one are experiencing signs and symptoms of the condition. The quicker that signs can be spotted and you can discuss what you’re going through, the quicker your mental health challenges can be understood and acted upon appropriately.

How do I know if I have bipolar disorder?

Unfortunately there are no tests or scans that can be done to determine if you have bipolar disorder. Only a specialist mental health professional can make the diagnosis based on detailed assessment of the current situation and historical information. It may be that to start with a provisional diagnosis of bipolar is made, with you and the health team deciding to monitor the situation before a definitive diagnosis and treatment plan is established.

Treating bipolar disorder

The most important thing to take away from this blog is that if you or a loved one is diagnosed with bipolar disorder, effective treatments are available and the vast majority of people with a diagnosis of bipolar disorder are able to successfully manage the condition and live a fulfilling and meaningful life.

HelloSelf Clinical Director Dr Nicky Hartigan specialises in bipolar and explains how.

“I have been working with people with a diagnosis of bipolar disorder for over 20 years now. Pharmacological treatments have advanced over this period and for the majority of people I work with, medication is an important part of their treatment. However, psychological interventions are an evidence-based approach to managing bipolar and my experience has been that they bring a huge sense of hope and empowerment for people living with the condition.

A typical intervention will involve assessing and understanding where someone is at in their journey with the condition - do they want to know more about the causes of bipolar, the triggers for relapses and ways to reduce or prevent further episodes? Do they want to think about what it means to be a person living with bipolar and how this impacts on their sense of self and identity? Or do they want to think about the impact on relationships and whether or not to tell friends, family and employers?

In reality, most people will want to work on all of this to some extent, and that is perfectly possible with a relatively short course of structured Cognitive Behavioural Therapy. I will typically see people for between 16-20 sessions, during which time we would expect to make significant progress and devise a comprehensive relapse prevention plan. People will then often come back for 3-6 monthly review appointments, to check in that their strategies are working and to review and make changes where necessary.”

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If you’d like to know more about bipolar and how HelloSelf can help you or someone you care about, don’t hesitate to get in touch at hello@helloself.com.

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