Bipolar disorder is a condition that primarily affects mood, causing swings from extreme elation (mania) to severe depression, with normal periods in between. It was previously called manic depression. ‘Classic’ bipolar disorder affects about 1% to 2% of the population but in recent years the diagnosis has been extended to include those who experience less severe forms of mania – hypomania. There is a good deal of debate regarding the severity of symptoms required to make the diagnosis.
Mania is characterised by:
The lack of inhibition can be very destructive resulting, for instance, in over spending money to the extent of accumulating significant debts or sexual behaviour that the patient subsequently deeply regrets.
The definition of hypomania is not clear-cut. In general, there is no flight of ideas, delusions or hallucinations and the level of destructiveness is not as extreme.
There are professionals who would consider quite minor symptoms to constitute a hypomanic episode. There is also dispute as to how long an episode needs to last to be considered significant. The generally accepted time is 4 days but again, there are many who would accept a much shorter period of time in making a diagnosis.
In bipolar disorder there are discrete episodes of mania/hypomania alternating with depression, with normal periods in-between.
Depressive symptoms in bipolar disorder are exactly the same as those in depression (so called unipolar depression). However bipolar depression, defined as depressive episodes occurring with at least 1 episode of mania or hypomania, has some differences from unipolar depression:
Another feature of bipolar disorder is that there may be so called ‘mixed episodes’ where an individual has symptoms of both mania/hypomania and depression.
It was thought that patients returned to complete normality during the periods between episodes in bipolar disorder. However, it has come to be recognised that in severe forms of the disorder there are subtle changes, similar although generally less severe than the ‘cognitive’ symptoms seen in schizophrenia, that are apparent between episodes.
Medication is considered a key component of the treatment of Bipolar disorder and the National Institute of Health Care and Excellence (NICE) recommends certain psychological therapies. The experience of bipolar disorder can be very challenging for both patients and those around them and it is important to understand the disorder and how to prevent and manage relapses.
The treatment of the less severe forms of bipolar disorder, associated with hypomania rather than mania, is similar but at what point medication is indicated is not at all clear.
Recommended psychological treatments are:
There are a number of approaches. All are based on increasing understanding of bipolar disorder and on recognising early warning signs and ensuring early treatment of relapses.
All the therapies recommended for depression apply to treating the depressive episode of bipolar disorder.
The main medications used in bipolar disorder are
Elite Psychology comprises of an expert team, specialising in the range of best private evidence-based therapies for bipolar disorder. Our highly qualified associates are accredited in all of the most successful therapies, complemented by psychiatrists who can prescribe medication on private prescriptions. We can assess you and provide the most efficacious therapy tailored to your difficulties. We know the importance of being understood, and endeavour to deliver the highest standard of psychological interventions to meet your needs.
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