bipolar disorder



Bipolar, otherwise known as manic depression, now exists largely within common consciousness and understanding, thanks to high profile stigma-busting publicity.

Characterised by episodic shifts in a person’s mood (between manic and depressed states), as well as their energy and activity levels, which can significantly impact their daily functioning, bipolar is estimated to affect 1% of the population across the lifetime. However, this figure rises to over 4% if you include those who experience more than one episode of sub-threshold manic (or ‘hypomanic’) symptoms.

What we know already

Anxiety is unsurprisingly common in people living with bipolar. Similarly, substance abuse is frequently reported.

Whilst there is no cure, there are several well-established treatment options. Bipolar is usually treated using mood-stabiliser, atypical anti-psychotic and/or antidepressant medications, alongside psychological, and diet and lifestyle interventions. We know, for example, that bipolar can be well managed using regular monitoring of mood, keeping stress levels to a minimum, and ensuring good sleep.

Areas of uncertainty 

Like many mental health difficulties, the precise causes of bipolar are unknown, though they are likely multi-faceted. Research shows that you are more likely to develop bipolar if it exists in your family. Although most children with such circumstances will not go on to develop bipolar, there appears to be a strong genetic component. Environmental factors such as stressful life events are also thought to play an important role.

Recent research suggests that, whilst it appears beneficial to treat bipolar with psychological interventions, the heterogeneity of the evidence makes it difficult to decide which treatments (such as CBT, Mindfulness etc) work best.

What’s in the pipeline?

Large-scale studies, such as the U.S-based Bipolar Disorder Phenome Database, are seeking to better understand the complex genetic picture.

Advances in brain imaging will no doubt provide rich information regarding the neurochemical and neurostructural profile of bipolar. Similarly, technological advances are enabling more sophisticated ways of promoting self-management in conditions such as bipolar.


Merikangas, K.R., Akiskal, H.S., Angst, J., et al. (2007) Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Archives of General Psychiatry, 64, 543-552. [Abstract]

Stratford, H.J., Cooper, M.J., Di Simplicio, M., Blackwell, S.E. and Holmes, E.A. (2015) Psychological therapy for anxiety in bipolar spectrum disorders: a systematic review. Clinical Psychology Review, 35, 19-34. [Abstract]


Written by: Patrick Kennedy-Williams
Reviewed by:
Last updated: Sep 2015
Review due: Sep 2016

Our bipolar disorder Blogs

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Martin Webber considers a Canadian study about social enterprises and employment opportunities for people with mental health problems such as psychosis.

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Early intervention in psychosis: how long is long enough?


Rachel Brand looks at a recent RCT which investigates the optimal duration of an early intervention in psychosis programme for young people in Hong Kong.

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Lifetime prevalence of anxiety disorders in people with bipolar disorder


Alan Underwood appraises a recent meta-analysis that finds anxiety disorders are three times more common in people with a diagnosis of bipolar disorder.

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John Baker summarises the findings of a recent review of people with schizophrenia, bipolar disorder and depression. The study looks at the adverse effects on physical health of psychotropic drugs (antipsychotics, antidepressants and mood stabilisers).

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Ian Cummins considers the implications of a new cohort study of convicted prisoners in Sweden, which links psychiatric disorders with violent reoffending.

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Caring for people with severe mental illness: poor research means that carers get a raw deal

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Caroline Struthers is frustrated by the lack of high quality research identified by this recent review, which looks at interventions to improve the experience and well-being of those caring for people with severe mental illness.

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Mood Matters: mood instability is common and associated with poor outcomes


Farhana Mann summarises an observational study of mood instability in people with mental illness, which explores its relationship with days spent in hospital, frequency of admissions, the likelihood of being sectioned and the chance of being prescribed antipsychotics and mood stabilisers.

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Joining the dots: mental and physical health

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Lia Ali and colleagues from the IMPARTS project present the findings of their group discussions about a recent review of mortality in mental disorders. Along the way she discusses the staff training they carried out and the tweet chat they ran to consider the implications of this research, both to individuals and on the global burden of disease.

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