bipolar disorder

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Introduction

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.

References

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]

Acknowledgement

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

Our bipolar disorder Blogs

Staff views on digital self-management of severe mental illness

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Laura Hemming presents a recent qualitative study of staff views on the use of the Internet and smartphones for digital self-management of severe mental health problems.

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Online intervention for bipolar disorder: what do service users think? #DigiMHweek

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Today is the start of Digital Mental Health week, so look out for blogs, webinars, podcasts and loads of social media on the latest digital mental health research #DigiMHweek!

We start with Sarah Rowe blogging about a qualitative study that explores users’ experiences of an online intervention for bipolar disorder.

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Personal well-being networks for severe mental illness: the importance of being social

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The University College London Mental Health Masters students summarise a recent exploratory study on personal well-being networks, social capital and severe mental illness.

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People with severe mental illness die younger and things are getting worse

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Judith Harrison publishes her debut blog on a recent cohort study in the British Journal of Psychiatry, which shows that the “mortality gap” is increasing for people with bipolar disorder and schizophrenia.

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How consistent are international treatment guidelines for bipolar disorder?

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Steven Marwaha publishes his debut blog on a review article that asks if there is consensus across international evidence-based guidelines for the management of bipolar disorder.

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Severe mental illness in offspring may not be linked to smoking during pregnancy

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Andrew Jones considers a recent cohort study that looks into the associations between maternal smoking during pregnancy and severe mental illness in offspring.

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Mental health expenditure associated with higher quality care and better service user experience

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Kwame McKensie publishes his debut Mental Elf blog on a recent cross-sectional study, which explores the relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe.

This is the fourth in a new series of Mental Elf blogs produced in partnership with the British Journal of Psychiatry.

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Can network meta-analysis decide the best psychosocial intervention for bipolar disorder?

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Guy Goodwin and Andrea Cipriani highlight a number of methodological concerns in a new network meta-analysis of psychosocial therapies for the adjunctive treatment of bipolar disorder.

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A crisis map: charting the topography of home treatment

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Derek Tracy and Lisa Lloyd look back over the last 17 years of mental health crisis care and consider the findings of a new survey of Crisis Resolution Teams in England.

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