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

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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The role of pets in supporting people living with mental distress

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Alison Faulkner (and her cats) delight in a recent qualitative study looking at the impact pets can have on the everyday lives of people diagnosed with a long-term mental health condition.

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Peer support for physical health improvement: recovering ‘stolen years’?

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Lucy Simons discusses whether peer support interventions can help to provide physical health improvements for people living with severe mental illness.

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Antidepressants for bipolar depression: weighing up the benefits and harms

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Murtada Alsaif considers a recent systematic review on the safety and efficacy of adjunctive second-generation antidepressant therapy with a mood stabiliser or an atypical antipsychotic in acute bipolar depression.

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Childhood adversity and bipolar disorder

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Jasmin Wertz presents the findings of a recent systematic review and meta-analysis that explores the relationship between childhood adversity and bipolar disorder.

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Nutrition interventions for people with severe mental illness: do we need more dieticians?

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Elena Marcus considers a brand new systematic review, which evaluates the impact of nutrition interventions for people with severe mental illness.

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Bipolar disorder in older men linked to increased risk of dementia

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Elena Marcus presents a recent study that shows how older Australian men with bipolar disorder have an increased risk of dementia and early death.

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Exercise in severe mental illness: barriers and motivating factors

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Joanne Wallace considers a recent systematic review of exercise in severe mental illness, which focuses on the factors that motivate people to exercise, and the barriers that can prevent physical activity.

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