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

Panic disorder in people with bipolar disorder: very common, but treatment options limited

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Tobias Rowland writes his debut elf blog on a recent systematic review and meta-analysis, which finds that panic disorder is highly prevalent in people with bipolar disorder, but there are very limited treatment options.

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Poorer cardiovascular screening, diagnosis and management if you have a mental illness

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Joanne Wallace summarises a systematic review that highlights disparities in the management of cardiovascular risk factors in people with mental illness.

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Sexual function matters to people living with serious mental illness

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Rudiger Pittrof and Elana Covshoff from SHRINE (Sexual and Reproductive Health Rights, Inclusion and Empowerment) explore a recent review, which looks at the impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management.

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How valid are hospital psychiatric diagnoses?

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Vishal Bhavsar explores a recent study that uses data linkage to electronic patient records to assess the validity of selected mental health diagnoses in English Hospital Episode Statistics.

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People with severe mental illness have more adverse outcomes from medical or surgical treatment

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Laoise Renwick considers the findings of a recent systematic review on the safety of service users with severe mental illness receiving inpatient care on medical and surgical wards.

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“Nobody knows the trouble I’ve seen”. Depression and bipolar disorder in people with intellectual disabilities

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Kathryn Mitchell and Stephen Moore summarise a recent prospective cohort study in the British Journal of Psychiatry, which looks at the incidence of unipolar and bipolar depression, and mania in adults with intellectual disabilities.

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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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