bipolar disorder

8560840624_7452a42f5e_k

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

What are mental health staff doing to address the sexual health needs of service users? It’s complicated.

michael-prewett-126900-unsplash (1)

Sarah Watts explores a small qualitative study that asked NHS staff about the sexual health and sexuality needs of people with serious mental illness.

[read the full story...]

Physical health inequalities in primary care

list-not-equals

Andy Bell from Centre for Mental Health and the Equally Well UK collaborative, calls for action in response to the Public Health England briefing on severe mental illness and physical health inequalities.

[read the full story...]

Victims of crime with mental illness: differences between Denmark and the US

angelo-pari-1054344-unsplash

Chris Millar writes his debut blog on a recent paper that explores the link between mental illness and being subjected to crime in Denmark and the United States. This blog asks: how much do poverty and the safety net matter? There are some important implications for policy makers.

[read the full story...]

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

40933137154_a00a57d606_k

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.

[read the full story...]

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

nick-fewings-532590-unsplash

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

[read the full story...]

Sexual function matters to people living with serious mental illness

bryan-apen-567698-unsplash

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.

[read the full story...]

How valid are hospital psychiatric diagnoses?

equalizer-2818803_1280

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.

[read the full story...]

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

marcelo-leal-525139-unsplash

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.

[read the full story...]

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

woman

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.

[read the full story...]

Staff views on digital self-management of severe mental illness

justin-main-189752

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.

[read the full story...]