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

Many causes of death among people with bipolar disorder are potentially preventable

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Anneka Tomlinson and Andrea Cipriani from the University of Oxford co-write this important blog on causes of mortality among those with bipolar disorder, highlighting the importance of suicide prevention across age groups.

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South Asia’s silent struggle: people with severe mental illness suffer high burden of physical illness

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An international group of experts from the University of York CADA Implementation Science Summer School summarise a recent study on the prevalence of physical health conditions and health risk behaviours in people with severe mental illness in South Asia (Bangladesh, India and Pakistan).

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Smoking and bipolar disorder: the physical and mental health impact of tobacco cessation

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Hannah Walsh explores the clinical and research implications of this French cohort study on bipolar disorder and smoking status, and how risks differ for current, former and never smokers.

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People with severe mental health difficulties are more likely to have poor dental health and dental disorders

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Masuma Pervin Mishu summarises an umbrella review on the prevalence of dental disorders among people with severe mental illness.

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Severe mental illness and comorbid chronic physical illness: the clock’s ticking

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In her debut blog, Jodie Ferris summarises a recent cohort study on the temporal relationship between severe mental illness diagnosis and chronic physical comorbidity in the UK, which contains important findings for care and future research.

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Is High Intensity Interval Training a HIIT for psychiatric inpatients?

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Suzy Ker and Garry Tew consider a qualitative study exploring patient, carer and staff perspectives on implementing High Intensity Interval Training for service users in inpatient mental health settings.

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Prediction of psychosis and bipolar disorder in children and adolescents: the role of CAMHS

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Matthew Broome considers a Finnish study on the potential of predicting psychosis and bipolar disorder in young people who have previously used child and adolescent mental health services.

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#SmokingAndMentalHealth conversations: NIHR 3 schools webinar

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SmokingAndMentalHealth – Carolyn Chew-Graham summarises the conversations that took place at the Smoking and Mental Health webinar on 28th September 2022.

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Youth mental health interventions: umbrella review presents efficacy and acceptability data

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In his debut blog, Nick Meader tackles a huge umbrella review of youth mental health interventions, which presents the efficacy and acceptability of 72 different approaches to help children and young people.

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The caring dyad: how patients and their informal carers experience severe mental illness and cardiometabolic disease

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Lydia Poole considers the caring dyad (the relationship experience of the patient and their informal carer) and the realities of living with cardiometabolic risk, metabolic syndrome and severe mental illness.

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