Bipolar disorders, also called maniaco-depressive psychosis, are a group of disorders that cause mood fluctuations characterized by phases of depression and phases of excitement (mania) that can manifest in response to stress or for no apparent reason.

Mood changes are a normal part of life. However, with bipolar disorders, the swings are more extreme. They become so intense that the person does not realize that he/she is not behaving normally or the person suffers so much from depression that he/she is paralyzed and overwhelmed by suicidal thoughts. These states may cause problems at work, with the family, with finances, and sometimes with legal authorities. Treatment for this disorder may require hospitalization.

Symptoms of bipolar disorders

In the depressive phase:

  • Sadness, depressed mood lasting almost all day, everyday and for at least two weeks
  • Fatigue and loss of energy
  • Loss of interest and pleasure
  • Trouble sleeping (insomnia or hypersomnia)
  • Appetite problems with weight gain or weight loss
  • Psychomotor retardation or agitation
  • Loss of concentration or loss of ability to think or make decisions
  • Feelings of guilt
  • Recurrent thoughts of Death (60% of cases) and recurring suicidal thoughts (15% of cases)
  • Sudden social isolation or aggressive behavior

In the manic phase:

  • High self-esteem and thoughts of grandeur
  • Extremely high energy levels and an intense sense of well-being or irritability
  • Reduced need for sleep
  • Increased speed of talking or non-stop talking
  • Racing thoughts or a feeling of idea overflow
  • Inability to concentrate, very distracted
  • Increased social, professional or scholarly activities
  • Psychomotor agitation, increased energy level
  • Pleasure increased to an excessive degree with a high risk of negative consequences: shopping, sex or financial investments
  • Affected people may also experience delusions (impossible, but firm beliefs) or hallucinations.

Differences between mania and hypomania

Mania is defined by the appearance of a significant functional impairment that lasts for a minimum of one week and that can lead to hospitalization or the onset of psychotic symptoms (hallucinations, deliria or paranoia). In hypomania, symptoms last a shorter amount of time, or approximately four days. These symptoms do not cause a significant functional decrease; on the contrary, people in the hypomania phase are often more functional than usual (increased energy, better concentration, more socializing). This phase could seem positive for those with the disorder, but it can also discourage them from seeking or continuing treatment.

Mini-Psych School videos

Volatile Emotions - Bipolar and other mood disorders (2011) The Ups And Downs of Bipolar Disorders (2009)
Volatile Emotions - Bipolar and other mood disorders. A 2011 lecture by Serge Beaulieu and Suzane Renaud (in French)
Volatile Emotions - Bipolar and other mood disorders. A 2011 lecture by Serge Beaulieu and Suzane Renaud (in French)
The Ups And Downs of Bipolar Disorders: a 2009 lecture by Serge Beaulieu-Part 1
The Ups And Downs of Bipolar Disorders: a 2009 lecture by Serge Beaulieu-Part 1

Watch other Mini-Psych School lectures.

Who is affected?

The first symptoms usually appear between the ages of 15 and 25. The most serious symptoms tend to appear at around age 30.

It tends to affect men and women in equal numbers.

Causes of bipolar disorders

Bipolar disorders is still not completely understood by researchers. Some results indicate that several genes cause the symptoms and treatment to differ from person to person, and explain increased incidence within certain families.

Factors that can trigger the illness in genetically-vulnerable people are the drugs use, increased stress, and a lack of sleep.

Treatments of bipolar disorders

Biological, psychological and community treatments for bipolar disorders are designed to improve the general state of the person affected by the disease while taking into account the different biopsychosocal factors causing the disorder. With proper treatment, most individuals with bipolar disorders can live satisfying lives and function well at home and at work.

Biological treatments
Mood stabilizers are the cornerstone of treatment for bipolar disorders. These medications are neither stimulants nor sedatives. As their name indicates, they stabilize mood and maintain it at a normal level. It is common for people affected with the disease to use medication for years or even for the rest of their lives. There are three main mood stabilizers used in treating bipolar disorders: Lithium, Epival (divalproex) and Tegretol (carbamazepine).

Psychotherapies:
Treatment may also include psychotherapy. A very effective therapy for bipolar disorders is psycho-education. The goal is prevent manic episodes by develop coping strategies, like regulating sleep, diet and exercise. An information session for families is also possible with this therapy. Other beneficial and effective therapeutic alternatives include cognitive behavioural therapy. Many different services are also offered in the community to help patients achieve optimum rehabilitation.

The best route to wellness involves stabilizing mood, maintaining a healthy lifestyle (routine) and working on personal issues (psycho education).

Research at the Douglas

The following Douglas scientists specialize in bipolar disease research:

[Bipolar Disorders: causes, symptoms and treatments] [Bipolar Disorders: advice for the family]