What Is Bipolar Affective Disorder?

Bipolar affective disorder is sometimes called manic depression or bipolar illness. In this condition, you have periods where your mood ('affect') is in one extreme or another.

One extreme is called depression where you feel 'low' and have other symptoms.

The other extreme is called mania (or hypomania if symptoms are less severe) where you feel 'high' or elated along with other symptoms.

The length of time you spend in each extreme can vary. It is usually for several weeks at a time or longer. Bipolar affective disorder is very different from the mood swings that moody people have which last minutes or hours.

You can have any number of episodes of highs and lows throughout your life. In between episodes of highs or lows there may be gaps of weeks, months or years when your mood is normal. However, some people swing from highs to lows quite quickly without a period of normal mood in between. This is called 'rapid cycling'. (If you have the rapid cycling form of the illness you have at least four mood swings per year.)

Who Gets Bipolar Affective Disorder?

About 1 in 100 people develop this condition at some stage in life. It can occur at any age, but most commonly first develops between the ages of 18 and 24. It occurs in the same number of men as women. The rapid cycling form of the illness occurs in about 1 in 6 cases.

(Note: mania or hypomania occurs in only a small number of people who develop depression. It is much more common to just have depression without episodes of mania or hypomania.)

What Causes Bipolar Affective Disorder?

The cause is not known. Your genetic makeup seems to play a part as your chance of developing this condition is higher than average if other members of your family are affected. Stressful situations may trigger an episode of mania or depression in people prone to this condition. However, stress is not the underlying cause.

What Are The Symptoms Of Mania And Hypomania?

Mania causes an abnormally 'high' or irritable mood, which lasts at least one week - but usually lasts much longer than this. It can develop quite quickly - over a few days or so. When you are 'high' you will usually have at least 3 or 4 of the following:

• Grand ideas about yourself and your own self-importance.
• Increased energy. You also tend to move quickly and need less sleep than usual.
• Be more talkative than usual. You tend to talk quickly.
• 'Flight of ideas'. You tend to quickly change from one idea to another. You may feel as if your thoughts are racing.
• Easily distracted. Your attention is easily drawn to unimportant or irrelevant things.
• Full of new ideas and plans. Often the plans are grandiose and unrealistic.
• Irritation or agitation, particularly with people who do not seem to understand your 'great' ideas and plans.
• Wanting to do lots of pleasurable things (but these can often lead to painful consequences). For example, you may:
• Spend a lot of money (which you often cannot afford).
• Be less inhibited about your sexual behaviour.
• Make rash decisions, often on the spur of the moment. These can be about jobs, relationships, money, health, etc, and are often disastrous.
• Take part in risky 'exciting' adventures.
• Drink a lot of alcohol, or take illegal drugs.

Severe mania may also cause 'psychotic' symptoms where you lose touch with reality. For example, you may hear voices which are not real (hallucinations), or have false beliefs (delusions). These tend to be delusions of importance (such as believing that you are a famous celebrity).

Usually, you do not realise that you have a problem when you are high. But, as the the illness develops, to others your behaviour can be bizarre. Family and friends tend to be the ones who realise that there is a problem. But, if someone tries to point out that you are behaving oddly, you tend to become irritated as you can feel really good.

If mania is not treated, the bizarre and uninhibited behaviour may cause great damage to your relationships, job, career, and finances. When you recover from an episode of mania you often regret many of the things that you did when you were high.

Hypomania is the term used when you are high, but the symptoms are less severe or extreme as in true mania. You may function quite well if you have hypomania. For example, you may just appear to be full of energy, the 'life and soul' of the party, work too much, but find it difficult to 'switch off' and relax. However, you are still at risk of making rash and dangerous decisions. Family and friends will recognise that you are not your normal self.