Understanding Bipolar Disorder

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1 Barnet, Enfield and Haringey Mental Health NHS Trust Understanding Bipolar Disorder Information for patients and carers Page

2 What is bipolar disorder? Bipolar disorder is a serious mental illness involving extreme mood swings (highs and lows). It is also known as manic depression. Both men and women of all ages, and any social or ethnic background may develop bipolar disorder, though people with bipolar disorder tend to be more intelligent and creative than average. The illness occurs in phases. In the manic' phase, which comes and goes often with little warning, you might: Become elated, overexcited or unreasonably angry Take unnecessary risks Make unwise decisions Become too frantic to look after your basic needs (food, drink, hygiene) Feel paranoid, and even have hallucinations (hear voices / see visions) or delusions (bizarre ideas). In the depressive' phase, you may: Feel low, hopeless empty or worthless Become tired and lack motivation Feel life is not worth living or contemplate suicide Some people will experience just one or two episodes, while others may have repeated episodes. Who experiences bipolar disorder? Bipolar disorder can run in families but it can also occur in people who have no psychiatric illness in their family. The risk of developing bipolar disorder is less than 1 in 100 and is extremely rare before puberty. This risk is higher in teenagers and adults and may be triggered after a physical illness or stressful events. Page 2

3 How does it start? In the early stages you may seem to be at your most creative or productive. In later stages, thoughts and speech may become rapid and difficult for others to understand. Loss of inhibitions may mean that you behave in a way that is unlike your normal self, perhaps becoming sexually uninhibited, or reckless in other ways, become verbally abusive or highly critical of others. What are the symptoms of bipolar disorder? With bipolar disorder, friends, family or colleagues are often the first to notice that there is a problem. Unfortunately the person will often object if anyone tries to point this out. This is understandable, as the individual experiencing a manic episode often feel better than they have ever done. However after the person has recovered, they will often regret things that they have done while in the manic state. What causes bipolar disorder? The cause of bipolar disorder is not fully understood, but it is very strongly inherited and so the major cause is genetic. Stressful events in life may often happen before an episode of mania or depression. Other possible factors include physical illness, alcohol or drug abuse. Sometimes a mood swing will occur without an obvious cause. What treatments are available? Most people can get help from their GP or local hospital, an assessment will be made and a care plan written showing the your needs and how they will be met. Medication prescribed will help control your mood. In mild depression, counselling may be sufficient to reduce the symptoms and possible underlying cause. With severe depression, psychotherapy may be needed with or without antidepressants. Admission to hospital may be necessary in cases of severe mania and life threatening depression. Page 3

4 What professional help is available? Community mental health teams and voluntary organisations provide help and support for patients and their relatives. GP's can give information on treatments and places to contact. Professional help can include: Counselling - this is a way of talking over problems with someone with special training who is not involved in the persons daily life. Psychotherapy - a deeper talking therapy that helps overcome stress, emotional and relationship problems. A GP will be able to arrange if necessary. Support groups - discussion groups, sometimes run by a professional, which help those taking part to re-structure their life. What can I do to help myself? There are many ways to improve your quality of life: Find out as much as you can about your illness Monitor your mood and thoughts: List and monitor for early warning signs of illness (for example, other people noticing that you are not your usual self, trouble sleeping, changes in energy levels, particular thoughts or types of thoughts becoming prominent) and seek advice early if they are identified. Develop a plan for what to do when these warning signs occur and share it with friends and relatives. Take medication as prescribed: medication is a vital component of the management of bipolar disorder. Learn self-management of illness, for example how to adjust your medication doses, or introduce specific additional medications at early signs of relapse: alternatively you might take yourself away somewhere quiet if you are going high: you will need to work very closely with your doctor or a psychiatrist to learn to manage illness. Learn how to deal effectively with stressful situations Take care around alcohol and other drugs: they will probably worsen your illness, and people with bipolar disorder are at very high risk of developing addictions. Maintaining a regular rhythm to your life may help control mood swings. Find someone to confide in Make sure you have enough time to relax Try not to get too busy when you feel well Arrange care in advance, so that things are taken care of in a crisis Page 4

5 What can partners, friends and relatives do to help? When someone is experiencing a manic or depressive phase it can seriously affect those close to him or her. Families and friends can be left feeling powerless to help or understand what is happening. If you are a family member or friend: Try to be as patient and understanding as possible Help them develop a contingency plan: agree how you should help if you or they think they are becoming unwell If being verbally abused, remember that it is a result of the illness and is not the person that you know or love If you become frightened of their behaviour, either because you feel in danger, or feel they are, tell them, and call for help Help them to structure their day If the person is seriously neglecting their health, seek help from the care team urgently If they talk of harming themselves, take it seriously and get professional help Give yourself space and time to relax and recharge If a manic episode becomes severe, the person may become suspicious, angry or difficult. Don't get into arguments seek help immediately (GP or psychiatric nurse) Keep contact telephone numbers of professionals handy in case of emergencies. What is the outlook? It is possible to remain well for long periods of time. Recognising the signs of bipolar disorder early and accepting the condition will help. It is very important to get in control of the illness as early as possible, and maintain that control, through using medication and other techniques, as there is evidence that bipolar disorder can get worse with each episode. Page 5

6 Useful organisations MDF The Bipolar Organisation 21 St. George's Road London SE1 6ES Tel: Web: MDF The Bipolar Organisation is a national user-led charity for people whose lives are affected by bipolar disorder. Services include self help groups, a members helpline and on-line resources. Depression Alliance Tel: Web: Provides information and support for people with depression through local self help groups and information their website. Samaritans 40 Queens Road Bounds Green N11 2QU Tel: (24 hours, 7 days a week) or Web: To write: Chris, PO Box 9090, Stirling, FK8 2SA Samaritans provide confidential non-judgmental emotional support 24 hours a day for people who are experiencing feelings of distress or despair. You can contact them by phone, or in writing. Page 6

7 Saneline Tel: (6-11pm) Web: Saneline offers support and information for people experiencing mental health problems and to their families and carers. Rethink Information and Advice Tel: or (National Advice Line open 10am to 2pm Mon-Fri) Web: Rethink is a charity working to help everybody affected by severe mental illness. Services provided include an advice helpline, advocacy, carer support, and helplines. Young Minds Tel: (Parents support line) Web: Young Minds is a UK charity committed to improving the emotional wellbeing of children and young people. Services include a support line for parents and online resources for children and young people. For more information or help visit: Page 7

8 You can ring for a translation Monday - Friday 9.00am pm. Please give this number: and also for Audio, Large Print and Braille, call now on: Produced By: Date of Publication: Page 12Review Date: Reference: Communications 04/07/ /07/2015 lc

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