What is bipolar disorder?

Bipolar disorder is a chronic (ongoing) mood disorder. It involves mood changes that disrupt everyday life — from extreme highs (mania or hypomania episodes) to extreme lows (depressive episodes).

If you have bipolar disorder, what you experience during each episode (and for how long) can vary. An episode can last for weeks or even months. Your moods may not make sense in the context of what else is going on in your life.

Around 1 in 50 Australians has bipolar disorder. Bipolar disorder often develops for the first time during teenage years or early adulthood. Bipolar disorder used to be called 'manic depression'.

What are the different types of bipolar disorder?

There are different types of bipolar disorder and related disorders, including:

• bipolar I
• bipolar II
• cyclothymic disorder

Bipolar I includes extreme, long-lasting highs (mania) as well as depressive episodes. It may also include psychosis (difficulty knowing what is real or not). It can disrupt your life and relationships.

Bipolar II involves highs that are less extreme (hypomania) than bipolar I. Bipolar II also includes depressive episodes and periods of normal mood. It tends to affect more females than males.

Cyclothymic disorder causes mood changes that are less severe than bipolar I or II, but still impacts your daily functioning.

What are the symptoms of bipolar disorder?

If you or someone else is in immediate danger, call triple zero (000). You can also call Lifeline on 13 11 14 to talk to someone 24 hours a day, 7 days a week.

A person with bipolar disorder goes through mood changes that range between manic and depressive episodes.

During a manic phase, symptoms can include:

• feeling euphoric and very happy or irritable and agitated
• inflated self-esteem or grandiose ideas
• increased energy and activity along with a reduced need to sleep
• racing thoughts and speech — such as talking loudly, talking over people or jumping from topic to topic
• being very easily distracted — such as by noises or other people
• impulsive or risky behaviours with spending, business or sexual activity
• unrealistic plans, delusions or hallucinations

Mania lasts at least one week and can disrupt your life.

Hypomania means 'less than mania'. Symptoms of hypomanic episodes are similar to those of a manic episode. But in hypomania, changes in mood are less severe and don't last as long. This means that they are less likely to affect how you function throughout your day.

During a depressive phase, symptoms may include:

• low mood
• lack of motivation
• a loss of interest in hobbies or activities that you would usually enjoy
• changes in sleep patterns
• difficulty concentrating or making decisions
• withdrawing from social contact and activities
• feelings of worthlessness or guilt, which may include suicidal thoughts

Depressive episodes last for at least 2 weeks.

Try the Black Dog Institute's self-test to see if you have symptoms that may indicate bipolar disorder.

What causes bipolar disorder?

The exact cause of bipolar disorder isn't fully understood. A combination of factors can make someone more likely to develop the condition. These include physical, environmental and social factors (including mental stress).

Genetics

In 4 out of 5 people with bipolar disorder, genetics plays a strong role. If one parent has bipolar disorder, there is a 1 in 10 chance their child will also develop the condition. If both parents have bipolar disorder, the likelihood rises to 4 in 10.

Medical research is working towards understanding how genes affect your chance of having bipolar disorder.

Triggers

In some people vulnerable to bipolar disorder, a stressful circumstance or experience can trigger an episode of mania or depression. This may include:

• childhood physical, sexual or emotional abuse
• family conflict
• other major life-altering events

Misuse of certain substances, such as recreational drugs, are also linked to bipolar disorder.

When should I see my doctor?

If you're concerned about extreme mood changes in yourself or someone else, it's important to seek support and help. Speak to your doctor for a mental health assessment. They may provide you with a mental health treatment plan.

Your doctor can refer you to a mental health professional, such as a psychologist or psychiatrist.

When to seek urgent care

If you, or someone you know, is having suicidal thoughts and is in immediate danger, seek urgent care. You can call triple zero (000) and ask for an ambulance. For help and support, call Lifeline on 13 11 14.

How is bipolar disorder diagnosed?

Your doctor will ask about:

• your physical health
• your life experiences
• your mood changes
• how long you have experienced mood changes
• how mood changes affect your daily life

Your doctor will diagnose bipolar disorder by ruling out any physical causes or other health concerns, and by carefully assessing your symptoms.

How is bipolar disorder treated?

Bipolar disorder can be treated. But it needs careful and ongoing monitoring. Treatment usually involves:

• medicines
• psychological therapy
• lifestyle changes and self-care

Medicines for bipolar disorder

To treat bipolar disorder, your doctor can prescribe medicines to suit your specific needs.

Most people with bipolar disorder are first prescribed medicines to stabilise their mood. This is known as acute treatment. Acute treatment is usually with a mood stabilising agent.

Mood stabilising agents for bipolar disorder include lithium, a long-term mood stabiliser, and anticonvulsant medicines such as:

• valproate
• carbamazepine
• lamotrigine

Electroconvulsive therapy (ECT) is sometimes recommended by psychiatrists if medicines aren't effective in stabilising your mood.

Ongoing treatment can then be given to:

• prevent relapse
• build resilience
• improve your quality of life

To manage bipolar disorder effectively, it's important to take your medicines exactly as directed. Tell your doctor if you're concerned about any side effects. Your doctor may be able to change your treatment or suggest ways to manage the problem.

You can read more about medicines for bipolar disorder.

Therapy

Psychological therapies ('talking therapies') can help to manage bipolar disorder, alongside medicines. These include:

• psychotherapy
• cognitive behavioural therapy (CBT)
• counselling

These therapies can help to reduce the risk of relapse and improve your quality of life.

During therapy, you may learn how to think differently about events in your life and respond to them in a helpful way. Therapy can also help you learn how to cope with stressors that may have triggered episodes in the past.

Self-care

If you have bipolar disorder, it's important to take care of yourself.

Things that may help you prevent relapses or episodes include:

• learning to manage your stress
• ensuring you get enough sleep

Your doctor can give you advice on how to care for yourself. You can also read more about self-help strategies.

Living with bipolar disorder

Living with bipolar disorder can be challenging. If you have bipolar disorder, you can manage it successfully.

With the right treatment and support, most people with bipolar disorder can live productive and fulfilling lives.

What are the complications of bipolar disorder?

If left untreated, bipolar disorder can lead to longer and more severe mood changes. For example, episodes of bipolar-related depression can last up to 12 months. Manic episodes can last up to 6 months without ongoing treatment.

Someone living with bipolar disorder may also have a higher risk of:

• substance abuse (for example, alcohol or drugs)
• anxiety
• heart and cardiovascular conditions
• diabetes
• unhealthy weight (such as overweight and obesity)
• suicidal thoughts

Some of these problems may need to be managed at the same time as bipolar disorder.

Can bipolar disorder be prevented?

There's no guaranteed way to prevent bipolar disorder. But treatments can help prevent manic and depressive episodes, so you can function in daily life.

If you have a family history of bipolar disorder, it's important to be aware of early warning signs. Your friends and family need to be aware of them too. Family members can also let you know if they have noticed warning signs of relapse.

Try to avoid anything that may trigger manic or hypomanic episodes, such as a lack of sleep.

Resources and support

Visit Lifeline Australia or call on 13 11 14 for support 24 hours a day.

Black Dog Institute has information on bipolar disorder. You can also read testimonies of living with bipolar disorder.

Explore ReachOut for information on mental health, including bipolar disorder, and First Nations wellbeing support.

For advice and to get connected to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Other languages

If you prefer to read languages other than English, visit Embrace multicultural mental health or phone the Transcultural Mental Health Line on 1800 648 911.