Barnet, Enfield and Haringey

Mental Health NHS Trust

Understanding
Bipolar Disorder
Information for
patients and carers

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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.

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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.

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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
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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.

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Useful organisations
MDF The Bipolar Organisation
21 St. George's Road
London
SE1 6ES
Tel: 020 7793 2600
Email: mdf@mdf.org.uk
Web: www.mdf.org.uk
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: 0845 123 23 20
Email: information@depressionalliance.org
Web: www.depressionalliance.org
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: 08457 909090 (24 hours, 7 days a week) or 020 8889 6888
Email: jo@samaritans.org
Web: www.samaritans.org
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, email or in writing.

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Saneline
Tel: 08457 678 000 (6-11pm)
Email: sanemail@sane.org.uk
Web: www.sane.org.uk
Saneline offers support and information for people experiencing mental
health problems and to their families and carers.
Rethink
Information and Advice Tel: 0207 840 3188 or 0845 456 0455 (National
Advice Line open 10am to 2pm Mon-Fri)
Email: advice@rethink.org
Web: www.rethink.org
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: 0808 802 5544 (Parents support line)
Web: www.youngminds.org.uk
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: www.beh-mht.nhs.uk/wereheretohelp

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Produced By:
Date of Publication:
Page 12 Review Date:
Reference:

Communications
04/07/2013
04/07/2015
lc00005507