Bipolar Disorder: Managing Extreme Highs and Lows
Published: 09 December 2019
Published: 09 December 2019
Bipolar and related disorders now have a chapter of their own in the updated American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5): ‘Bipolar and Related Disorders’.
An estimated 1 in 50 (1.8%) Australian adults experience a bipolar disorder each year (Black Dog Institute 2018).
The exact causes of bipolar disorders are not yet clear. However, there is evidence to suggest that some people have a genetic disposition to developing bipolar disorder (Sane Australia 2016).
In the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), bipolar disorders are defined as a group of brain disorders that cause extreme fluctuations in a person’s mood, energy, and ability to function (DSM-5 quoted by Truschel 2019).
People with bipolar disorder will experience periods of mania and depression.
During mania, feelings of excitement, overactivity, delusions and euphoria will be present. In depressive periods, a person will feel sad and hopeless (Truschel 2019).
The term bipolar reflects the nature of the condition: a fluctuation between extreme highs and lows. These extreme emotional states may occur at distinct times or periods, categorised as manic, hypomanic, or depressive (Truschel 2019; APA 2017).
People with bipolar disorders will have periods of regular moods as well. There are treatments available for bipolar disorders; people with these conditions are still able to lead full and productive lives (APA 2017).
(Truschel 2019)
(Truschel 2019; APA 2017)
(Truschel 2019; APA 2017)
As per the DSM-5, there are five possible diagnoses for adult bipolar disorder:
(DSM-5 quoted by Purse 2019)
The first step to diagnosing bipolar disorder is to seek the opinion of a mental health professional.
To be considered as ‘manic’, the elevated, expansive or irritable mood alongside increased activity and energy must last for at least one week and be present most of the day, nearly every day (DSM-5 quoted by Black Dog Institute 2018).
Mania will be severe enough to disrupt work, family life, social life, and daily responsibilities (APA 2017).
During mania, three or more of the following must be present:
(DSM-5 quoted by Truschel 2019)
A hypomanic episode is quite similar to a manic episode. However, the symptoms will be less severe. Symptoms only need to last four days to be considered a hypomanic episode.
Hypomanic symptoms do not lead to the major problems that mania is associated with. Generally, a person will still be able to function (APA 2017).
A depressive period is a period of two weeks in which a person presents at least five of the following:
(DSM-5 quoted by Truschel 2019)
Bipolar requires long-term management. It is generally treated with a combination of medications - such as mood stabilisers, antidepressants or antipsychotics - as well as counselling, psychotherapy or community support (Healthy WA n.d.; Beyond Blue n.d.; Smith 2019).
The impact bipolar disorder can have on a person’s life should not be underestimated. Suicide risk is significantly higher among people who are living with bipolar disorder (APA 2017). Thankfully, there are treatments widely available for people who have bipolar disorders.
If you or someone you know needs help now, call Lifeline on 13 11 14. If someone is in immediate danger, call Triple Zero (000).
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True or false? 1 in 50 Australians of adult experience bipolar disorder each year.
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