Bipolar Disorder

Understanding Bipolar Disorder

Bipolar disorder is associated with severe fluctuations in mood and energy, which can disrupt a patient’s personal life, family and work.

Bipolar disorder overview

Bipolar disorder is a mood disorder in which patients can experience periods of elevated mood and depressed mood.1 A period of elevated mood is known as a ‘manic episode’, and a period of depressed mood is known as a ‘depressive episode’. Between such episodes, a patient’s mood may return to normal, though they are often unable to perform to the best of their ability.1

 

Bipolar disorder is a serious condition, as shown by a risk of suicide that is more than 20 times greater than in the general population.2 Around a third of patients with bipolar disorder have attempted suicide during their lifetime.3

Facts about Bipolar Disorder 

Bipolar disorder is a mood disorder in which patients can experience periods of elevated mood and depressed mood.

A period of elevated mood is known as a ‘manic episode’, and a period of depressed mood is known as a ‘depressive
episode.

Symptoms of Bipolar disorder

Manic symptoms and depressive symptoms are polar opposites, hence the name ‘bipolar disorder’.

 

  • Manic episode1 – a person experiencing a manic episode will seem abnormally cheerful and full of energy. They may be extremely talkative and say things like, ‘I feel on top of the world.’ They may become obsessed with one particular activity, such as writing a novel, or it may seem that their thoughts are racing and that they are easily distracted. The person may sleep little, if at all. They may engage in risky activities, such as spending sprees, sexual promiscuity, or foolish business investments. The person may become irritable, and in some cases it is necessary to admit them to hospital. The symptoms may last for a week or more.
  • Depressive episode1 – a person experiencing a depressive episode will have a very low mood and is likely to lose interest in, or be unable to get pleasure from, almost all activities. They may feel sad, empty, and hopeless for a period of several weeks, affecting their ability to work and interact with others.

There are different types of bipolar disorder, depending on the presence and severity of manic and depressive symptoms.1 In most cases, patients will experience both types of episode.1

76%

of patients have their first symptoms before the age of 21 years.3

46 million

people worldwide live with bipolar disorder.2

Epidemiology and burden

Worldwide, 46 million people suffer from bipolar disorder,4 a roughly equal number of men and women.1 Bipolar disorder commonly emerges during adolescence, with 76% of sufferers having their first symptoms before the age of 21 years.5 Most people experience multiple episodes during their lifetime, with roughly one in four treated patients having a recurrence each year.6

 

Bipolar disorder has a negative impact on employment prospects, work performance, and work attendance.7 A global survey by the World Health Organization (WHO) found that people with bipolar disorder miss an average of 17 days of work or activities per year.8 According to the WHO, bipolar disorder is the 12th leading cause of moderate-to-severe disability worldwide.9

People who are concerned that they – or their loved ones – are experiencing symptoms of Bipolar Disorder should see their doctor for help and advice.

Diagnosis and care

People who are concerned that they – or their loved ones – are experiencing symptoms of bipolar disorder should see their doctor for help and advice. Bipolar disorder is diagnosed using patient interviews, and may involve discussions with loved ones.10 Bipolar disorder is commonly misdiagnosed, despite numerous assessment scales that can be used to help identify the symptoms. In one survey, 69% of patients had been misdiagnosed at least once, most commonly as having depression, and it can be many years before the correct diagnosis is made.11

 

Bipolar disorder is a recurrent, lifelong illness. Once a diagnosis is made, a combination of medication and psychosocial therapy is usually recommended.10 Depending on whether the patient is having a manic or depressive episode, different treatments are required.10

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
  2. Pompili M, Gonda X, Serafini G, Innamorati M, Sher L, Amore M, et al. Epidemiology of suicide in bipolar disorders: a systematic review of the literature. Bipolar Disord. 2013;15(5):457–490.
  3. Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010;12(1):1–9.
  4. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858.
  5. Perlis RH, Dennehy EB, Miklowitz DJ, Delbello MP, Ostacher M, Calabrese JR, et al. Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study. Bipolar Disord. 2009;11(4):391–400.
  6. Vázquez GH, Holtzman JN, Lolich M, Ketter TA, Baldessarini RJ. Recurrence rates in bipolar disorder: systematic comparison of long-term prospective, naturalistic studies versus randomized controlled trials. Eur Neuropsychopharmacol. 2015;25(10):1501–1512.
  7. Dean BB, Gerner D, Gerner RH. A systematic review evaluating health-related quality of life, work impairment, and healthcare costs and utilization in bipolar disorder. Curr Med Res Opin. 2004;20(2):139–154.
  8. Alonso J, Petukhova M, Vilagut G, Chatterji S, Heeringa S, Üstün TB, et al. Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys. Mol Psychiatry. 2011;16(12):1234–1246.
  9. World Health Organization. World Report on Disability 2011. Available from: http://www.who.int/disabilities/world_report/2011/report.pdf [accessed 17 September 2019].
  10. Grande I, Berk M, Birmaher B, Vieta E. Bipolar disorder. Lancet. 2016;387(10027):1561–1572.
  11. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic–depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64(2):161–174.

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
  2. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858.
  3. Perlis RH, Dennehy EB, Miklowitz DJ, Delbello MP, Ostacher M, Calabrese JR, et al. Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study. Bipolar Disord. 2009;11(4):391–400.
  4. Pompili M, Gonda X, Serafini G, Innamorati M, Sher L, Amore M, et al. Epidemiology of suicide in bipolar disorders: a systematic review of the literature. Bipolar Disord. 2013;15(5):457–490.
  5. Alonso J, Petukhova M, Vilagut G, Chatterji S, Heeringa S, Üstün TB, et al. Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys. Mol Psychiatry. 2011;16(12):1234–1246.
  6. World Health Organization. World Report on Disability 2011. Available from: http://www.who.int/disabilities/world_report/2011/report.pdf [accessed 17 September 2019].