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Symptoms of mania

  • Elevated mood or feeling elated

  • Talking very quickly

  • Becoming irritable or agitated

  • Having an excess of energy

  • Reduced need for sleep

  • Reduced appetite

  • Impulsivity

  • Engaging in risky or harmful behaviours

  • Increased creativity or having lots of new ideas

  • Feeling self-important or grandiose

  • Can experience hallucinations or delusions

  • Acting significantly out of character

Symptoms of depression

  • Low mood or persistent feeling of sadness

  • Feeling hopeless or that life has no purpose

  • Difficulty sleeping or sleeping too much

  • Early morning wake ups

  • Difficulty concentrating

  • Self doubt or feeling pessimistic

  • Feeling numb or 'empty'

  • Feelings of guilt or despair

  • Lack of interest in activities or socialising

  • Lack of appetite or eating too much

  • Suicidal thoughts or urges

  • Dissociation or feeling 'zoned out'

  • Lack of energy

  • Low self esteem

Diagnosing bipolar affective disorder

 

Bipolar disorder is usually diagnosed by a psychiatrist.  General practitioners and other health professionals will usually refer to mental health team if they suspect that someone has bipolar disorder and the person will be assessed within that service.

 

The psychiatrist will usually ask the person questions about their symptoms and how long they have experienced them.  They will also ask about suicidal thoughts or thoughts that a person may harm themselves to assess level of risk.  They often ask about family history of mental illness because bipolar disorder can often run in families, as with Carrie and her father in Homeland.

 

Sometimes the doctor will carry out physical tests to rule out other health conditions that could mimic symptoms of bipolar disorder and they are always aware of differential diagnoses such as substance misuse, personality disorders or anxiety disorders.  In order for a person to be diagnosed as having bipolar affective disorder, they must have experienced at least two episodes of a clinically significant disturbance in mood.  This could include an episode of full mania (elevated mood that significantly interferes with daily functioning for a period of at least seven days) and an episode of depression or a moderate to severe depressive episode lasting at least two weeks and an episode of mania or hypomania (elevated mood lasting at least four days with similar symptoms to full mania but less intense).

 

On average, manic episodes can last from two weeks to five months whereas depressive episodes can last up to a year, although most last approximately six months.  There are different sub-types of bipolar disorder ranging from mostly depressive episodes alternating with hypomania to mixed episodes or rapid-cycling bipolar disorder where a person experiences symptoms of depression and of mania either in the same episode or in quick succession.  Many people have periods of stable mood in between episodes and treatment is mainly focussed on stabilising moods.

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