Bipolar Disorder
- medyouthalliance
- 6 days ago
- 7 min read
Written by Dilmi Bodha-Hennadige
Med Youth Alliance | October 2025
What is Bipolar Disorder?
Bipolar Disorder is classed as a long-term mental health condition with no established cure. It is most commonly recognised through extreme mood swings between emotional highs. There can be periods of high moods, low moods and stability which can last days or even weeks at a time. The lack of control that people with bipolar disorder have over these mood changes leads to problems in concentration, energy, judgement, sleeping patterns and daily functioning and activity.
What are the emotional highs that people with bipolar experience?
Before looking at the symptoms of bipolar disorder, it is imperative that we first understand the two moods that people who suffer from bipolar experience: mania (or hypomania) [the high moods] and depression [the low moods].
What is mania?
Mania is an abnormal state of erratic mood and extreme happiness. You would gain a highly energized level of physical and mental activity, and would have a decreased need for sleep (which could lead to insomnia - the difficulty of falling and staying asleep). Hypomania is less severe than mania, and usually never leads to hospitalization, unlike many cases of mania can, because of its reduced impacts on daily functioning and activity. However, the effects of both mania and hypomania are noticeable by the people you surround yourself with, especially when a person is deviating from the 'normal' behaviour that others perceive them to display on a daily basis. A simpler way to condense this is behaviour that is seen to be way 'over-the-top'.
A manic episode is how we describe the time period of which a person who is suffering from bipolar experiences these extreme highs. These usually last for a week, or only a few days if it is a case of a hypomanic episode. A rare yet severe case of mania is unipolar mania, where a person experiences recurring manic episodes and no low moods (depressive episodes).
Another severity of a manic episode is that it can occasionally lead to psychosis. This is when you could experience a break in reality, and perceive the world very differently through disorientation and confusion. It has two main symptoms: hallucinations and delusions. You would see or heard things that aren't really there, blurring the lines between reality and illusion, and you would indulge in unrealistic thoughts, from being extremely paranoid to exaggerated confidence.
What are some symptoms of mania/manic episodes?
Feeling extremely happy and excited
Experiencing abnormal levels of energy
Reduced need for sleep (can develop insomnia)
Having reduced concentration and focus
Talking very quickly and jumping between topics
Lacking coherent sense in the way you speak or think
Feeling erratic confidence/well being
Being impulsive and making poor decisions instantly
Easily irritated and saying inappropriate things you wouldn't normally say
What is a depressive episode?
We all have some familiarity with the separate mental health of depression. However, a depressive episode is a state of persistent sadness and melancholy that a person who suffers with bipolar will experience alongside manic episodes. It could last from a few days to a week. You would struggle with intense unhappiness, which can lead to low self-esteem and confidence, and in extreme cases, can cause suicidal thoughts. You would have abnormally low levels of energy, making you feel sluggish and unmotivated to do the things that you would normally love doing. The people who you surround yourself with can notice your withdrawal from many social situations and your loss of contact with them, isolating yourself for prolonged periods of time, deviating from you 'normal' behaviour.
Most people suffering with bipolar have acknowledged that depressive episodes are sometimes harder to manage than manic episodes. Although manic episodes can lead to embarrassment, the regretting of decisions and anger after it has passed, depressive episodes can leave long-lasting impacts on a person, such as the development of self-harm, addiction to drugs and alcohol and thoughts of suicide. Furthermore, people who experience depressive episodes can still experience psychosis (above).
What are some symptoms of depressive episodes?
Extremely sadness/melancholy
Abnormally low energy levels
Loss of interest in passions and activities
Problems with sleeping patterns (insomnia or hypersomnia can be developed)
Eating too much or too little food
Low self- esteem and confidence
Low motivations towards personal hygiene and self-care
Isolation and loss of contact with others
Low concentration and focus
Increasing thoughts of suicide
Are there states of stability?
Yes, there can be periods of time where a person suffering with bipolar will not experience a manic or depressive episode. These can last days, weeks, months, or even years, so a person with bipolar isn't always just in one state or the other. However, the opposite of this is rapid cycling, when a person experiences many recurring episodes between mania and depression.
What are some other types of bipolar disorder?
1) Bipolar I Disorder = You've experienced one or more manic episodes before or after a major depressive one, which can lead to psychosis.
2) Bipolar II Disorder = You've experienced one or more depressive or hypomanic episodes, but never a manic one.
3) Cyclothymia = You've experienced mostly hypomanic episodes across a two-year period and some depressive ones, which are less severe than major depressive episodes.
What are some risk factors for bipolar disorder?
Although it is unknown what directly causes bipolar disorder, there are some risk factors that can lead to its development.
1) Family History = If your family has had a history of diagnoses in bipolar disorder, especially a first-degree relative such as a parent or sibling, then your genes may contain a vulnerability towards it development. Scientists are working towards identifying these complex links of genes.
2) Periods of High Stress = When a stressful event impacts your life, such as the death of a loved one, abuse or financial problems etc., it increases your chances of developing bipolar.
3) Misuse of recreational drugs or alcohol = Indulging in severe amounts of drugs such as cocaine and cannabis, or alcohol, has been proven to be a risk factor. Sometimes, even the medication you take for certain ailments can lead to hypomanic episodes (speak to your doctor about this!).
4) Childhood trauma = Since distress and trauma from a young age can affect your ability to control your emotions, childhood trauma acts as another risk factor. This involves physical or sexual abuse, neglect and losing a loved one.
5) Environmental/Social factors = Beside family history, research has found that the environment that you surround yourself with also influences your chances in developing bipolar disorder. Growing up in a particularly toxic and stressful environment can act as a risk factor too.
6) Brain Chemistry = Since some symptoms of bipolar can be treated by medications that work on neurotransmitters, it can show an indirect link of neurotransmitter levels to the development of bipolar (more on this will be discussed down below).
How can brain structure/chemistry affect bipolar disorder?
As briefly explained above, the brain has relevance to the development and symptoms of bipolar disorder.
One way is through neurotransmitter levels. Neurotransmitters are the chemicals found in synapses (gaps) between the neurons in the brain. Differing levels in neurotransmitters leads to changes in how the nervous system communicates, and this leads to changes in behaviour. We have not yet found which specific neurotransmitters are linked to bipolar, however most scientists suspect neurotransmitters such as dopamine, serotonin and norepinephrine.
Another way is through the brain's physical structure itself. Bipolar affects mainly the:
Prefrontal Cortex
Hippocampus
Gray Matter
Prefrontal Cortex = This area plays a crucial role in mood disorders, so any structural change or damage to it can lead to abnormal behaviours.
Hippocampus = This area is essential for emotional control, a key factor concerning bipolar. It even oversees stress control, which we saw was a risk factor for developing bipolar. A study in 2017 found that the hippocampus has a reduced size in those with bipolar, especially those who suffer with Bipolar I Disorder with more severe manic episodes. However, some of the results for similar studies lacked consistency, so we cannot be 100% sure that the size of the hippocampus and the development of bipolar disorder correlate.
Gray Matter = This is the area of the outermost part of the brain and spinal cord. It is crucial for everyday human functioning, which is clearly affected by bipolar disorder. A 2016 analysis of gray matter has found that there is a significantly lower volume of gray matter in the brains of those with bipolar disorder, finding a link between manic episodes and the decreasing volume of matter.
[REMEMBER: a key fact to take into account is that all of these biological factors cannot be determined and sorted into categories of causes or symptoms of bipolar disorder. We still do not know if the factors above are what will cause its development or if they are what happens because of the development of bipolar disorder.]
If there is no cure, are there any treatments for bipolar disorder?
Yes, although the disorder can never fully 'disappear', there are methods to relieve symptoms and make the journey more manageable.
Medication = Doctors usually prescribe 1 of 3 medications or patients with bipolar: antipsychotics, anticonvulsants or antidepressants.
Antipsychotics are used to both treat manic and depressive episodes. If they aren't working, the doctor may also prescribe lithium to be taken alongside it to reduce suicidal thoughts, severe episodes and self-harm tendencies. However, the dosage must be exactly right, so patients have to go through regular blood tests.
Anticonvulsants are simply 'mood stabilizers' that reduce the chances of episodes.
Antidepressants are used to treat only depressive episodes through methods such as selective serotonin reuptake inhibition (SSRIs). However, antidepressants are sensitive territory, as taking them with lithium can cause implications.
Talking Therapy = Talking therapies are usually prescribed alongside medication in order to aid the patient in the long term. The most common are CBT, Interpersonal Therapy and Individual Psychoeducation.
CBT is Cognitive Behavioural Therapy, which focuses on your feelings, thinking patterns and thoughts. You can discuss your irrational thoughts whilst a therapist tries to dispute these and reassure you. This helps you cope with your emotions on a daily basis.
Interpersonal Therapy focuses on your relationship with others and how this affects your thoughts and feelings. You discuss how your disorder can ruin relationships, and how you can amend this for future references.
Individual Psychoeducation focuses on your triggers, warning signs and helps you develop coping strategies, like making a crisis plan for when you experience an episode.
It is crucial that we stay aware of symptoms, warning signs and treatments of bipolar disorder so that you can help someone who could be struggling, because it will never be an easy thing to battle alone.
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