What is bipolar disorder and could I have it?

People living with bipolar disorder can experience extreme mood swings. Recognising the symptoms and getting help earlier can make all the difference.

Susana Bluwol hadn’t been sleeping much. She was a 21-year-old university student on a scholarship in the United States, buzzing with energy and ideas – and experiencing symptoms of bipolar disorder.

“I was actually enjoying it at first because the first symptom was that I didn’t sleep very much,” says Susana. “It was just two hours per night. But I woke up very refreshed with a lot of energy. I thought ‘this is fantastic because I can do a lot of things during the day’.”

She was very sociable and did well at her studies. But some of her decisions seemed questionable to those who knew her. Susana experienced her first psychotic episode while on a university trip.

“I noticed my thoughts were getting very, very rapid and I couldn’t stop them. I thought ‘if I write them down maybe they will stop’, but they didn’t. I just couldn’t put a stop to them.”

That night, she stayed up all night talking with a traveller she’d met and didn’t get even her usual two hours of sleep.

“When you reach the psychotic level, you live your own reality. There’s very little that other people can do to move your idea. Everyone is wrong. You’re the only one that is right,” says Susana, recalling what happened that day that led to her first hospitalisation.

“It’s not that I was having a hallucination. It was something coming from inside me telling me I had to give the world a message to live in peace. And I realised, what better time to do it? I’m only two blocks from the White House. I will visit the President and he can pass on the message.

“I was absolutely convinced I was going to do that. In my mind, all the media was already arranged. Everybody was going to be there.”

Her lecturer called emergency services and professional help stepped in.

The manic episode was followed by a very deep depression.

“And that’s typical bipolar. Everything that goes up, comes back down again,” says Susana. She left university and spent many difficult months recovering.

She was 39, with a professional career, and married with two young children before she experienced another episode and received a diagnosis of bipolar I.

What is bipolar disorder?

Bipolar disorder (previously known as manic depression) affects one in 50 Australians each year. People living with bipolar disorder can experience extreme mood swings, known as episodes, between mania and depression; high moods and low.

There are several different types, but the most common are Bipolar I (long-lasting, extreme highs and lows, and possibly hallucinations and delusions) and Bipolar II (less extreme moods that don’t involve psychosis, lasting hours or days).

What causes bipolar disorder?

Genetics is a big factor, accounting for around 80% of the cause of the condition. Physical and environmental factors play an important role, too: a stressful life event can trigger onset, and symptoms can be brought on by things like pregnancy, medication, illicit drugs and even seasonal changes.

“People need to know that by reaching out, by getting help, and the sooner the better, they don’t need to get into very, very bad episodes of mania or depression if they reach a doctor and they follow their instructions,” Susana stresses.

She co-founded Bipolar Australia to help others with their recovery, raise awareness, and to educate communities, professionals, families and carers about bipolar disorder.

What are the symptoms of bipolar disorder?

Most people first experience bipolar disorder in their teenage years or early 20s, but it can still occur in childhood or mid-to-late adulthood. It takes an average of nine years from onset of bipolar disorder to diagnosis. And the sooner you can start getting help, the better.

Symptoms of a manic episode can include:

• feeling extremely high, happy, or irritable
• having very grand ideas and self-esteem
• having a lot of energy, heightened creativity, feeling ‘wired’ or ‘hyper’, and needing far less sleep than usual
• staying up all night to get things done, focusing intensely on specific things
• talking and thinking quickly, jumping from one thought or topic to another, not being able to focus
• impulsive, inappropriate or risky behaviour (like spending a lot of money, a lack of inhibition, doing outrageous things)
• experiencing delusions or hallucinations.

Depressive episodes can involve:

• a low mood
• lack of motivation
• no interest in your usual hobbies or enjoyment of the things that make you happy
• different sleep patterns
• lack of concentration
• not wanting contact with people and withdrawing from activities
• feeling worthless, guilty, or having suicidal thoughts.

The pattern of episodes is different for everyone. Some people experience them daily (called “rapid cycling”), while for others the gap between episodes can be years.

If you have any concerns, your first port of call is your GP, who can put you in touch with a specialist. Only a qualified mental health professional can diagnose bipolar disorder.

Treatment, support and recovery

While bipolar disorder is a chronic, long-term condition there is effective urgent and long-term treatment and management. Education, psychological and lifestyle approaches, and a good support team are key to long-term recovery. Medication is used to achieve and maintain stability and in some cases, electroconvulsive therapy (ECT) can help some people experiencing manic or depressive episodes.

“It’s not just taking a pill, definitely not,” Susana explains. Her support team has included psychiatrists, psychologists, and other health professionals for improving things like her diet and exercise.

Support groups also play a very important role and can be found around Australia.

Educating family, friends and carers also makes an enormous difference to recovery.

“Recovery is possible through diagnosis, treatment and management,” says Susana. “There is nothing wrong with having the condition, and you will help yourself if you can [get help] as soon as possible.”

If you need to speak to someone right now, call Lifeline on 13 11 14.

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