Bipolar I Disorder: Information, Symptoms, Treatment and More

Bipolar I Disorder, also known as Bipolar Disorder Type 1, is a mental health condition characterised by intense mood swings, feelings of excessive highs (mania), and depressive lows (depression).

While many people have mood swings, Bipolar I Disorder involves intense mood swings – which can cause significant functional impairment.

Bipolar I Disorder is the most well-known form of Bipolar Disorder. This form of Bipolar Disorder features both manic and depressive mood states. These mood states can last for several weeks, causing substantial distress.

Bipolar I Disorder is a very difficult condition to live with. However, with the right treatment and support, symptoms can be controlled more, which should lead to an improvement in quality of life.

What are the symptoms of Bipolar Disorder Type 1?

The symptoms of Bipolar I Disorder typically fall into two categories – mania and depression. An individual with Bipolar I Disorder will tend to encounter periods of both mania and depression, with either capable of lasting anywhere from days to months.

Depressive phases typically last longer. The behaviour exhibited during the manic and depressive phases will differ from individual to individual.

An individual with Bipolar I Disorder will have had at least one manic episode in their life. Depressive episodes aren’t always included. In between episodes, an individual with Bipolar I Disorder can usually lead a relatively normal life.

As mentioned, both manic and depressive episodes are exhibited.

Mania

• Excessively happy feeling, euphoria
• Uncontrollably excited
• Racing thoughts
• Very confident
• Not needing much sleep
• Feelings of grandiosity
• Acting impulsively
• Taking risks
• Irritable
• More promiscuous
• Symptoms of psychosis

Depression

• Sadness
• Hopelessness
• Lack of energy
• Loss of interest in formerly enjoyable activities
• Feelings of guilt
• Changes in appetite
• Insomnia
• Low self-esteem
• Poor concentration
• Suicidal or Self-Harm Ideation

This isn’t an exhaustive list of symptoms, everyone will experience mood states differently. These symptoms will typically lead to an individual behaving in a markedly different way from their normal self.

For example, someone who is in a depressed state may feel suicidal, or avoid social activities wherever possible. Conversely, an individual in a manic state may engage in risky behaviour like drug abuse, or may appear to be over-friendly. They may go on a spending spree that has significant long-term ramifications.

Sometimes, symptoms of psychosis can appear. You can read more about mania here. Additionally, you can read more about a depressive episode here.

What are the causes of Bipolar Disorder Type 1?

It isn’t known what causes Bipolar I Disorder. Similarly, it isn’t known why some people suffer from certain types of Bipolar Disorder. There is rarely one set cause, sometimes multiple factors can contribute to the onset of the illness.

Genetics appears to be a significant risk factor – with all types of Bipolar Disorder capable of running in families [1].

Moreover, a chemical imbalance linked to key neurotransmitters in the brain has also been put forward as a potential cause.

Any form of trauma, especially during childhood, can act as a trigger. Similarly, being the victim of abuse can lead to Bipolar I Disorder developing. A major life event like money worries or divorce can also act as a risk factor.

Other mental health conditions can lead to Bipolar Disorder too. For instance, someone with Depression may later go on to develop Bipolar Disorder.

A range of factors can contribute to the onset of Bipolar I Disorder. Sometimes however, there is simply no cause involved.

Diagnosis of Bipolar Disorder Type 1

It is important to see a Doctor or mental health professional if an individual believes they are suffering from Bipolar I Disorder. Bipolar I Disorder is a serious illness, which left untreated, can cause result in all manner of problems.

At an appointment, a Doctor will ask the individual a series of questions regarding their symptoms, and subsequent feelings and behaviour. If they suspect the individual has Bipolar Disorder, the patient will be referred to a mental health specialist for a diagnosis.

When meeting a mental health specialist, a full assessment of the individual’s condition will be conducted. This will include more detailed questions regarding the symptoms – as well as any feelings in the build up to an episode.

A family history of mental illness may also be requested. A mood diary can be used to aid diagnosis.

For Bipolar I Disorder to be diagnosed, an individual will have:

• Experienced at least one manic episode in their lifetime.
• While a depressive episode isn’t required for diagnosis of Bipolar I, in the majority of cases, a depressive episode will have been present.

Sometimes, a different type of Bipolar Disorder will be diagnosed, if the symptoms of the patient better fit a different type.

Sometimes, someone may have a hypomanic episode prior to a fully-blown manic episode. In this case, they would be diagnosed with Bipolar II Disorder, before later being diagnosed with Bipolar I Disorder.

A diagnosis is seldom made over one appointment. A specialist may want to observe the behaviour of an individual over a period of time, due to risks of misdiagnosis.

Bipolar Disorder can easily be confused with other conditions like Depression, Schizophrenia and various Personality Disorders. Sometimes, one of these conditions will be diagnosed instead.

Once a diagnosis has been made, treatment can proceed. By getting a full picture of how Bipolar Disorder affects an individual, the specialist can tailor a treatment plan to fit the specific symptoms.

How is Bipolar Disorder Type 1 treated?

Treatment is available for Bipolar I Disorder. In many instances, with the right treatment plan, symptoms can be controlled much more. Treatment normally consists of:

Talking Therapy

Talking therapy is often used in the early stages of Bipolar Disorder, as an individual attempts to come to terms with their condition.

As the years go by, it is likely that the individual involved will have become more accustomed to living with their condition, meaning they may not need talking therapy.

There are many different types of therapy that can be used. Talking therapy can be particularly useful for helping an individual to recognise episode triggers, and to come up with healthy coping mechanisms.

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

There are a range of other types of talking therapies available. Therapy is recommended due to the many ways that talking therapy can help. We have more information on our Therapy section.

Medication

Medication plays an important role in the treatment of Bipolar Disorder, and is the primary component of treatment.

There are an array of medicines that can be used in treatment for Bipolar Disorder. Mood stabilisers, such as Lithium Carbonate, are predominantly used. They need to be taken on a long-term basis, and also involve regular blood tests.

Some anticonvulsants (primarily used for epilepsy), also have mood-stabilising properties. These include Valproate, Lamotrigine and Carbamazepine. These are useful when someone can’t take Lithium.

Sometimes, both Lithium and an anticonvulsant can be prescribed together. Valproate shouldn’t ever be prescribed to women who are at a childbearing age due to a high risk of physical and mental defects in an unborn child.

In cases where mania is present, antipsychotics may also provide relief. Antipsychotics such as Quetiapine, Risperidone, Olanzapine and occasionally Haloperidol can be used.

Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Others include Lamotrigine and Sodium Valproate, which are anticonvulsant medicines that have mood stabilising properties. These medicines are generally taken on a long-term basis.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Other

In severe cases, Electroconvulsive Therapy can be used. This can only ever be used in Bipolar Disorder when an individual has failed to respond adequately to a range of treatments, is experiencing a long and severe period of depression or mania, and is in a life-threatening situation.

Electroconvulsive Therapy (ECT): Electroconvulsive Therapy (commonly referred to as shock treatment) is a treatment that sees an electric current sent through the brain of an individual. The aim is to trigger an epileptic seizure, with the ultimate objective to relieve symptoms of a mental health problem. The human body is fully restrained during the procedure, which also involves a general anaesthetic. Electroconvulsive therapy is normally a last resort. Despite this, ECT actually has an impressive efficacy rate, with many people finding it helps immeasurably.

In the majority of cases, treatment can be conducted outside of a secure hospital. On occasion though, especially where cases of Bipolar involve psychosis, treatment will need to take place in a hospital.

This is especially relevant if an individual appears to be at risk of harming themselves or someone else. This is rare though.

Summary

Overall, Bipolar I Disorder is a very difficult condition to live with. Treatment however can be helpful, and should lead to an individual coping with symptoms in a much better way.

For more information, advice and support, our website has plenty of content to assist you.

See Also

• Bipolar Disorder Section
• What Is The Prognosis for Bipolar Disorder?
• Therapy Homepage
• Medicine Homepage