Bipolar personality disorder and Addiction

Bipolar disorder is often a misunderstood mental health condition. People with bipolar disorder experience intense mood swings, from manic highs to depressive lows. This unpredictability can make it challenging for others to grasp their struggles, leading to misconceptions and stigma. Recognising the complexities of bipolar disorder is vital for building empathy, dispelling misunderstandings and ultimately, getting the help needed to make a full recovery.

What is bipolar disorder?

Bipolar disorder, formerly known as manic-depressive illness, is a mental health condition characterised by extreme mood swings or episodes of mania and depression. It is classified as a mood disorder, specifically falling under the category of affective disorders.

The key features of bipolar disorder are the extreme highs, known as manic episodes and the extreme lows, known as depressive episodes. These mood swings can be severe and interfere with a person’s daily life, relationships and overall functioning.

There are two main subtypes of bipolar disorder, bipolar I and bipolar II, although other variations of the disorder exist.

What are the symptoms of bipolar disorder?

Bipolar disorder is characterised by distinct episodes of mania, major depression and hypomania, but it is worth noting that these symptoms aren’t a one-size-fits-all. Some people diagnosed with the disorder may show different symptoms.

What is a major depressive episode?

Major depressive episodes manifest as persistent sadness, lethargy and feelings of worthlessness, representing a profound downturn in mood and energy. Some of the symptoms of a depressive episode include;

  • Persistent sadness or low mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite or weight
  • Sleep disturbances (insomnia or hypersomnia)
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Difficulty concentrating or making decisions
  • Thoughts of death or suicide

What is a manic episode?

Manic episodes in bipolar disorder involve heightened energy, euphoria and impulsivity, often leading to risky behaviours. They reflect an extreme shift towards elevated mood and excessive activity. The symptoms of a manic episode are;

  • Elevated or irritable mood
  • Increased energy and activity
  • Racing thoughts and rapid speech
  • Decreased need for sleep
  • Grandiosity or inflated self-esteem
  • Impulsivity and poor judgement
  • Increased involvement in activities that may have negative consequences (e.g., excessive spending, risky sexual behaviour)

What is a hypomanic episode?

A hypomanic episode is a milder form of mania that characterises bipolar II disorder. It involves an elevated mood, increased energy and heightened activity levels. While individuals in a hypomanic state may experience enhanced productivity and creativity, their behaviour remains manageable, and they typically don’t exhibit severe impairment or psychosis, as seen in full manic episodes. The symptoms are as follows:

  • Similar to manic episodes but less severe
  • Increased energy and activity
  • Elevated mood
  • Increased confidence and productivity


There are specific criteria for confirming each of these three bipolar episode characteristics. Confirmation should be obtained from a medical specialist and not based on self-diagnosis. If you suspect any of these symptoms in yourself or others, it is imperative to contact professional healthcare specialists for further assessment and appropriate action.

What are the different types of bipolar disorder?

There are several types of bipolar disorder, each with its own distinct features. Here is an overview of the different types:

Bipolar I disorder
This is marked by manic episodes persisting for a minimum of seven days or by intense manic symptoms necessitating immediate hospitalization. Depressive episodes may also manifest, typically enduring for a minimum of two weeks. Certain individuals diagnosed with Bipolar I Disorder might undergo mixed episodes, wherein both manic and depressive symptoms co-occur.
Bipolar II disorder
In this type, individuals experience both depressive episodes and hypomanic episodes. Hypomanic episodes do not usually lead to severe impairment in daily functioning, and individuals with Bipolar II disorder may not require hospitalisation.
Cyclothymic disorder
Cyclothymic disorder represents a less severe manifestation of bipolar disorder, marked by recurring periods of hypomanic and depressive symptoms that do not fulfill the criteria for major depressive or manic episodes. These symptoms endure for a minimum of two years.
Substance/medication-induced bipolar and related disorder

This type of bipolar disorder is directly caused by substance abuse, medication or exposure to toxins. Symptoms of bipolar-like mood swings emerge during or shortly after substance use or withdrawal.

Bipolar and related disorder due to another medical condition
Some medical conditions can lead to symptoms resembling bipolar disorder. For example, certain neurological conditions or endocrine disorders may trigger mood swings. In this case, the bipolar symptoms are attributed to the underlying medical condition.
Other specified bipolar and related disorder
This category includes presentations of bipolar disorder that do not fit the criteria for the specific types mentioned above. It allows for the acknowledgement of variations in symptom patterns.
Unspecified bipolar and related disorder
This category is used when the symptoms do not clearly align with any specific subtype of bipolar disorder or when there is insufficient information to make a more specific diagnosis.

What causes bipolar disorder?

The precise causes of bipolar disorder remain unclear, yet it is believed to arise from a complex interplay of various elements encompassing biology, neurobiology, genetics and environmental factors. Here are some potential causes:

  • Genetics: Bipolar disorder tends to run in families, suggesting a genetic component. Individuals with a family history of bipolar disorder may be at a higher risk.
  • Biological factors: Imbalances in neurotransmitters (chemical messengers in the brain) may play a role in bipolar disorder. Neurotransmitters like dopamine, serotonin and norepinephrine are involved in regulating mood and disruptions in their functioning may contribute to mood swings.
  • Brain structure and functioning: Some studies suggest that abnormalities in the structure and functioning of certain brain areas, such as the prefrontal cortex and amygdala, may be linked to bipolar disorder. These areas are involved in emotional regulation and decision-making.
  • Hormonal imbalances: Changes in hormonal levels may trigger the onset of bipolar disorder in some individuals. One recent study suggests that participants with bipolar showed higher levels of testosterone, estradiol and other hormones when experiencing a manic episode.
  • Stressful life events: High levels of stress, trauma, or major life changes can contribute to the development or exacerbation of bipolar disorder in susceptible individuals. Stressful events may act as triggers for both manic and depressive episodes.
  • Drug or substance abuse: Substance abuse, including alcohol and drugs, can contribute to the onset or worsening of bipolar disorder. Additionally, some medications or recreational drugs may induce manic or depressive episodes.

Can bipolar be dangerous?

Bipolar disorder itself is a mental health condition that is not dangerous. It can be challenging to manage, but it doesn’t inherently make you dangerous. People with bipolar disorder can lead fulfilling and productive lives with appropriate treatment and support.

However, during manic episodes, people with bipolar disorder may experience heightened energy, impulsivity and sometimes a lack of judgement. In some cases, this can lead to risky behaviours or actions that may harm themselves or others. Individuals with bipolar disorder must receive appropriate medical care to help manage their symptoms and reduce the risk of potential harm.

If someone you know is struggling with bipolar disorder or you are concerned about their well-being, it’s important to encourage them to seek professional help from mental health professionals. Early diagnosis and effective treatment can make a significant difference in managing bipolar disorder and preventing potential dangers associated with extreme mood swings.

What treatment is available for bipolar disorder?

The primary objective of bipolar disorder treatment is to reduce the intensity and frequency of depressive and manic episodes, facilitating a more typical and functional life.

When left untreated, episodes of manic states associated with bipolar disorder can persist for 3 to 6 months, while depressive episodes often endure for 6 to 12 months. However, with effective treatment, the duration and severity of these episodes typically diminish.

A comprehensive approach to treatment often involves a combination of the following strategies:

  • Recognition and management: Learning to identify triggers and early signs of depressive or manic episodes is crucial for effective self-management.
  • Medication: Long-term use of mood stabilisers helps prevent both manic and depressive episodes. Additionally, medications targeting specific symptoms are prescribed when episodes occur.
  • Psychological treatment: Therapeutic interventions play a significant role in helping you cope with depression and offering guidance on improving interpersonal relationships. These therapies could include CBT, DBT, and family therapy, which could be used individually or in combination.
  • Lifestyle recommendations: Incorporating lifestyle changes for those suffering from bipolar disorder could contribute to their overall well-being. Activities such as regular exercise, playing sports, and adopting healthier dietary habits and sleep patterns can significantly help you on your road to recovery.

The majority of individuals with bipolar disorder can undergo treatment without requiring hospitalisation. However, in cases of severe symptoms or when treatment is mandated under the Mental Health Act (in the UK) due to potential self-harm or harm to others, hospitalisation may be necessary. In certain situations, day hospital treatment is an option, allowing individuals to return home at night.

What are the next steps?

If you think you or someone you care about might have bipolar disorder, don’t be afraid to ask for help. Treatment today can make a huge difference, allowing people with bipolar disorder to lead full and satisfying lives. Reach out to professionals for support and guidance. Getting help is a brave and important step toward a better, more balanced future. You’re not alone, and there’s hope for a brighter tomorrow.

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Do people with bipolar have an increased risk of addiction?
People with bipolar disorder face an increased risk of substance abuse and addiction. It’s currently not known why, but research suggests that common neurobiological and genetic factors may be the reason why. However, not everyone with bipolar disorder will develop a substance use disorder, emphasising the importance of proper diagnosis, treatment and support from mental health professionals to manage these complex conditions.
How common is bipolar disorder?
According to Bipolar UK, a bipolar disorder charity, approximately 1.3 million individuals presently carry a diagnosis of bipolar disorder, representing 1 in 50 people. Bipolar UK further suggests that 1%-2% of the UK’s population encounter bipolar disorder throughout their lifetime, with up to 5% of individuals falling within the broader bipolar spectrum.
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