What is bipolar disorder?
Bipolar disorder is a mental health problem that mainly affects your mood. If you have bipolar disorder, you are likely to have times where you experience:
manic or hypomanic episodes (feeling high)
depressive episodes (feeling low)
potentially some psychotic symptoms during manic or depressed episodes
You might hear these different experiences referred to as mood states, and you can read more about them in our page on bipolar moods and symptoms.
Everyone has variations in their mood, but in bipolar disorder these changes can be very distressing and have a big impact on your life. You may feel that your high and low moods are extreme, and that swings in your mood are overwhelming.
Depending on the way you experience these mood states, and how severely they affect you, your doctor may diagnose you with a particular type of bipolar disorder.
It’s an emotional amplifier: when my mood is high I feel far quicker, funnier, smarter and livelier than anyone; when my mood is low I take on the suffering of the whole world.
What causes bipolar disorder?
No one knows exactly what causes bipolar disorder. Lots of recent research has focused on looking for causes in genetics or the biology of the brain, but many researchers also believe social factors may play a part, such as difficult life events or experiencing trauma as a child.
Some experts believe you may develop bipolar disorder if you experienced severe emotional distress as a child, such as:
sexual or physical abuse
losing someone very close to you, such as a parent or carer
This could be because experiencing trauma and distress as a child can have a big effect on your ability to regulate your emotions.
Stressful life events
You may be able to link the start of your symptoms to a very stressful period in your life, such as:
a relationship breakdown
money worries and poverty
experiencing a traumatic loss
Although lower levels of stress are unlikely to cause bipolar disorder, they can trigger an episode of mania or depression. (See our pages on managing stress for more information on the links between stress and mental health).
Some researchers believe that a manic episode may be a way to escape from feeling very depressed or having very low self-esteem. It may be that when you feel very bad about yourself, mania increases your self-confidence to help you cope.
Evidence shows that bipolar symptoms can be treated with certain psychiatric medications, which are known to act on the neurotransmitters (messenger chemicals) in your brain. This suggests that bipolar disorder may be related to problems with the function of these neurotransmitters – and this is supported by some research. However, no one knows for certain what exactly these problems are, or what causes them.
If you experience bipolar disorder, you are more likely to have a family member who also experiences bipolar moods and symptoms (though they might not have a diagnosis). This suggests that bipolar disorder might be passed on through families.
However, this does not necessarily mean that there is a ‘bipolar gene’ – family links are likely to be much more complex. For example, researchers think that environmental factors can also be triggers for experiencing symptoms of bipolar disorder. And for most people, family members are an influential part of your environment as you grow up.
How does a diagnosis get made?
To make a diagnosis your doctor will ask you about:
how many symptoms you experience
how long your manic or depressive episodes last
how many episodes you’ve had, and how frequently they occur
the impact your symptoms have on your life
your family history
They may also:
ask you to keep a diary of your moods to help them assess you
check for any physical health problems, such as thyroid problems which can cause mania-like symptoms
You can only be diagnosed with bipolar disorder by a mental health professional, such as a psychiatrist – not by your GP. However, if you’re experiencing bipolar moods and symptoms, discussing it with your GP can be a good first step. They can refer you to a psychiatrist, who will be able to assess you.