What is bipolar disorder?Bipolar disorder is a condition in which your mood can swing very high, or very low, for weeks or months. It used to be called Manic Depression.Your mood can be:low with intense depression and despair high or ‘manic’ with elation, over-activity or angera mixed state with symptoms of depression and mania.Bipolar disorder is less common than depression. It affects about 1 person in a 100.What causes bipolar disorder?It seems to run in families, so genes are involved. Genetic causes are less common in the elderly.There may be a physical problem with the brain systems which control mood.Stress can trigger episodes.How does it feel to have bipolar disorder? Depression Feelings of unhappiness that dont go awayAgitation and restlessnessLoss of self-confidenceFeeling useless, inadequate and hopelessThoughts of suicideNot able to think positively or hopefullyCant make decisionsCant concentrate, lose interestCant eat, lose weightCant sleep properly, wake early in the morningGo off sexAvoid other people ManiaVery happy and excitedFeel more important than usualFull of new and exciting ideasMove quickly from one idea to anotherFull of energyDont want to sleepMore interested in sexMake unrealistic plansVery overactive, talking quicklyIrritable with other people who cant go along with your mood and ideasSpending more moneyLose insight and be unaware of how unwell you areIn a severe mood swing, you can have psychotic symptoms. When depressed, you may believe that you are evil or guilty, that you are worse than anybody else, or even that you dont exist.When manic, you may feel that you are on an important mission or that you have special powers and abilities.You might also experience hallucinations - when you hear or see something that isn’t there. TreatmentTreating a high: lithium, antipsychotics and sodium valproate are the medications most commonly used. Sodium valproate should not be prescribed to women of child-bearing age.Treating depression: antidepressants should be used carefully as they can make people go high. Its best to stop them as soon as the depression goes away.Psychological treatments: these can also help. Methods include:psycho-education: learning about the condition and how to control itmood monitoring: you learn to notice when your mood is starting to changeCognitive Behavioural Therapy (CBT) to prevent a full blown manic or depressive episode.Self helpLearn to spot the early warning signs so you can get help early.Find out as much as you can about bipolar disorder.Be aware of how stress affects you.Have at least one person that you can rely on and confide in - someone who can warn you if you think you are not well.Balance your life and work, leisure, and relationships.Do things that you enjoy and that give your life meaning.Dont stop medication suddenly.You may find it useful to keep a diary to record your daily mood.You may want to write an ‘advance directive’ with your doctor and family to say how you want to be treated if you become unwell again.Try to eat a healthy diet and to sleep well.If you drink alcohol, stick to the safe limits. Helping someone elseWhen someone is depressed, it can be difficult to know what to say. They see everything in a negative light. Listen and try to be patient and understanding. During mania, the person will appear to be happy, energetic and outgoing. But the excitement of any social situations will risk sending their mood even higher and their doing things that are out of character for them. Try to steer them away from parties or heated discussions. Persuade them to get help.In between mood episodes, find out more about the condition. Go to appointments with them (if they are willing). Make sure you give yourself space and time to recharge your batteries.For more in-depth information see our main leaflet: Bipolar DisorderThis leaflet reflects the most up-to-date evidence at the time of writing.Produced by the RCPsych Public Education Editorial Board.Series Editor: Dr Philip TimmsReviewed by Dr Ros Ramsay© April 2015. Due for review: April 2018. Royal College of Psychiatrists.