Bipolar disorder

What bipolar disorder is

Bipolar disorder, formerly called manic-depressive illness, is a mental health condition that causes marked shifts in mood, energy, activity and concentration (NIMH). It is not the ups and downs everyone has: these are episodes that usually last days or weeks and change the way a person thinks, acts and relates to others.

There are two poles. In the high phases (mania or, when milder, hypomania) a person may feel euphoric or very irritable, with lots of energy, little need for sleep and racing thoughts. In the low phases depression appears: sadness, tiredness, loss of interest and hopelessness. Between episodes it is common to have periods of stable mood, which can last weeks, months or years (NHS).

It is a long-term condition, but there are treatments that help manage it and live a full life (NHS). The diagnosis is made by a psychiatrist, and it can take time, because the symptoms resemble those of other mental health problems and many people first seek help for depression.

Signs to look out for

• You have spells when you sleep very little and still feel full of energy.
• At times your thoughts race so fast you struggle to keep up, and you talk non-stop.
• You feel invincible or very impulsive: you spend a lot of money, take risky decisions or do things that are not like you.
• At other times you sink into deep sadness, with no energy or interest in anything.
• People close to you say there are times when you seem like a different person.
• You have been treated for depression, but you feel there is something more that does not fit.

How it is treated and what helps

Treatment is led by psychiatry. Clinical guidelines recommend combining medication that helps stabilise mood with psychological interventions designed for bipolar disorder (NICE CG185). Medication is assessed and prescribed by psychiatry, and it should not be stopped or changed without talking first to whoever prescribes it, even if you feel better (NHS).

Knowing your own pattern. Learning what triggers your phases, how they start and what your warning signs are (sleeping less, speeding up, withdrawing) lets you act before an episode escalates. Keeping a record of your mood and sleep helps you see it.

Routines that protect. Keeping regular hours, getting enough sleep, reducing stress and avoiding alcohol and other drugs help keep mood more stable (NHS).

What therapy does. At We Are Psycho we work alongside your psychiatric treatment, never instead of it. Therapy helps you understand the condition, recognise your warning signs, build a plan to prevent relapse and manage the impact it has on your life, your studies, your work and your relationships. It can also include your family, who are part of your support (NICE CG185).

What it does not do. Our team is made up of psychologists: we do not diagnose bipolar disorder or prescribe medication. If you do not have a diagnosis yet and recognise yourself in this page, the first step is to talk to your doctor, who will assess whether a psychiatric evaluation is needed.

When to ask for help

Everyone has better and worse days. It is time to see your doctor if you have extreme mood changes that last a long time or affect your daily life, or if you already have a diagnosis and feel your treatment is not helping (NHS).

Do not wait if, during a high phase, someone close to you is doing things that put them at risk, or is hearing or believing things that are not real: they need urgent medical attention. In immediate danger, call 112.

People with bipolar disorder are at higher risk of suicide (WHO). If thoughts of hurting yourself or of not wanting to go on appear, call 024 (Línea 24h de atención a la conducta suicida). We Are Psycho does not provide emergency care.

Frequently asked questions

Does having mood swings mean I am bipolar?

No. Mood swings are normal and usually relate to what is happening in your life. In bipolar disorder the changes are far more intense, last days or weeks, and change energy, sleep and behaviour. Only a psychiatric specialist can make the diagnosis.

Can you diagnose me or prescribe medication?

No. Our team is made up of psychologists, and diagnosis and medication are assessed and prescribed by medical staff. If your psychologist thinks a psychiatric assessment could help, they will tell you so you can discuss it with your doctor.

Can therapy replace medication?

No. In bipolar disorder, psychological therapy is added to psychiatric treatment: it helps prevent relapse and live better with the condition, but it does not replace it (NICE CG185). Any change to medication is decided with whoever manages your psychiatric treatment.

How does therapy work at We Are Psycho?

It is online and confidential. You tell us what is going on, we suggest the psychologist who fits you best and you choose. If you have questions about how it works first, we explain it in a free 20-minute call, with no commitment.