Overview
What is bipolar disorder?
Bipolar disorder previously known as manic depression is a mental health condition marked by extreme shifts in mood, energy levels, and ability to function. It goes beyond ordinary ups and downs. People living with bipolar disorder experience episodes of emotional highs (mania or hypomania) and lows (depression), which can be intense and disruptive.
These aren’t mood swings you can simply "snap out of." They often disrupt relationships, jobs, and even one’s sense of identity. For someone in Nairobi or Lagos managing a demanding job, these swings can be particularly destabilizing, especially in healthcare systems still catching up with mental health care access.
Manic episodes
Manic episodes are periods of elevated or irritable mood that last at least one week (or less if hospitalization is required). They come with increased activity, impulsive behavior, racing thoughts, and a decreased need for sleep. These highs may feel good at first, but they can spiral into reckless decisions with long-term consequences.
Depressive episodes
On the flip side, depressive episodes bring deep sadness, hopelessness, fatigue, and difficulty concentrating. Simple tasks getting out of bed, showing up to work, taking care of oneself can feel insurmountable.
Why is bipolar disorder no longer called manic-depressive illness?
The term “manic-depressive illness” was phased out because it focused solely on two poles of the disorder mania and depression while missing the complexity of the condition. “Bipolar disorder” better reflects the broader spectrum of mood disturbances and allows for classification into different types.
What are the types of bipolar disorder?
There are several types of bipolar disorder:
-
Bipolar I Disorder: Involves full-blown manic episodes lasting at least 7 days, often followed by depressive episodes.
-
Bipolar II Disorder: Involves hypomania (a less intense form of mania) and major depression. Many people mistake this for ordinary mood changes, but it can be just as disruptive.
-
Cyclothymic Disorder (Cyclothymia): Characterized by periods of hypomanic and depressive symptoms lasting at least two years but not severe enough to be classified as full episodes.
What’s the difference between borderline personality disorder and bipolar disorder?
These two conditions can appear similar but are fundamentally different. Manic depression is primarily a mood disorder, while borderline personality disorder (BPD) is a personality disorder marked by unstable relationships, self-image, and emotions. The emotional swings in BPD are typically shorter and triggered by interpersonal conflict, while bipolar mood episodes last longer and follow a more cyclical pattern.
Who does bipolar disorder affect?
Manic depression doesn’t discriminate. It affects men and women equally and usually starts in the late teens or early adulthood. Unfortunately, in many African societies, it’s misunderstood or wrongly attributed to spiritual causes, leading to late diagnosis and limited support.
How common is bipolar disorder?
According to the National Institute of Mental Health, approximately 2.8% of U.S. adults had bipolar disorder in the past year. While African data are limited, global prevalence averages between 1–3%, and experts believe rates in Africa are likely similar, though underdiagnosis is widespread. Yet, the stigma in many African communities keeps many from seeking or receiving proper care.
Symptoms and Causes
What are the signs and symptoms of bipolar disorder?
The symptoms vary depending on the episode type.
Signs and symptoms of manic episodes
-
Unusually high energy and reduced need for sleep
-
Inflated self-esteem or grandiosity
-
Fast talking and racing thoughts
-
Risky behavior, like overspending or reckless driving
Signs and symptoms of hypomania
-
Similar to mania but less severe
-
May actually feel productive and exciting
-
Doesn’t typically cause significant disruption, but still indicates an underlying problem
Signs and symptoms of depressive episodes
-
Intense sadness, hopelessness
-
Loss of interest in activities
-
Changes in appetite and sleep
-
Suicidal thoughts or behaviors
Signs and symptoms of a mixed episode
-
Symptoms of both mania and depression occurring simultaneously
-
Feeling agitated but deeply sad
-
High energy combined with hopelessness one of the most dangerous states for suicide risk
What causes bipolar disorder?
There isn’t a single known cause. Rather, it’s believed to be a combination of:
-
Genetics: It tends to run in families.
-
Biological differences: Brain structure and chemistry may play a role.
-
Environmental factors: Stress, trauma, and substance abuse can trigger or worsen episodes.
Diagnosis and Tests
How is bipolar disorder diagnosed?
There’s no blood test or scan to diagnose Manic depression . A mental health professional uses detailed interviews, mood tracking, and symptom history to make a diagnosis. Sometimes, input from family or friends is essential, especially in cases where the person may not fully recognize their symptoms.
Management and Treatment
How is bipolar disorder treated?
Treatment aims to manage symptoms, prevent episodes, and improve functioning. It usually involves a combination of medication, therapy, and lifestyle changes. The goal isn't just to stabilize moods it’s to help individuals lead fulfilling, productive lives.
What types of therapy are used to treat bipolar disorder?
-
Cognitive Behavioral Therapy (CBT): Helps manage negative thought patterns.
-
Family-focused therapy: Strengthens family support systems.
-
Interpersonal and Social Rhythm Therapy (IPSRT): Focuses on maintaining routines and managing triggers.
What medications are used to treat bipolar disorder?
Mood stabilizers for bipolar disorder
Common ones include lithium and valproate. These are often long-term medications that help prevent both manic and depressive episodes.
Neuroleptic medications for bipolar disorder
Also known as antipsychotics, these help with severe mania and mixed episodes. Examples include olanzapine and risperidone.
Antidepressants for bipolar disorder
Used cautiously because they can trigger mania. Often combined with a mood stabilizer.
What are the side effects of bipolar disorder medications?
Side effects vary and may include weight gain, drowsiness, tremors, or nausea. Regular blood tests may be needed, especially with medications like lithium. Patients in African countries may face additional challenges due to inconsistent access to these drugs or trained psychiatrists.
What other medical treatments are used for bipolar disorder?
In severe or treatment-resistant cases, electroconvulsive therapy (ECT) might be used. Though often misunderstood, ECT can be life-saving when depression or mania is extreme.
What lifestyle changes can help with bipolar disorder?
Consistency is key. This includes regular sleep, a balanced diet, physical activity, and avoiding drugs or alcohol. Stress management, support groups, and open conversations with loved ones can also make a big difference.
Outlook / Prognosis
What is the outlook (prognosis) of bipolar disorder?
With proper treatment, many people live full, meaningful lives. It’s not always easy. Relapses can happen. But the earlier treatment begins, the better the outcome. Early intervention can also reduce the risk of job loss, relationship strain, and hospitalizations.
Prevention
Can bipolar disorder be prevented?
You can’t prevent bipolar disorder entirely, especially if there’s a genetic predisposition. However, early recognition of symptoms and quick access to treatment can prevent full-blown episodes and improve long-term outcomes.
Living With
When should I see my healthcare provider about bipolar disorder?
If your mood changes feel extreme, persistent, or are affecting your ability to function, it’s time to seek help. Don’t wait for a crisis.
When should I go to the emergency room (ER) for bipolar disorder?
If you or someone you know is having suicidal thoughts, engaging in reckless behavior, or experiencing psychosis, go to the ER immediately. Mental health emergencies are just as urgent as physical ones.
Frequently Asked Questions (FAQ)
How bipolar disorder is diagnosed?
Mental health professionals use clinical interviews, behavior assessments, mood charts, and history from family members to make a diagnosis.
Can bipolar disorder go away?
Bipolar disorder is a lifelong condition. While symptoms may lessen with treatment, the condition doesn’t just "go away."
Can bipolar disorder be cured?
There is no cure, but effective treatment can help people manage symptoms and lead stable, productive lives.
Will bipolar disorder go away?
Not entirely. It may become less severe or more manageable with treatment, but it usually requires ongoing care.
Published 21st August 2025
References
National Institute of Mental Health – Bipolar Disorder Available at: https://www.nimh.nih.gov/health/publications/bipolar-disorder
NHS (UK) – Bipolar Disorder. Available at: https://www.nhs.uk/mental-health/conditions/bipolar-disorder/
Cleveland Clinic – Bipolar Disorder. Available at: https://my.clevelandclinic.org/health/diseases/9294-bipolar-disorder
Mayo Clinic – Bipolar Disorder: Diagnosis & Treatment. Available at: https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961
Want to learn about brain fog?