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Depression involves low mood and volition, feelings of hopelessness, extreme sadness and lack of interest and pleasure in things. At extremes, depression may involve suicidal ideation or action.
Mania (or hypomania) includes extremely high mood and activity or agitation, racing thoughts, little need for sleep and rapid speech. Extreme forms of mania may include psychotic elements, where the sufferer has break with reality. Sufferers may have grandiose or persecutory delusions, or have auditory or visual hallucinations. During a manic episode, sufferers often do not want the experience to end as they feel highly energised and vigorous. Hypomania is a mild form of mania.
Sufferers with depression will exhibit signs of low mood, lack of energy and lack of volition. They will typically not engage in or take pleasure in regular life activities.
Sufferers with mania will exhibit signs of agitation, high levels of creativity, rapid speech and thought, and little need for sleep. Some people with mania may spend money in an uncontrollable or insensible way. People with extreme mania may display symptoms of psychosis or break with reality.
Triggers for relapse may include taking cannabis and other drugs and alcohol, excessive stress, negative life events, disturbed sleep patterns, suddenly stopping prescribed medication or flying overseas.
Early diagnosis and treatment of bipolar is very important to boost long-term prognosis.
While there is no known cure for bipolar disorder, the severity and the frequency of episodes can be reduced or prevented with medication and other supports, such as psychological therapies and family. Medication is typically constituted by mood stabilisers, antipsychotics and antidepressants. The most widely used mood stabilisers for the treatment of bipolar disorder include lithium carbonate and sodium valproate.
In general the best first step if you think a loved one has bipolar should be to contact your local GP. If possible, bring your loved one to meet the GP.
However, in some cases, a person experiencing mania may not want to visit a clinician as they may have little insight or do not want the experience to stop. If they display psychotic symptoms, they may be quite convinced of the reality of what they are experiencing. To them, the delusion or hallucination may seem very real. In such circumstances it is best to find a mental health worker via your local community mental health service who has experience dealing with people with bipolar in these circumstances.
If you think your loved one is in danger of hurting themselves or someone else, please contact your local hospital or emergency services.