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Causes and Symptons

Causes
The cause of Bipolar Disorder is unknown[4]. The symptoms of Bipolar Disorder are thought to be caused by an imbalance of dopamine and serotonin neurotransmitters in the brain, which play a crucial role in emotional health[5-8].

Symptoms
Bipolar Disorder causes dramatic changes in mood: from overly ‘high’ and/or irritable (mania) to sad and hopeless (depression), and then back again, often with periods of normal mood in between. Extreme changes in behaviour and energy are associated with these changes in mood.[1]

Signs and symptoms of mania (or a manic episode)

  • Increased energy activity and restlessness
  • Excessively ‘high’ overly good euphoric mood
  • Easily distracted – unable to concentrate
  • Need for sleep significantly reduced
  • Unrealistic beliefs in one’s abilities and powers
  • Provocative intrusive or aggressive behaviour
  • Racing thoughts and talking very fast
  • Questionable/unreasonable business transactions and/or wasteful expenditure of money
  • Hyper sexuality
  • Occasional psychotic symptoms with as hallucinations
  • Denial that anything is wrong


Signs and symptoms of depression (or a depressive episode)
  • Lasting sad anxious or empty mood
  • Feelings of hopelessness and guilt
  • Feelings of pessimism and worthlessness
  • Loss of interest or pleasure in activities once enjoyed including sex
  • Decreased energy - a feeling of fatigue or of being ‘slowed down’
  • Difficulty concentrating remembering and making decisions
  • Sleeping too much or difficulty sleeping
  • Change in appetite and/or unintended weight loss or gain
  • Thoughts of death or suicide or suicide attempts


Between episodes, most people with Bipolar Disorder are free of symptoms, but as many as one-third of people have some residual symptoms. Even though symptoms may resolve between manic/depressive episodes the long term effects on the diseased patients’ lives may be significant and include marital difficulties, debts, social isolation, struggling at work or even losing their job.

Risk of Comorbid Conditions
Evidence shows that patients with severe mental illness can die up to three decades earlier than the general population. In Bipolar disorders, increased mortality can result from different causes:
  • Dangerous/erratic behaviour during manic episodes: i.e. car accidents resulting from dangerous driving
  • Drug Abuse/alcohol dependence: Bipolar patients have an increased risk of drug and particularly alcohol dependence
  • Suicide: During depressive episodes - bipolar patients may attempt to end their own lives due to profound desperate feelings of hopelessness and worthlessness
  • Somatic comorbidities: e.g. heart disease for which a major risk factor is weight gain