Bipolar Affective Disorder


Bipolar Affective Disorder

Table of Contents

What is Bipolar Affective Disorder?

Mental health disorders are a top leading cause of disabilities in the United States and worldwide. According to John Hopkins Medicine, “Approximately 9.5% of American adults ages 18 and over, will suffer from a depressive illness (major depression, bipolar disorder, or dysthymia) each year.” Mental disorders have the capability of overwhelming victims simultaneously. A person can suffer from a mental health disorder such as depression and suffer from anxiety at the same time.1

Bipolar affective disorder, which was known as manic depression, is a medically diagnosed characterization based on the alterations of an individual’s mood experiencing depression and mania. Manic depression, or bipolar affective disorder, consists of two poles – a high and a low. Affective disorder deals with an individual’s mood where the high pole is considered mania and the low pole considered depression.2


During a depressive bipolar episode, individuals can feel so down that leaving their bed becomes challenging. Some individuals may also experience challenges going to sleep while others sleep longer. The National Alliance on Mental Illness states, “When people are depressed, even minor decisions such as what to eat for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt or helplessness; this negative thinking can lead to thoughts of suicide.”3


Bipolar episodes of mania and hypomania are distinct but have similarities. Hypomania is a milder version of mania where the episodes of elation and excitement are less psychotic. Mania is more noticeable in instances such as work, school, and recreational activity, and mania is commonly noticeable in relationships. The dangers of mania can trigger a psychosis state that requires hospitalization.4


Bipolar episodes cause mood swings between the highs and lows. A person experiencing a low mood, such as sadness, is caused by the depressive state of a bipolar episode. An individual experiencing excitement, which can become irritable and excessive, is experiencing a high mood. The moods can vary based on the individual.

What Causes Bipolar Affective Disorder?

A variety of factors, such as an individual’s environment and stressors, affect their chances of acquiring bipolar affective disorder.


Trauma is an environmental factor that causes manic depression. Individuals who have suffered traumatic life events (often during childhood) are often unable to manage their moods or stay stable. Traumatic events may include sexual abuse, loss of a loved one, severe accidents, or more. The lack of control in one’s mood triggers manic depression episodes.

Drug Use

The misuse of drugs and alcohol also creates the risk of developing manic depression or bipolar disorder. Although the drugs themselves do not cause the disorder, the influence of substances decreases an individual’s ability to control their emotions and maintain their mood stability. Substances can also worsen the symptoms of bipolar disorder.5


Stressful situations or sudden life changes, either good or bad, can trigger an overwhelming feeling of stress that leads to bipolar episodes. This can either trigger new symptoms or worsen the existing ones.


Individuals suffering from illnesses and taking medications such as antidepressants are more likely to experience manic depression – specifically episodes of mania. Drugs such as e levodopa, corticosteroids, and anabolic-androgenic steroids can cause manic symptoms, and antidepressant drugs of certain types can induce mania in those with pre-existing bipolar disorder.6

What are the Symptoms of Bipolar Affective Disorder?

Bipolar disorder is experienced in episodes. Episodes exhibit highs and lows; the highs are represented by exciting moods and the lows are represented by depressive moods. Episodes vary from person to person and are not always consistent. Individuals also experience balanced moods between high/low episodes.

Manic State

During a manic state, a person can experience complete elation and euphoria accompanied by physical strength. A manic episode begins with one showing signs of euphoria and excitement. The Canadian Mental Health Association explains, “in the early stages of the episode, the person may appear to be more sociable, active, talkative, self-confident, perceptive, and creative than usual.”

Manic state symptoms include:

Increased strength and energy

Decreased sleep

Extreme irritability

Rapid, unpredictable emotional changes

Uncontrollable racing thoughts, flight of ideas

Increased interest in activities, overspending

Grandiosity, inflated self-esteem

Increased and uninhibited

Poor judgment

Depressive State

During the depressive state, the individual experiences low moods such as sadness and despair.

Depressive state symptoms include:

Lack of energy

Sleep problems where a person may sleep too much or too little

Loss of interest in work, family, and friends

Change in eating habits

Preoccupation with failures or inadequacies

Loss of self-esteem

Feelings of guilt

Excessive concern about physical complaints

Decreased sexual drive

Crying easily, suicidal, and occasional homicidal thoughts

Treating Bipolar Affective Disorder

Combining medication and therapy is the most effective way of treating bipolar affective disorder. Often, more than one medication may be used to handle the disorder’s symptoms.7


Psychotherapy is an important part of mental illness treatment. Psychotherapy can include interpersonal and social rhythm therapy or IIPSRT. This form of therapy focuses on stabilizing an individual’s rhythms such as sleeping, waking up, and eating. Individuals struggling with manic depression can benefit from re-identifying their daily rhythms.

Cognitive-behavioral therapy, or CBT, is also beneficial for individuals with manic depression. According to the Mayo Clinic, “The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones. CBT can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.”8


One of the oldest forms of treatment in psychiatry is mood stabilizers. Mood stabilizers are medicines made of lithium carbonate. They reduce the symptoms of mania and delay their return, and these medicines can also reduce the risk of suicide.

Support Groups

Bipolar affective disorder often makes victims feel isolated. Support groups allow those suffering from manic depression to meet others in a similar state. Support groups benefit the patient by sharing coping strategies and suggestions on how to manage any side effects.


Psychoeducation teaches patients that are struggling with manic depression more about their disorder. This treatment supports the individual by identifying triggers and creating a plan to reduce the risk of relapse.

Coping Skills

Developing and learning coping skills benefits the individual suffering from manic depression by recognizing the triggers before their impact. Copying skills also provide methods of dealing with triggers.

The Link Between Bipolar Affective Disorder and Addiction

Bipolar affective disorder affects individuals through a variety of factors. Manic depression places individuals at risk for inconsistent lifestyles that may lead to addiction.


According to the National Institute on Alcohol Abuse and Alcoholism, a study done on the relationship between bipolar disorder and alcoholism released the following:

32% of individuals with any mood disorder had a history of alcohol misuse

60.7% of individuals with Bipolar I disorder had a history of alcohol misuse

48.1% of individuals with Bipolar II disorder had a history of alcohol misuse9


Research by the National Institute on Alcohol Abuse and Alcoholism states, “One proposed explanation is that certain psychiatric disorders (such as bipolar disorder) may be risk factors for substance use. Alternatively, symptoms of bipolar disorder may emerge during the course of chronic alcohol intoxication or withdrawal. For example, alcohol withdrawal may trigger bipolar symptoms.”9

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