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Bipolar Disorders

Bipolar disorder is a mood disorder involving episodes of mania, hypomania, and/or depression. There are two subtypes of bipolar disorder – types I and II. Bipolar disorders may occur at any age, though they usually develop during adolescence. Young people with bipolar disorders commonly experience a major impact on their normal development and functioning of daily lives. Their school lives and relationships with peers are also usually disrupted.




Manic episodes are characterised by changes in mood and energy, which affect behaviour, thoughts, and sleep. Patients often experience feelings of euphoria with behavioural changes such as social disinhibition (e.g., becoming naked in public), and risky behaviours (e.g., unprotected sexual intercourse with multiple partners, gambling, shopping sprees). Additionally, there is a decreased need for sleep, flight of ideas and interests, as well as pressured thoughts and speech.


Hypomania is similar to mania except the episodes are less intense.




If you experience any of the above symptoms along with episodes of depression over a period, you should consult a doctor who will be able to properly diagnose you and recommend you a series of treatments.


Other conditions that may present similarly include attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), conduct disorders and substance use disorders. The former 3 conditions are often diagnosed before adolescence.




The mainstay treatment for bipolar disorder is pharmacological therapy. However, adjunctive psychotherapy is also recommended especially for children and teenagers. When patients are started on treatment, regular follow up is often required as the first-line treatment, lithium, has a narrow therapeutic index and potentially risky side effects. This means that most patients on long-term lithium therapy may experience an episode of toxicity at least once in their lifetime; side effects include thyroid and parathyroid disorders, decreased kidney function, and cardiovascular problems. However, when weighing the risks and benefits, lithium is still a recommended form of treatment as it is highly effective in managing symptoms of mania. However, if you have any pre-existing conditions, your physician will recommend you the alternatives and monitor you closely.  

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