Manic Depression

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This factsheet aims to explain manic depression (also called bipolar disorder). You will find a description of the condition, its symptoms and the treatments available. If you are experiencing manic depression, you will find suggestions of ways that you may help yourself and the options open to you. You will also find ideas on how friends and family may help.

What is manic depression?

People diagnosed with manic depression tend to experience mood swings from periods of severe depression to periods of elation known as mania. Most people experience ups and downs in daily life, but with manic depression the changes between highs and lows are extreme. It is known as a psychotic illness because people can lose touch with reality.

What are the symptoms of manic depression?

Mania
If you are experiencing a manic phase you may feel marvellous, on a high, excitable and euphoric. In manic states, people can lose insight and may experience delusions. For example, people may think that they are famous and important. They may make wild plans, spend extravagantly and lose social inhibitions. In manic phases, people may lose insight into the fact that they are ill and deny that there is anything wrong with them or their behaviour.

Depression
If you are experiencing a depressive phase, you may feel unhappy, that everything you do is a struggle, and perhaps not worth the effort. Often people feel hopeless about the future and unable to see any positives in life. You may feel apathetic and unable to participate in activities you used to enjoy. At its worst, depression can lead to such feelings of helplessness and lack of worth that people may give up the will to live, or begin to consider suicide.

What causes manic depression?

There is no single cause of manic depression; it varies from person to person. Stressful life events such as losing your job, divorce or bereavement can trigger manic depression in some people. For other people, the trigger may be psychological factors such as chronic anxiety or depression, childhood rejection or family background. It is also thought that some people may have a genetic predisposition towards manic depression.

How common is manic depression?

Manic depression can affect anyone at any time. It can occur in people from all backgrounds, any occupation, and at any time of life. It is equally common in men and women. Around one in a hundred in Britain are diagnosed as having manic depression.

What treatments are available?

Most people diagnosed with manic depression are referred to see a psychiatrist. The psychiatrist will conduct an in-depth assessment of your treatment and support needs. The treatments for manic depression are designed to stabilise your mood and prevent the severe swings.

Mood stabilising drugs
These drugs are not a cure for manic depression, but they can be an effective treatment for the condition. The drugs are designed to combat the extreme mood swings that are characteristic of manic depression. People starting a course of mood-stabilising drugs should be aware that this is usually a long-term treatment rather than a quick fix cure. There are a number of side-effects associated with these drugs, and you may need regular blood tests to ensure that the drug does not reach toxic levels in your blood.

For more information on drug treatments please see: Medical Methods of Treatment

Anti-psychotic drugs
These drugs, also known as major tranquillisers, are sometimes used to treat people during periods of mania. They have a sedative effect and aim to relieve the distressing symptoms associated with manic states. These are powerful drugs that can cause unwanted side-effects. If you are concerned about any side-effects you may be experiencing, it is a good idea to talk these over with your doctor or psychiatrist.

For more information on drug treatments please see: Medical Methods of Treatment

Admission to hospital
If you are very distressed or in an acute state of mania, your doctor may feel that hospital admission offers the best treatment options for you. Hospital can provide a safe environment in which you can be assessed and treated more effectively than if you were at home. Your doctor will normally seek your consent for you to be voluntarily admitted to hospital. However, if your mental state is such that the doctor feels you may be a risk to yourself or others, then you may be admitted to hospital compulsorily under the Mental Health 1983. This option would be a last resort, though.

Crisis services
In some parts of the country, but by no means all, a variety of crisis services have been developed to provide an alternative to hospital admission for some people. Some crisis services provide short-term supported accommodation, but most provide services that enable people to stay in their own homes with regular support.

Which treatment may be right for me?

Individuals respond to different treatments in different ways. What works well for one person may not be effective for another. Speaking to your doctor will help you weigh up the pros and cons of the different treatments available. Your doctor should be able to provide you with information on how treatments work, how effective they are, and what side-effects you may experience. Drug treatment may be extremely effective for some people, others may find talking treatments the best option. Others may find a combination of drug treatment and talking treatments works best for them.

What can I do to help myself?

There are many ways in which you can help yourself manage the symptoms of manic depression. It is important that you come to understand the nature of your illness, its causes and symptoms. If you can recognise the early signs of a relapse or deterioration in your mental health, you can seek help and treatment before your condition worsens.

When you are feeling depressed, it can be difficult to see beyond the day-to-day problems in life. It can be very difficult finding the energy and motivation to actively try and help yourself. On the other hand, when you are in a manic phase, you may lose insight into the illness and believe that you do not need any support. However, if you are able to take an active part in your treatment it may help your situation improve.

Self-help groups
Many people find it helpful to meet other people in a similar position. It can be very useful to share experiences with those who may be going through a similar experience to you. There are opportunities for mutual support, and you may get ideas of what things other people have found helpful. Above all, it is an opportunity to help you realise that you are not alone in how you are feeling.

Fighting negative attitudes
Depression can cause people to sink into a cycle of negative thinking. The more depressed you become, the less you are able to find the motivation to fight the depression. It can be extremely helpful if you are able to recognise patterns of negative thinking, challenge these yourself, and try and replace them with more positive, constructive thoughts.

Physical Activity
Although it may be difficult finding the motivation to exercise, it can be very therapeutic to take part in physical activities. Jogging, swimming, sports, even brisk walking can stimulate production of chemicals in the brain called endorphins. These endorphins can help lift your mood, give you more energy and make you feel better.

Care for yourself
When you are feeling depressed it is extremely important that you care for yourself. Many depressed people lose the motivation to look after themselves properly. You may find yourself feeling much better if you are able to eat properly, pay attention to your physical appearance, and don’t abuse alcohol or drugs. Be kind to yourself, allow yourself treats, and try not to cut yourself off from other people.

Complementary therapies
Some people find non-medical treatments helpful. However, it is important that you discuss such treatments with your doctor first in case of any interaction with any treatment they have prescribed. Massage can help to alleviate stress and make you feel better. Some people benefit from meditation, yoga, homeopathy and acupuncture. You may find creative therapies such as art and poetry can help channel energies.

What can friends and family do to help?

Supporting a friend with manic depression can be frustrating and hard work . However, it can also be immensely satisfying and an opportunity to build a closer relationship. In depressive phases people can withdraw from social situations and relationships and be reluctant to confide in people and ask for help and support. Friends and relatives can be of great help, providing emotional and practical help and encouraging people to seek appropriate support and treatment. Friends and family can become involved in treatment plans and, above all, make the person feel wanted, needed and loved.

Where can I find help and support?

There are a wide a range of services providing care, support and information to people experiencing manic depression, their friends, relatives and carers. You may find some of the following useful:

SANEline / SANEmail
1st Floor Cityside House, 40 Adler Street, London, E1 1EE
helpline:0845 767 8000
email: sanemail@sane.org.uk
web: http://www.sane.org.uk/
SANEline and SANEmail offer emotional support and information to those experiencing mental health problems, their families and carers.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Victoria Buildings, 9 – 13 Silver Street, Bury, BL9 0EU
tel.0161 797 4484, fax: 0161 797 2670
email: babcp@babcp.com
web: http://www.babcp.com/
A directory of psychotherapists is available online.

British Association for Counselling and Psychotherapy (BACP)
BACP House, 15 St John’s Business Park, Lutterworth, Leicestershire, LE17 4HB
tel: 0870 443 5252
email: bacp@bacp.co.uk
web: http://www.bacp.co.uk/
See website for details of local practitioners.

British Psychoanalytic Council
West Hill House, 6 Swains Lane, London N6 6QS
tel: 020 7267 3626; fax: 020 7267 4772
email: http://www.sane.org.uk/admin/pages/edit/mail@psychoanalytic-council.org
web: http://www.bcp.org.uk/
A linking body of psychoanalytical psychotherapist societies.

Carers UK
20–25 Glasshouse Yard, London EC1A 4JT
carers line: 0808 808 7777, tel. 020 7490 8818, fax: 020 7490 8824
email: info@carersuk.org
web: www.carersuk.org
Information and advice on all aspects of caring.

Depression Alliance
Suite 212, Spitfire Studios, 63-71 Collier Street, London N1 9BE
tel: 0845 123 2320
email: information@depressionalliance.org
web: www.depressionalliance.org
Support and understanding for anyone affected by depression.

Fellowship of Depressives Anonymous
Box FDA, Ormiston House, 32-36 Pelham Street, Nottingham, NG1 2EG
tel: 0870 774 4320; fax: 0870 774 4319
email: fdainfo@aol.com
web: http://www.depressionanon.co.uk/
Mutual support and self-help for anyone affected by depression.

MDF: The Bipolar Organisation
Castle Works, 21 St Georges Road, London SE1 6ES
tel: 08456 340 540; fax: 020 7793 2639
email: mdf@mdf.org.uk
web: www.mdf.org.uk
Works to enable people affected by manic depression to take control of their lives.

National Debt line
Tricorn House, 51 – 53 Hagley Street, Edgbaston, Birmingham, B16 8TP
freephone: 0808 808 4000, fax: 0121 703 6940
email: advice@nationaldebtline.co.uk
web: www.nationaldebtline.co.uk
Offers free, confidential advice regarding how to deal with debt problems.

Rethink
28 Castle Street, Kingston-upon-Thames, Surrey KT1 1SS
tel: 0845 456 0455; advice line: 020 8974 6814
email: advice@rethink.org / info@rethink.org
web: www.rethink.org
Working together to help everyone affected by severe mental illness to recover a better quality of life.

Samaritans
The Upper Mill, Kingston Road, Ewell, Surrey KT17 2AF
helpline: 08457 90 90 90, fax: 020 8394 8301
email: jo@samaritans.org
web: http://www.samaritans.org/
24-hour telephone helpline offering emotional support for people who are experiencing feelings of distress or despair.

United Kingdom Council for Psychotherapy (UKCP)
2nd Floor Edward House, 2 Wakley Street, London, EC1V 7LT
tel: 020 7014 9955; fax: 020 7014 9977
email: info@psychotherapy.org.uk
web: http://www.psychotherapy.org.uk/
Umbrella organisation for psychotherapy in UK. Regional lists of psychotherapists are available.