Bipolar Disorder​​


Bipolar disorder (previously referred to as manic depression) causes serious shifts in mood, energy, thinking and behaviour; from the highs of mania on one extreme, to the lows of depression on the other. It is more than just a temporary good or bad mood. The cycles of bipolar disorder last for days, weeks, or months. Unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function.

During a manic episode, you might display impulsive behaviour such as quitting your job, charging up huge amounts on your credit cards, or feeling rested after sleeping for a very little time. During a depressive episode, you might be too tired to get out of bed, and be full of anxiety and hopelessness in the same situation.

The causes of bipolar disorder aren't clearly understood, but it is often believed to be genetic. The first manic or depressive episode of bipolar disorder usually occurs in the teenage years or early adulthood. The symptoms are subtle and may be confusing. However, with proper treatment and support, you can lead a fulfilling life.​​

Bipolar disorder presents itself differently in all cases as the symptoms can vary widely. There are four types of mood episodes in bipolar disorder: mania, hypomania, depression, and mixed episodes. Each type of bipolar disorder mood episode has a unique set of symptoms.

Symptoms of mania include:

  • Feeling unusually optimistic or extremely irritable

  • Unrealistic beliefs about one’s abilities or powers

  • Sleeping very little, but feeling extremely energetic

  • Talking rapidly 

  • Racing thoughts

  • Being very distracted

  • Impaired judgment and impulsiveness

  • Acting recklessly without thinking about the consequences

  • Delusions and hallucinations (in severe cases)

Signs and symptoms of bipolar depression include:

  • Feeling hopeless, sad, or empty

  • Irritability

  • Fatigue or loss of energy

  • Appetite or weight changes

  • Sleep problems

  • Concentration and memory problems

  • Feelings of worthlessness or guilt

  • Thoughts of death or suicide

Mixed episodes include symptoms of both. 

If you or a loved one is facing alternating manic and depressive episodes, seek help from your doctor working with the Mind and Brain Service Line​ at The Aga Khan University Hospital.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.

There are different types of bipolar disorders:

  • Bipolar I Disorder in which you have manic or mixed episodes that last at least seven days, or solely manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.

  • Bipolar II Disorder in which you have a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.

  • Bipolar Disorder Not Otherwise Specified (BP-NOS) is diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II. 

  • Cyclothymic Disorder or Cyclothymia is a mild form of bipolar disorder with episodes of hypomania as well as mild depression for at least 2 years. 

  • Rapid-cycling Bipolar Disorder where you have four or more episodes of major depression, mania, hypomania, or mixed states, all within a year. This is more likely if you have bipolar at a younger age.

When making a diagnosis, your doctor will conduct a physical examination, interview, and lab tests. Currently, there are no specific blood tests or brain scans to diagnose bipolar, but these tests can help rule out other factors that may contribute to mood problems, such as a stroke, brain tumour, or thyroid condition. Your doctor will conduct a mental health evaluation and discuss with you any family history of bipolar disorder or other mental illnesses. He/she will get a complete history of your symptoms and also talk to your close relatives or spouse about your symptoms and family medical history.

Because you are more likely to seek help when you are depressed than during mania or hypomania, it is necessary to give a detailed and careful medical history to assure that bipolar disorder is not mistakenly diagnosed as major depression.

Bipolar disorder cannot be cured, but it can be treated effectively over the long-term. Proper treatment can help you to gain better control of your mood swings and related symptoms. It is a lifelong, long term illness, and continuous treatment is needed to control symptoms. In the attempts to treat the disorder, you will be prescribed a number of medications including:

  • Mood stabilizers

  • Antipsychotics

  • Antidepressants

  • Anti-anxiety medications

Some medications have side effects that may seem very debilitating but symptoms improve as you find the right medications and doses that work for you, and your body adjusts to the medications. Never stop medication without your physician’s approval, as withdrawal may make your symptoms worse.

Psychotherapy will also be part of your treatment plan, in combination with medication. Psychotherapy can be an effective treatment for bipolar disorder by providing support, education, and guidance. A particular type of psychotherapy called CBT (Cognitive Behavioural Therapy) can help you to change harmful or negative thought patterns and behaviours. Therapy will also help you to improve your relationships with others and manage your daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​