Manic depression, also known as Bipolar disorder is characterised by extreme fluctuations in mood ranging from periods of intense "highs" or mania to periods of severe depression or "lows", however, in reality it is much more complex than that as there is no clear pattern and some can even experience mixed state bipolar, with a combination of both mania and depression.

There is also no known single cause of Bipolar and no way of predicting who will develop it although it does appear to be a tendency for it to run in families suggesting that genetics play a part. According to the Royal College of Psychiatrists, Bipolar affects around one in one hundred adults, although it is possible that these figures are on the low side as it is believed that many people with Bipolar will not seek help due to denial, misunderstanding and lack of knowledge surrounding the condition. It affects both men and women equally and usually begins in early adulthood but the way it manifests itself is anything but consistent. Episodes can be triggered by stressful events and physical illness or even nothing at all. So how do you know if you have Bipolar disorder?

Symptoms of a manic episode include:

A manic episode can be diagnosed if at least 3 of the symptoms occur along with an elevated mood for most of the time for at least a week. If the overall mood is one of irritability then another 4 symptoms must be present.

• Increased energy, activity, and restlessness • Excessively "high," overly good, euphoric mood • Extreme irritability • Racing thoughts and talking quickly, jumping from one idea to another • Distractibility, lack off concentration • Little sleep needed • Unrealistic beliefs in one's abilities and powers • Poor judgment • Spending sprees • A lasting period of behaviour that is different from usual • Increased sexual drive • Abuse of drugs, particularly cocaine, alcohol, and sleeping medications • Provocative, intrusive, or aggressive behaviour • Denial that anything is wrong

Symptoms of a depressive episode include:

A depressive episode can be diagnosed if five or more of these symptoms are present for most of the time for a period of at least 2 weeks.

• feeling sad, anxious, or empty mood • Feelings of hopelessness or pessimism • Feelings of guilt, worthlessness, or helplessness • 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, making decisions • Restlessness or irritability • Sleeping too much, or can't sleep • Change in appetite and/or unintended weight loss or gain • Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury • Thoughts of death or suicide, or suicide attempts

The gaps in between a high and a low episode can vary significantly with each individual. Some people will experience rapid shifts between moods and others will change more slowly over a period of time. Conventional treatment usually consists of some form of mood stabilising medication to reduce the severity and duration of the episodes, for example, Lithium is the most commonly used. Achieving the correct dosage is crucial as high levels of Lithium can be toxic so this will be carefully evaluated and monitored by a GP or health professional. However, it doesn't always prove to be effective and isn't suitable for everyone. The side effects can be difficult to cope with for some people and include, thirst, nausea, weight gain, anxiety, shakes, dry mouth, disturbed sleep, hair loss, and sexual dysfunction.

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