Bipolar disorder - a guide for parents and carers
Bipolar disorder (BD) is a mental health condition that affects how you feel. Sometimes you can feel low in mood or depressed but this can swing to feeling excitable and high in energy.
There is no research into how many autistic people have bipolar disorder.
Bipolar disorder can have a significant impact on a person’s life, but with treatment, it can be managed. This guide explores how BD might affect your child or family member, and the treatment and support options.
What is bipolar disorder?
“Bipolar disorder is a mental health condition that affects your moods, which can swing from one extreme to another. It used to be known as manic depression. Bipolar usually means a person experiences episodes of mania (high energy, excitable) and depression (low energy and mood).” NHS (2019)
Symptoms of bipolar disorder can include:
- manic episodes
- hypomanic episodes (similar to mania but generally shorter episodes and can feel more manageable)
- depressive episodes
- mixed episodes of mania and depression
- psychotic symptoms (not everyone experiences these).
Mind has further information on these symptoms.
Anyone can be diagnosed with bipolar disorder. It usually develops in the late teens (15-19 years old) - it’s rare for it to develop after 40. The exact cause of bipolar is unknown but some potential triggers include:
- extreme stress
- life-changing events; for example, relationship breakdowns or death of loved ones
- genetic factors – BD seems to run in families so if you, or another member of your family, has BD it could be a trigger for your child
- drug use.
Bipolar can affect a person in various ways, including:
- mood swings that are severe enough to affect everyday life
- driving (anyone diagnosed with BD must notify the DVLA)
- suicidal thoughts and self-harm
- difficulty with sleeping
- difficulty with eating
- strained relationships
- changing personality – making a usually calm person more agitated or aggressive.
Due to a lack of research, we don’t know if there are specific triggers for bipolar disorder in autistic people, or how many autistic people may have the condition. Some research suggests there are similarities between symptoms of bipolar disorder and autistic traits, making a diagnosis of both difficult. This is echoed in the personal accounts of autistic people and parents.
Bipolar disorder can be upsetting and distressing for your child and can result in significant changes in their behaviour and mood. It can therefore have a significant impact on family relationships and their relationships with friends and for older children, partners. Treatment and support is essential to help manage BD.
Getting help with bipolar disorder
If you think your child may be experiencing some of the symptoms of bipolar disorder, contact your GP. Your GP should be able to refer you to a local mental health team for further help.
To get a better understanding of the symptoms, your GP or the mental health team may ask questions such as:
- How many symptoms does your child experience?
- How long do the manic or depressive episodes last?
- How many episodes have they had, and how frequently do they occur?
- What impact do the symptoms have on their life?
- What is your family history?
The mental health team may also ask you/your child to keep a diary of your child’s moods to help them to rule out other possible conditions that could be causing their symptoms.
The full diagnosis process can take time, as doctors and psychiatrists may want to monitor symptoms over time to avoid/prevent misdiagnosis.
Read our Seeking help with mental health information guide for further details on accessing support.
Treatment for bipolar disorder
There are no guidelines for the treatment and support for autistic people with a diagnosis of bipolar disorder. The National Institute for Health and Care Excellence (NICE) (2014) has general guidelines for the assessment and treatment of BD and recommends both medication and psychological treatments such as cognitive behavioural therapy (CBT) and individual therapy. Therapy should be adapted for autistic patients.
NICE recommends certain types of medications, specifically antipsychotic or mood stabilisers, which can be prescribed to manage BD. These include:
The NICE guidance also states that if antipsychotic medication is not sufficient, Lithium (adult only) or Valproate may be used (excluding women who may become pregnant), but it should not be the first course of treatment.
Organisations offering advice
There is no specific advice for autistic people with BD, but there are several charities and organisations that offer general help and information on BD, such as Mind and the NHS.
Useful links
Personal accounts
Some of the following accounts may share information and experiences that you may find distressing: