Intellectual Disability and Bipolar DisorderBipolar disorder (formerly known as manic-depressive illness) affects about one per cent of people in our community. People who have bipolar disorder experience major changes in mood for no obvious reason. These repeated mood swings range from one extreme to another and the person is often completely well between the episodes of mania and depression.

Bipolar Disorder and Intellectual DisabilityPeople with intellectual disability can suffer from bipolar disorder. Research shows that the incidence is higher than the general population.

Like everyone with bipolar disorder, people with intellectual disability experience recurring episodes of depression and elation, both of which can vary from mild to severe. In between these episodes there are periods of normal mood.

Everyone experiences mood changes, 'highs and lows', from time to time but it is when these swings are extreme and interfere with life's activities that assistance is required. The frequency and duration of mood swings varies from person to person.

Recognising Bipolar DisorderChanges in a person's emotional or behavioural state are classic signs/symptoms of bipolar disorder. There are a variety of symptoms that can occur in any number of combinations because bipolar disorder affects people in different ways.

Common symptoms for mania include:

An elated, high, happy, energetic, euphoric or irritable mood

Having grandiose thoughts and plans which are an overestimation, especially in relation to the person's abilities

Changes in sleep patterns (usually needing less sleep)

More talkative, rapid and insistent speech, talking loudly, seeking more attention, unable to attend to others speaking

Rapid repetitive speech, jumping from one topic to another with little connection

Inability to concentrate, skipping from activity to activity, highly distractible

Lack of inhibitions, increase in sexual interests, intrusive

High levels of activity.

Most people with a bipolar disorder will also experience times of depression. Refer to the information sheet Intellectual Disability and Depression for more information.

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What Causes Bipolar Disorder?The causes are different for each person and often there is combination of factors. Some causes include:

Increased stress (eg the departure of a favourite carer, changes in housing or work) and inadequate coping abilities can play a part in triggering the symptoms, but not always

Genetic susceptibility: children of parents with bipolar mood disorder are at greater risk of developing the condition

An imbalance of chemicals in the brain.

Getting HelpThe first step is awareness and the time to get professional help is when the behaviour changes, and withdrawal or elation is evident. Speak to the person's general practitioner, their Service Coordinator, a mental health professional, psychiatrist, psychologist or counsellor.

It may be useful to have a familiar person accompany the person with intellectual disability to their initial appointments, because they will be able to provide support and describe any changes they have noticed.

Data collection is a great help in the assessment, treatment and prevention of further episodes. This sets in place an objective behaviour observation system, which can highlight changes in patterns of behaviour over time.

With early diagnosis and treatment, symptoms and frequency of episodes can be reduced or eliminated, and the long-term outlook is good.

Some treatment options may involve a combination of support, psychological approaches and medication:

Support may include information regarding bipolar disorder and treatment options. Support personnel can also look at addressing some of the environmental factors, which may contribute to the stress levels.

Psychological approaches include exploring problems and finding practical solutions. Counselling may involve the use of charts, pictures, photos, drawings, and diaries to help describe feelings and worries.

Medication can be used to help the brain restore its chemical balance and alleviate symptoms. Medication is used to reduce the manic and depressive phases and also as a preventative measure to stabilise mood swings.

Other Helpful ResourcesDisability SA: Centre for Disability Health, Telephone: 8397 8100

Adult Mental Health Services: Assessment and Crisis Intervention Service (ACIS)24 hours, 7 days per week, Telephone: 13 14 65 (statewide)

Beyond Blue: Website: www.beyondblue.org.au

SANE Australia: Website: www.sane.org

Black Dog Institute: Website: www.blackdoginstitute.org.au

Copies of this publication are available from the Disability Information ServiceTel: 1300 786 117 Email: disabilityinfo@dfc.sa.gov.au Website: www.disability.sa.gov.au Revised July 2008