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Bipolar Affective Disorders.

Bipolar disorder is characterised by the recurrent occurrence (at least 2) of depressive and manic (or hypomanic) episodes. In both types of illness episode, the mood and activity level of those affected are displaced towards the opposite pole and significantly disturbed. Manic episodes typically begin suddenly and last 2 weeks to 4 months; depressive episodes begin more gradually and tend to be considerably longer in duration. Typically, remission between illness episodes is complete.

Inpatient Treatment · Private Insurance · Government Allowance · Self-Pay

Medically reviewed by
Vivien Müller-Prasse, Specialist in Psychiatry and Psychotherapy
Last updated
Reading time
approx. 5 minutes
Mandala for bipolar disorders: split pattern of darkness and agitation
The alternating poles
12-Month Prevalenceapprox. 1%

of the population; depressive and manic episodes alternate.

Clinical Picture

Between the poles.

The prevalence of bipolar disorders is approximately 1 % of the population (12-month prevalence). Men and women are equally affected. The first episode usually occurs between the ages of 15 and 30. However, years often pass before the diagnosis of bipolar disorder is made, as initially only depressive episodes tend to occur and it only becomes clear at a later stage (with the first manic episode) that it is not a unipolar recurrent disorder but a bipolar disorder. Genetic vulnerability plays an important role in the development of manic-depressive illness. However, it is ultimately the gene-environment interaction that determines whether certain genes are 'activated' or not and whether a particular disorder becomes clinically manifest in later life or not (vulnerability-stress model). Twin studies (identical genetic material), for example, show that both twins need not necessarily develop bipolar disorder.

Depressive and manic episodes in bipolar disorders occur both in (variously rapid) alternation and in a mixed state. Both depressive and manic episodes may also be accompanied by psychotic symptoms. Precise classification and diagnosis are made by a psychiatrist.

Pharmacotherapy

The pharmacological pillar.

Pharmacotherapy is the decisive therapeutic pillar in the acute treatment of depressive (antidepressants) and (hypo-)manic symptoms (antipsychotics). The goal is always symptom reduction through to complete remission of symptoms. Beyond this, particularly in bipolar disorders, the aim is also protection against further illness episodes, and accordingly a pharmacological episode prophylaxis. The so-called mood stabilisers are medications designed to alleviate the symptoms of depressive and manic episodes and to prevent the recurrence of such symptoms. The most established substances for this purpose are: lithium, valproic acid, and lamotrigine. The appropriate medication or combination therapy is discussed in detail and in a differentiated manner with the patient.

Psychotherapy

Building stability.

Psychotherapeutically, we focus on comprehensive psychoeducation about the clinical picture, the course of the illness, and the treatment options (for the acute phase and for episode prophylaxis). In the further course, the work focuses on the inner process of accepting the illness, on taking into account one's own vulnerability and one's own resilience limits, on managing stress (capacity for self-delimitation, social skills, etc.), on the necessary mental hygiene in daily life (including sleep-wake rhythm, abstaining from alcohol, protection from overstimulation), and on the necessary compliance regarding medication intake. A crisis plan is always developed that sensitises to the recognition of early warning signs and defines how to respond to them (more frequent physician contacts, optimisation of medication, etc.). We also attach great importance to involving relatives in the therapy, to inform them about the clinical picture, the management of early warning signs and symptoms, and where appropriate to address intrafamilial communication style and stress management.

In the phase-out treatment, the aim is to ensure viable stability under increasing graduated exposure, as well as concrete planning of outpatient follow-up treatment and professional perspective (e.g. graduated return to work).

Häufige Fragen

Answers to frequently asked questions about bipolar affective disorders.

Patients, relatives, and referring physicians ask us recurring questions. Here you will find the most important answers summarised.

01.What role does medication play in bipolar disorders?

A central role: pharmacotherapy is the decisive therapeutic pillar in the treatment of bipolar disorders. In our clinic it is carefully calibrated medically and closely supervised — supplemented by supportive psychotherapy and psychoeducation.

02.What helps to prevent relapses?

Recognising one's own early warning signs, maintaining a stable daily structure, reliably continuing medication, and establishing a viable outpatient follow-up treatment — all of this is worked through together during the stay and set in place for the period afterwards.

03.Who covers the cost of treatment?

Admission is open to privately insured patients, those entitled to government allowance (Beihilfe), and self-pay patients. Some statutory health insurers (e.g. Techniker Krankenkasse and DAK) stipulate in their statutes that, under certain conditions, they may cover the costs of treatment at a purely private clinic up to the level of comparable rates at a hospital approved under Section 108 SGB V. We are happy to advise you during the initial telephone consultation.

04.How do I arrange an admission interview?

By telephone on +49 7083 748-0 (Mon–Fri 8:00–16:30) or via the Call-Back Service on the contact page. Our admissions office will respond within 24 hours with a proposed appointment for a detailed, no-obligation telephone consultation.

Quellen

Fachliche Grundlage der Inhalte.

  1. [1]S3 Guideline: Diagnosis and Treatment of Bipolar Disorders AWMF Guideline Registry (ed.). register.awmf.org — current guidelines
  2. [2]ICD-10-GM — Chapter V, F31 (Bipolar Affective Disorder) Federal Institute for Drugs and Medical Devices (BfArM). bfarm.de — ICD-10-GM
  3. [3]German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) Professional Information. dgppn.de
Admission

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Phone · Admissions Office
+49 7083 748-0
Admission
Privately insured · Entitled to supplementary benefits · Self-paying

Patients of some statutory health insurance providers (e.g. Techniker Krankenkasse and DAK) may in certain cases be able to obtain partial cost reimbursement from their insurer.

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