Dr Nick Stafford on bipolar disorder

They will be brimming with energy, can't stop talking and can be very funy with their humour.

However, when they are not on top of the world they can be in the depths of despair. They can experience depression for long periods. These mood swings can affect their relationships and their ability to be effective at work.

TEENAGE KICKS

I love seeing my 18-year-old son James on good form, but I'm concerned he's missing so many lessons at university. His moods often swing from being full of energy and brilliant ideas to low and unmotivated. I took him along to the university counsellor who just said he had typical teenage mood swings but I think it is more serious than that.

It's sometimes difficult to distinguish between typical teenage ups and downs (which, of course, are a normal part of human existence) and mood swings that could indicate a deeper problem. Bipolar mood swings are more sensitive to events, greater in nature and degree and are often accompanied by other thoughts, feelings and beliefs that are not part of a 'normal' mood swing.

Your son's repeated mood swings into depression and elation over periods of time, plus his current behaviour (high energy levels, talking fast, racing thoughts, expansive ideas) could indicate that he's going through a hypomanic or manic period – a severe upswing in mood.

See your family doctor as soon as possible. He or she will arrange an appointment with a specialist psychiatrist to assess and prescribe treatment.

SLEEPLESS WIFE

My wife was diagnosed with bipolar disorder some years ago and at times finds it very difficult to sleep. This can make her hypomanic or depressed and it always makes her mood worse. Once this led her on a downward spiral to hospital admission.

It's been said that sleep and mood are joined at the hip. Indeed, one study found that 80 per cent of psychiatric patients have a sleep disorder. Once your wife gets treatment for her condition – ideally a combination of medication, talking therapies and self-managements – this symptom of sleeplessness can be more easily managed.

Initially she will probably be prescribed mood stabilisers to keep her mood stable and antipsychotics to treat the hypomania. If she gets depressed, antidepressants may be given short term to treat her low mood.

She should be offered a talking therapy – possibly psycho-education to help her understand the condition to help prevent relapses and/or cognitive behavioural therapy (CBT) which looks at the links between thoughts, feeling and behaviours.

It's also advisable to avoid common sleep disrupters – late night study, daytime naps, plus heavy meals, caffeine or stimulating activities before bed.

SUBSTANCE STRESS

My brother Brian has bipolar disorder and for a couple of years he has been smoking cannabis with his friends. He says it makes him better but I know it always makes him worse. I also worry he's drinking too much alcohol, not eating properly and not getting any exercise.

If Brian has been diagnosed and is getting treatment, he'll find it easier to make lifestyle changes that can make a surprisingly big difference to the long-term outcome of bipolar. For instance, regular meals, work hours, exercise and sleep patterns helps synchronise the body clock, which has a direct impact on mood. Research also shows that taking time for relaxation (meditation, yoga, walking, listening to relaxing music) and spending time with loved ones also helps keep someone with bipolar well.

Dr Nick Stafford is a consultant psychiatrist and vice-chair of MDF the Bipolar Organisation (www.mdf.org.uk)

This article was first published in The Scotland on Sunday, June 13, 2010