Bipolar Disorder

Bipolar Disorder is usually associated with extreme mood swings, which is usually punctuated by periods of generally stable mood and behaviour. tends to run in families, and has a strong genetic linkage. This disorder typically begins in the mid-twenties and continues throughout life, mostly waxing-waning pattern. Without treatment, people who have bipolar Disorder often go through devastating life events such as marital break-ups, job loss, substance abuse, and even suicide. It has a few subtypes, mostly related to symptoms and other criteria. It takes a few years before patients get their correct diagnosis, and mostly Psychiatrists or other mental health professionals need to be involved in this process.

Common Symptoms:


  1. Expansive or irritable mood;
  2. Inflated self-esteem;
  3. Increased energy;
  4. Racing thoughts;
  5. Feelings of invulnerability;
  6. Decreased need for sleep;
  7. Poor judgment;
  8. Making adventurous plans;
  9. Heightened sex drive, and;
  10. Denial about these symptoms.


    1. Low mood;
    2. Feelings of hopelessness, guilt, worthlessness, or melancholy;
    3. Lack of pleasure in activities;
    4. Lethargy and fatigue;
    5. Loss of appetite for food or sex;
    6. Sleep disturbances;
    7. Thoughts of death or suicide, and;
    8. Suicide attempts.

Mania and Depression may vary in both duration and degree of intensity.


Most patients who have Bipolar Affective Disorder can be effectively treated with medication and psychotherapy. Can sometimes pose therapeutic challenges, and delays in treatment can cause multiple losses in patients’ lives. Screening and effective treatment remains the cornerstone for management of this disorder.

Psycho-education and Psychotherapy remains an important aspect of the treatment of this condition. Self-help groups can offer emotional support and assistance in recogniszing signs of relapse to avert a full-blown episode of Bipolar Disorder. The most commonly prescribed medications to treat Bipolar Disorder are three mood stabilizers: Lithium Carbonate, Carbamazepine, and Sodium Valproate. Other medications also have been of good benefit, including atypical antipsychotics, Lamotrigine, some antidepressants (under careful monitoring of Psychiatrist or GP well versed in this disorder).

Electroconvulsive Therapy uses small amounts of electricity applied to the scalp to affect neurotransmitters in the brain. Usually referred to as ECT, this highly controversial and potentially life-saving technique is considered only when other therapies have failed, when a person is seriously medically ill and/or unable to take medication, or when a person is very likely to commit suicide. Substantial improvements in the equipment, dosing guidelines and anesthesia anaesthesia have significantly reduced the possibility of side effects. Sometimes, ECT is used to enhance therapeutic effect for complex and treatment resistant mood disorder management.

Complex and Resistant Mood Disorders

At MARSAI CLINIC, we specialise in Complex and Resistant , that have been causing significant problems for patients, their families and carers, and also their GPs. Dr Saibal Guha has a special interest in holistic and algorithmic care for Complex Mood Disorder patients. He draws inspiration from similar services at the Black Dog Institute (Sydney) and other clinics in Canada and USA.

The Complex Mood Disorder and consultation cervice at MARSAI Clinic provides flexible and tailored service. Recovery-focused care is provided by a professional healthcare team based at Belmont Private Hospital (incorporating the REACH programme and also inpatient therapy programmes) that work with the patient to develop an individualized care plan to meet the patient’s needs. ‘One-off’ assessments are also available (MBS Item no. 291) from GPs.

Services include:

        1. Assessments
        2. Consultations and reviews
        3. Behavioural support and emotional monitoring
        4. Shared care with GPs and Psychologists
        5. Assistance connecting patients with community resources
        6. Follow-up to support the patient’s journey to recovery and goal attainment as well as counselling, medication and symptom management and support.


Individuals 18 to 65 years old who have been diagnosed with a serious mental illness including anxiety or a mood disorder, who show resistance to treatment and show signs of a persistent illness (present longer than six months) and may demonstrate impaired functional ability.

How to access this service:

Referrals are accepted from a GP to Dr Guha. All referrals are welcome. We welcome direct contact from patients and families to scope services.


Please refer to the Depression link in this website.

References and further information

      2. Depression:
      3. Bipolar Affective Disorder:
      4. Beyond Blue: The National Depression Initiative:
      5. The Black Dog Institute: