Bipolar Disorder:

Bipolar Disorder is usually associated with extreme mood swings, which are usually punctuated by periods of generally stable mood and behaviour. Bipolar Disorder 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 suffer 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.

Common Symptoms:


  • Expansive or irritable mood
  • Inflated self esteem
  • Increased energy
  • Racing thoughts
  • Feelings of invulnerability
  • Decreased need for sleep
  • Poor judgment
  • Making adventurous plans
  • Heightened sex drive, and
  • Denial about these symptoms



  • Low mood
  • Feelings of hopelessness, guilt, worthlessness, or melancholy
  • Lack of pleasure in activities
  • Lethargy and fatigue
  • Loss of appetite for food or sex
  • Sleep disturbances
  • Thoughts of death or suicide
  • 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. A delay in treatment can sometimes pose therapeutic challenges and can cause multiple losses throughout patients’ lives. Screening and effective treatment remains the cornerstone for management of this disorder.


Psycho-education and psychotherapy remain an important aspect of the treatment of this condition. Self help groups can offer emotional support and assistance in recognising signs of relapse to avert a full blown episode of Bipolar Disorder. The most commonly prescribed medications to treat Bipolar Disorder are three mood stabilisers: Lithium Carbonate, Carbamazepine, and Sodium Valproate. Other medications also have been of good benefit, including atypical antipsychotics, Lamotrigine, and some antidepressants (under careful monitoring of a 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 equipment, dosing guidelines and anesthesia 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 also specialise in complex and resistant mood disorders which 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 service 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 program and inpatient therapy programs), which work with the patient to develop an individualised care plan to meet patients’ needs.

Services include:

        • Assessments
        • Consultations and reviews
        • Behaviouralsupport and emotional monitoring
        • Shared care with GPs and Psychologists
        • Assistance connectingpatients with community resources
        • Follow-up to support the patients’ 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. We welcome direct contact from patients and families to scope services.


Please refer to the Depression link on this website.

References and further information: