Bipolar disorder is more than mood swings. It involves distinct episodes of depression and of mania or hypomania that can last days to months. It often takes years to diagnose, but with the right treatment and support, many people live full, stable lives.
Imagine a friend who’s been low for months suddenly becomes full of energy. They barely sleep, talk fast, start several businesses in a week and spend their savings. They insist they’ve never felt better. Two months later they crash into deep depression. That cycle is what bipolar disorder can look like.
Signs of mania or hypomania
- Feeling extremely high, irritable or energetic
- Needing much less sleep
- Racing thoughts and fast speech
- Risky behaviour, such as overspending or reckless decisions
- In severe mania, losing touch with reality (psychosis)
Signs of depression
Low mood, loss of interest, exhaustion, changes in sleep and appetite, hopelessness and sometimes thoughts of suicide.
Treatment
- Mood stabilisers such as lithium, and some antipsychotic medicines, with regular monitoring
- Talking therapies and psychoeducation
- Regular sleep and routine, and learning early warning signs
- A crisis plan agreed with your care team and family
Antidepressants on their own can trigger mania in some people with bipolar disorder, which is one reason a correct diagnosis matters.
But when is it a crisis?
Get urgent help if someone is at risk of harming themselves or others, has lost touch with reality, or hasn’t slept for days. If you’re having thoughts of suicide, contact your local emergency number or a crisis line, such as 988 in the US or Samaritans on 116 123 in the UK and Ireland.
Your next step: If you recognise these patterns, track your mood and sleep daily for a month and share it with your doctor. Mention any past periods of unusually high energy, not just the lows.
Sources: World Health Organization (Mental disorders), US National Institute of Mental Health (Bipolar disorder), NHS (Bipolar disorder), NICE guideline on bipolar disorder. This guide is for general information and does not replace advice from your own nurse, doctor or mental health professional.
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