Bipolar disorder is characterised by extreme mood swings. These can range from extreme highs (mania) to extreme lows (depression).

Episodes of mania and depression often last for several weeks or months.

Depression

During a period of depression, your symptoms may include:

feeling sad, hopeless or irritable most of the time

lacking energy

difficulty concentrating and remembering things

loss of interest in everyday activities

feelings of emptiness or worthlessness

feelings of guilt and despair

feeling pessimistic about everything

self-doubt

being delusional, having hallucinations and disturbed or illogical thinking

lack of appetite

difficulty sleeping

waking up early

suicidal thoughts

Mania

The manic phase of bipolar disorder may include:

feeling very happy, elated or overjoyed

talking very quickly

feeling full of energy

feeling self-important

feeling full of great new ideas and having important plans

being easily distracted

being easily irritated or agitated

being delusional, having hallucinations and disturbed or illogical thinking

not feeling like sleeping

not eating

doing things that often have disastrous consequences – such as spending large sums of money on expensive and sometimes unaffordable items

making decisions or saying things that are out of character and that others see as being risky or harmful

Patterns of depression and mania

If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.

Between episodes of depression and mania, you may sometimes have periods where you have a “normal” mood.

The patterns aren’t always the same and some people may experience:

rapid cycling – where a person with bipolar disorder repeatedly swings from a high to low phase quickly without having a “normal” period in between

mixed state – where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood

If your mood swings last a long time but aren’t severe enough to be classed as bipolar disorder, you may be diagnosed with cyclothymia (a mild form of bipolar disorder).

Living with bipolar disorder

Bipolar disorder is a condition of extremes. A person with the condition may be unaware they’re in the manic phase.

After the episode is over, they may be shocked at their behaviour. However, at the time, they may believe other people are being negative or unhelpful.

Some people with bipolar disorder have more frequent and severe episodes than others. The extreme nature of the condition means staying in a job may be difficult and relationships may become strained. There’s also an increased risk of suicide.

During episodes of mania and depression, someone with bipolar disorder may experience strange sensations, such as seeing, hearing or smelling things that aren’t there (hallucinations).

They may also believe things that seem irrational to other people (delusions). These types of symptoms are known as psychosis or a psychotic episode.