Bipolar disorder

This booklet describes the symptoms of bipolar disorder and what treatments are available. It also suggests how you can help yourself, and what family and friends can do.

What is bipolar disorder?

If you have bipolar disorder you will experience extreme swings in mood – from periods of overactive, excited behaviour – known as ‘mania’ or ‘manic episodes’ – to deep depression. Between these severe highs and lows, you may have stable times.

Some people also see or hear things that others around them don’t (known as having visual or auditory hallucinations) or have uncommon, unshared, beliefs (known as delusions).

Manic episodes

You may experience one or more of the following symptoms. However, it is unlikely that you will go through all of them. Symptoms may include:

  • feeling euphoric – excessively ‘high’
  • restlessness
  • extreme irritability
  • talking very fast
  • racing thoughts
  • lack of concentration
  • having a lot of energy
  • a reduced need for sleep
  • a sense of own importance
  • poor judgement
  • excessive and inappropriate spending
  • increased sexual drive
  • risky behaviour
  • misusing drugs or alcohol
  • aggressive behaviour.

You may feel like you are a genius and that you are the only person in the world who can see it the right way.

Impact of a manic episode

You may not be aware of the changes in your attitude or behaviour while you are having a manic episode. However, after a manic phase is over, you may be shocked at what you have done and the effect that it has had.

When I am hyper, I’m the life of the party, everyone is my friend and there isn’t anyone I won’t talk to about anything…

Because you feel so elated and full of energy, you may take on commitments and responsibilities that you cannot fulfil. For example, you may take on a large loan or mortgage because you think you can earn extra money from work or projects you are planning. When the high mood drops, you may find it hard to cope with all the commitments you have taken on.

Family, friends or colleagues may have expressed concerns while you were going through a manic episode. At the time, their comments and worries may not have made sense to you. After the manic episode, you may see it differently and understand their concerns.


You may experience a milder form of mania known as hypomania – this is less severe and lasts for shorter periods. During these periods you can become very productive and creative and so may see these experiences as positive and valuable. However, if you don’t get treatment for hypomania, it may develop into more serious mania, and it could be followed by an episode of depression. (See mania and hypomania, for more information.)

Depressive episodes

Symptoms may include:

  • a sense of hopelessness
  • feeling emotionally empty
  • feeling guilty
  • feeling worthless
  • chronic fatigue
  • difficulty sleeping or sleeping too much
  • weight loss or gain
  • changes in appetite
  • loss of interest in daily life
  • lack of concentration
  • being forgetful
  • suicidal feelings.

Depression can be tough to deal with. If you feel very low, you may not feel that life is worth living and you may have thoughts of harming or killing yourself.

When I’m depressed, it’s the absolute worst pain I can experience. I feel like I become a balloon and am just floating outside myself, I cry like a part of me has died.

When you feel depressed, you may find it hard to do anything, including asking for help. In turn, this can make you feel even more depressed and hopeless. You can find further information about depression and how to deal with it here.

Types of bipolar disorder

There are different types of bipolar disorder.

  • Mania with psychotic symptoms – if you experience mania with psychotic symptoms, you are likely to experience many of the symptoms listed under Manic episodes. Your symptoms might be severe and your sense of your own importance may develop into delusions. Suspicions may turn into delusions of persecution and you may feel convinced that others are out to get you.
  • Depression with psychotic symptoms – with severe depression you may start hearing or seeing things that others don’t see and hear (hallucinations) and/or have beliefs that others don’t share (delusions). This can be very distressing. You may, for example, hear voices accusing you of being nasty and bad. Or you may be convinced that some terrible disaster is about to happen and that you are responsible for it.
  • Bipolar I – characterised by manic episodes – most people will
    experience depressive periods as well, but not all do.
  • Bipolar II – characterised by severe depressive episodes alternating with episodes of hypomania.
  • Cyclothymic disorder – short periods of mild depression and short periods of hypomania.
  • Rapid cycling – four or more episodes a year. These can be manic, hypomanic, depressive or mixed episodes.
  • Mixed states – periods of depression and elation at the same time.

Length and frequency of episodes

You may have very few bipolar disorder episodes, with years of stability in between them; or you may experience many more. Episodes can vary in both length and frequency from weeks to months, with varying lengths of time in between.

Mania usually starts suddenly and lasts between two weeks and four to five months. Depression often lasts longer, on average around six months. It can last longer, but usually less than a year.

Although you may cope very well in between episodes, you may still experience low-level symptoms in these relatively ‘stable’ periods, which can impact on your daily life.

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