Bipolar disorder

Explains what bipolar disorder is, what kinds of treatment are available, and how you can help yourself cope. Also provides guidance on what friends and family can do to help.

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What are bipolar mood states?

This page provides information on:

manic episodes (feeling high)
hypomanic episodes (feeling high)
depressive episodes (feeling low)
mixed episodes (feeling high and low at the same time)
psychotic symptoms

Going through any of these experiences can be extremely difficult to cope with, so it's worth thinking about how you can look after yourself, and what kind of treatment could help. It's also worth planning ahead for a crisis.

About manic episodes

Mania can last for a week or more and has a severe negative impact on your ability to do your usual day-to-day activities – often disrupting or stopping these completely. Severe mania is very serious and often needs to be treated in hospital.

Here are some things you might experience during a manic episode:

How you might feel

happy, euphoric or a sense of wellbeing
uncontrollably excited, like you can't get your words out fast enough
irritable and agitated
increased sexual energy
easily distracted, like your thoughts are racing, or you can't concentrate
very confident or adventurous
like you are untouchable or can't be harmed
like you can perform physical and mental tasks better than normal
like you are understand, see or hear things that other people can't

How you might behave

be more active than usual
talking a lot, speaking very quickly, or not making sense to other people
being very friendly
saying or doing things that are inappropriate and out of character
sleeping very little or not at all
being rude or aggressive
misusing drugs or alcohol
spending money excessively or in a way that is unusual for you
losing social inhibitions
taking serious risks with your safety

"The hardest thing to explain is the racing thoughts when I'm manic. It's like I've got four brains and they're all on overdrive... it can be scary but also euphoric at the same time."

About hypomanic episodes

Hypomania is similar to mania, but has a few key differences:

it can feel more manageable – for example, you might feel able to go to work and socialise without any major problems
it lasts for a shorter time
it doesn't include any psychotic symptoms

While hypomania is less severe than mania, it can still have a disruptive effect on your life and people may notice a change in your mood and behaviour.

Here are some things you might experience during a hypomanic episode:

How you might feel

happy, euphoric or a sense of wellbeing
very excited, like you can't get your words out fast enough
irritable and agitated
increased sexual energy
easily distracted, like your thoughts are racing, or you can't concentrate
confident or adventurous

How you might behave

more active than usual
talking a lot or speaking very quickly
being very friendly
sleeping very little
spending money excessively
losing social inhibitions or taking risks

"On 'up' days I chatter 19 to the dozen with anyone to the point it annoys people, and I can't stay still."

After a manic or hypomanic episode you might:

feel very unhappy or ashamed about how you behaved
have made commitments or taken on responsibilities that now feel unmanageable
have only a few clear memories of what happened while you were manic, or none at all
feel very tired and need a lot of sleep and rest

(See our pages on hypomania and mania for more information.)

About depressive episodes

Here are some things you might experience during a depressive episode:

How you might feel

down, upset or tearful
tired or sluggish
not being interested in or finding enjoyment in things you used to
low self-esteem and lacking in confidence
guilty, worthless or hopeless
agitated and tense
suicidal

How you might behave

not doing things you normally enjoy
having trouble sleeping, or sleeping too much
eating too little or too much
misusing drugs or alcohol
being withdrawn or avoiding people
being less physically active than usual
self-harming, or attempting suicide

Many people find that a depressive episode can feel harder to deal with than manic or hypomanic episodes. The contrast between your high and low moods may make your depression seem even deeper.

(See our pages on depression for more information.)

"The lows can be flat and devoid of colour, or intense and torturous. Sometimes it's full of demons, and pain inside so bad nothing physical could hurt you."

About mixed episodes

Mixed episodes (also called 'mixed states') are when you experience symptoms of depression and mania or hypomania at the same time or quickly one after the other. This can be particularly difficult to cope with, as:

it can be harder to work out what you're feeling
it can be harder to identify what help you need
it might feel even more challenging and exhausting to manage your emotions
you may be more likely to act on suicidal thoughts and feelings
your friends, family or doctor might struggle to know how they can support you best

"The mixed episodes are the worst. The most unpredictable and most dangerous ones, I find them difficult to explain."

About psychotic symptoms

Psychotic symptoms can include:

delusions, such as paranoia
hallucinations, such as hearing voices

Not everyone with a diagnosis of bipolar disorder experiences psychosis, but some people do. It's more common during manic episodes, but can happen during depressive episodes too. These kinds of experiences can feel very real to you at the time, which may make it hard to understand other people's concerns about you.

(See our pages on psychosis for more information.)

"Then [with mania] comes the paranoia, the shadows, the voices, the thought someone is behind me following me everywhere I go, ready to get me."