Explains what bipolar disorder is, as well as different diagnoses and treatments. Offers information on how you can support someone with bipolar and tips for self-management.
We all have changes in our mood, but in bipolar disorder these changes can feel very distressing and have a big impact on your life.
You may feel that your high and low moods are extreme, and that swings in your mood are overwhelming. And you may feel and behave very differently, depending on your mood. This can be difficult and confusing.
These swings in mood are sometimes called mood episodes or mood states. Not everyone experiences mood episodes in the same way or for the same amount of time.
This page covers:
Manic and hypomanic episodes – or mania and hypomania – both mean feeling high.
Manic and hypomanic episodes have similarities in how they may make you feel or act. But there are some key differences:
Both mania and hypomania can be really tough to experience and manage. Whether you experience mania or hypomania, or if you're not sure what you're experiencing, it's always OK to seek support.
“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.”
During a manic or hypomanic episode, you might feel:
During a manic or hypomanic episode, you might:
“On 'up' days I chatter nineteen 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:
For more information, see our pages on hypomania and mania.
Depressive episodes are periods of feeling low. They last at least two weeks but can last much longer, sometimes for months. Like manic or hypomanic episodes, they can severely disrupt your everyday life. Severe depression may require medication or a stay in hospital.
Some people find that depressive episodes 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.
During a depressive episode, you might feel:
During a depressive episode, you might:
For more information, see our pages on depression.
“The lows can be flat and devoid of colour, or intense and torturous. Sometimes it's full of demons, and pain inside so bad that nothing physical could hurt you.”
A mixed episode, sometimes called a mixed state, is when you feel both high and low.
You may experience symptoms of depression, plus mania or hypomania at the same time. For example, you may feel very energised and impulsive, while feeling upset or tearful. Or you may feel very agitated or irritable.
You may also experience highs and lows very quickly after the other, within the same day or hour.
A mixed episode can be particularly difficult to cope with, as:
“The mixed episodes are the worst. The most unpredictable and most dangerous ones, I find them difficult to explain.”
Not everyone with a diagnosis of bipolar disorder experiences psychosis, but some people do. It's more common during manic episodes, but can also happen during depressive episodes.
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.
Psychotic symptoms can include:
For more information, see our pages on psychosis.
“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.”
It's common to have stable or neutral periods in between episodes. This doesn't mean that you have no emotions during this time. It means that you're not currently experiencing mania, hypomania or depression, or that you're managing your symptoms effectively.
You might find you feel stable for years in between episodes. Or your periods of stability might be much shorter.
Stable periods can feel like a relief. But they can also feel challenging in their own way. You may feel:
“It's a lot harder coming to terms with being stable than I could have imagined. I've had to struggle with a 'new' identity and way of life after spending so many years thinking the ups and downs of bipolar are 'normal'.”
Bipolar episodes happen at different times for different people. The frequency can depend on a lot of things, such as:
The length of mood episodes can also vary. They can last for a few weeks or much longer. What's normal for you can also change over time.
This information was published in February 2022. We will revise it in 2025.
References and bibliography available on request.
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