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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.

What are bipolar mood states?

This page provides information on:

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:

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."

This information was published in May 2018. We will revise it in 2021.

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