Bipolar disorder, previously known as manic depression, is a mental illness marked by periods of mania—where a person is in a chronically elevated or agitated state—alternating with, or sometimes mixed with, depression. The symptoms of the depressive period are the same as with major depression, except when a person is in what is known as a mixed affective episode. During a mixed episode, a person will have symptoms of mania at the same time as the depressive symptoms. During a depressive or mixed episode, people are at much greater risk of suicide.

The manic episodes can vary in duration and intensity. People who get more intense manic episodes are considered to have Bipolar I disorder. People with mild to moderate manic episodes, known as hypomania or cyclothymia, are considered to have Bipolar II.

The symptoms of mania may include:

  • Feelings of elation or euphoria
  • Increased energy and reduced need for sleep
  • Increased self-confidence, sometimes grandiose thinking that one is unique, special and better than others
  • Tendency to make grand plans that are often unattainable
  • Inability to focus, easily distractible
  • Tendency to make sudden and poor decisions about big things, such as terminating relationships, quitting a job or moving
  • Increased restlessness or agitation
  • Increased irritability or rages often alternating with great happiness and friendliness
  • Increased libido and sexual aggressiveness
  • Rapid speech and talkativeness
  • Tendency toward reckless and irresponsible behavior and sometimes substance abuse

With hypomania, the symptoms are often much milder and trend toward:

  • Decreased need for sleep
  • Feelings of happiness and greater productivity
  • Being more outgoing and confident
  • Feeling more energy
  • Having a higher sex drive
  • Increased feelings of impatience and irritability

Psychosis

In extreme cases, people experiencing a more severe manic episode may lose touch with reality and enter a psychotic state, where they have false, intense and unshakable beliefs (for instance a certainty that they alone can detect secret plots or intellectual concepts) and sometimes the perception that they have superhuman and almost god-like powers. For more info on pyschosis, click here. 

How is bipolar disorder treated?

Bipolar disorder is a chronic illness. Treatment for this mental disorder can help many people gain better control of their mood swings and other bipolar symptoms. An effective treatment plan usually includes a combination of medication and psychotherapy, or talk therapy.

  • Medications. Mood stabilizers, atypical antipsychotics, and antidepressants are generally used to treat bipolar disorder.
  • Psychotherapy. These therapies can provide support, education, and guidance to people with bipolar disorder and their families. Such therapies include cognitive behavioral therapy (CBT), family-focused therapy, interpersonal and social rhythm therapy, and psychoeducation.
  • Electroconvulsive Therapy (ECT). ECT can provide relief for people with severe bipolar disorder who have not been able to recover with other treatments.

Special Note: Suicide

One of the most serious symptoms of depression is suicidal thoughts and the desire to take one’s own life. People who are suicidal often feel no way out of their current circumstances, that nothing will ever change for the better, and that the world may be a better place without them. If you or someone you love is feeling this way it should be taken very seriously, and help should be sought immediately. A good first step can be calling the National Suicide Prevention Lifeline at all 1.800.TALK (1.800.273.8255).

Some of the warning signs of suicidal feelings include:

  • Thinking or talking about killing one’s self
  • Having many of the symptoms of depression 
  • A feeling of calm and sometimes happiness following a decision to commit suicide. For friends and loved ones, this may look like a sudden improvement after persistent sadness.
  • Taking risks that are unusual, such as standing extremely close to the edge of a precipice or driving dangerously
  • Feeling or talking about being hopeless or worthless
  • Suddenly visiting or contacting people. The person feeling suicidal often views this as a way to say goodbye.
  • Wrapping up loose ends—for instance giving away treasured possessions, or making or updating a will

Last Reviewed: February 27, 2019