Bipolar disorder is a mental health condition that causes cycles of extreme emotions — the emotional highs are called mania, and the lows are called depression.

People with bipolar disorder usually experience mania and depression in turns, switching between the two. The period of time when you’re experiencing one or the other is called an episode. An episode of mania or depression lasts for at least a week, and usually longer.

Signs of bipolar disorder

If you have bipolar disorder, your first episode can be either mania or depression. Here are some common signs.

An episode of depression can look like:

• Being very sad

• Getting angry easily

• Feeling like everything is boring

• Being extremely tired

• Eating or sleeping a lot more or less than is normal for you

• Struggling to think clearly

• Feeling very guilty or hopeless, like everything is your fault

• Not wanting to see or talk to your friends

• Thinking a lot about death or dying

• Making a plan to kill yourself, or trying to kill yourself

An episode of mania can look like: 

• Feeling much more energetic, happy, and excited than usual

• Thinking or talking very fast, and jumping quickly from idea to idea

• Not needing much sleep

• Doing dangerous or risky things, like taking drugs or having unprotected sex

• Having trouble paying attention to one topic

• Believing that you’re a lot better or smarter than other people

• Hearing or seeing things that aren’t there

• Believing things that aren’t true

Your symptoms may be relatively mild when you first notice them, then get worse as you go through more episodes.

Most people who have bipolar disorder are diagnosed as teenagers, but it can also show up for the first time in children and adults. It can be difficult to diagnose bipolar disorder after a first episode. If your first episode is depression, it may look like you are just depressed, until you have also had a manic episode. Similarly, if the first episode is mania, it is sometimes confused with ADHD or schizophrenia, until the pattern of alternating episodes becomes clear.  

Kinds of bipolar disorder

Bipolar disorder includes a few different diagnoses:

• Bipolar I disorder: This kind of bipolar disorder involves intense mania and deep depression. People who have it usually have separate episodes of mania and depression, but it’s also possible to have episodes that mix symptoms of both.

• Bipolar II disorder: Bipolar II is mostly the same as bipolar I. But instead of extreme mania, it involves a less intense emotional state called hypomania. If you’re experiencing hypomania, you might just feel really good or like you can get a lot done — your behavior isn’t that extreme, but you’re clearly different from your normal self.

• Cyclothymia: Cyclothymia also comes with both depression and hypomania, but the episodes of each are less intense or shorter than with bipolar I or bipolar II.

Major changes

Everyone’s normal behavior is different, so what looks like a possible sign of bipolar in one person might be someone else’s usual personality.

The most important sign of bipolar disorder is the huge change from how you usually act and feel. The feelings that come with bipolar are extreme — much bigger than an ordinary mood swing — and they can make you seem like a different person to your friends and family.

It’s also important that the changes in your mood show up as a pattern over time. You might have periods of several months when your mood is normal in between episodes of mania and depression, or you might cycle more quickly from one to the other. 

Bipolar can be confusing and scary, but there are effective treatments for it. Working with a professional can help you find the right combination of therapy and medication to treat your symptoms.