Bipolar Disorder

Woman resting head on mans shoulder

Bipolar disorder is a mental illness characterised by periods of extreme highs and lows. These are called manic and depressive episodes. Everyone experiences periods of happiness and sadness, but for those with bipolar disorder the changes in mood are extreme and can last for days or months. 

During a manic episode the person feels energetic, euphoric, and ‘on top of the world’. They may be very active, irritable, have racing thoughts, and engage in risky behaviour. These manic symptoms last for at least one week. Depressive episodes last for at least two weeks during which a person feels very sad and hopeless, has low energy, and loses interest in things they used to enjoy. 

There are different types of bipolar disorder. Bipolar I disorder is characterised by manic and depressive episodes. Bipolar II disorder involves depressive and hypomanic episodes. A hypomanic episode is less intense than a manic episode and only lasts four days. Cyclothymic disorder is characterised by at least two years of cycling between less intense hypomanic and depressive symptoms. 

There is a strong genetic component to bipolar disorder. 80% to 90% of those with bipolar disorder have a relative who also has bipolar disorder or depression. Other risk factors include drug and alcohol abuse, stress, trauma, physical illness, and sleep problems.

Common symptoms
  • Experiencing periods of extreme high mood [mania] or low mood [depression] which last several days to months.
  • Feeling euphoric, fantastic, energetic, ‘on top of the world’.
  • Irritability
  • Restlessness, increase in activity.
  • Feeling jumpy, ‘on edge’, wired.
  • Increase in risky behaviour and/or making poor decisions [e.g. use of drugs, spending money].
  • Racing thoughts
  • Easily distracted
  • Psychosis - losing touch with reality.
  • Feeling depressed, low mood, hopeless, worthless.
  • Loss of interest in things you used to enjoy
  • Difficulty making decisions.
  • Difficulty concentrating
  • Thoughts of harming yourself
  • Thoughts of suicide or death
  • Changes in sleep - increased or decreased need for sleep.
  • Increase or decrease in energy.
  • Changes in appetite - increase or decrease in appetite
How common is in the general population
Around 1% of the general population will be diagnosed with bipolar disorder at some point in their lives.
Gender differences
Similar numbers of men and women have bipolar disorder. Women tend to experience more depressive episodes and less manic episodes than men.
Bipolar disorder typically begins in late adolescence or early adulthood. The first episode usually occurs before 25 years old.
Typical Course
Bipolar disorder is a chronic condition. However, symptoms can vary over time with periods of more or less intense symptoms. Treatment can successfully reduce severity of symptoms.
Common Comorbid (concurrent) Conditions
Substance use disorders, anxiety disorders, eating disorders, attention deficit hyperactivity disorder (ADHD), thoughts of self-harm and/or suicide.
Common treatments

Treatment for bipolar disorder typically involves a combination of psychological therapy and medication. This can help to effectively manage and reduce the intensity of symptoms. If you think you have bipolar disorder, speak with your GP. They may refer you to a psychiatrist or psychologist for assessment. 


Antidepressants and mood stabilising medications are prescribed to treat depressive and manic symptoms. For more severe manic or depressive symptoms antipsychotics may be prescribed. Anti-anxiety medications, such as benzodiazepines, may also be used short-term to improve sleep and reduce anxiety. 

Psychological Therapy:

Alongside medication, psychological therapy (talk therapy) is important. The aims of psychological therapy include identifying warning signs of mood episodes, learning ways to manage symptoms, and addressing other emotional issues.

Cognitive behavioural therapy (CBT) is a structured form of talk therapy which aims to identify and change unhelpful thoughts, beliefs, and behaviours. CBT aims to help manage symptoms of bipolar disorder and address emotional issues. 

Interpersonal and social rhythm therapy (IPSRT) is beneficial for many with bipolar disorder. It aims to help create consistent daily routines, such as sleep, exercise, and mealtime routines, in order to manage mood.

Day Treatment Programmes, Residential Programmes, and Hospitalisation:

While learning to manage symptoms of bipolar disorder, or when experiencing more intense symptoms, day treatment programmes or residential programmes may be beneficial. If symptoms are severe (e.g. psychosis), suicidal thoughts are present, or there is a danger to the individual or others, then hospitalisation may be required. 

Other Treatments: 

If symptoms do not improve with medication and psychological therapy then electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may be used. ECT creates a small controlled seizure by passing electrical currents through the brain. This aims to change signalling within the brain. TMS involves sending short magnetic pulses into brain areas involved in mood regulation to stimulate nerve cells. 

Other Ways to Manage Bipolar Disorder:

Other ways to improve general well-being and reduce symptoms include avoiding alcohol and drugs, doing regular exercise, eating a healthy diet, getting enough sleep, keeping consistent daily routines, and learning ways to manage stress. Some find that joining a support group and talking to others about their experience with bipolar disorder can be helpful.