Bipolar disorder - the signs, symptoms and treatments

4 September 2016

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What is bipolar disorder?

"People living with bipolar disorder experience mood swings that range from periods of elation, described as mania, to severe depression. These highs and lows are punctuated by feelings of stability – the frequency and duration of the episodes can vary greatly from one person to the next," says Dr Mark Winwood, Clinical Director of Psychological Health at AXA PPP Healthcare.

Bipolar disorder, or bipolar affective disorder a condition previously referred to as manic depression, affects a person's moods, which can move from one extreme to another. Specifically, those living with bipolar disorder have episodes of:

  • Mania and hypomania: Having huge amounts of energy, with feelings of elation.
  • Depression can include feelings of lethargy and extreme unhappiness, and possible suicidal thoughts.
  • Psychotic symptoms can occur at either end of the bipolar spectrum.

A common misconception is that bipolar disorder mood swings only last for short periods of time, when in reality, they can last for several weeks. Most cases of bipolar disorder develop in people between the ages of 15 and 19. According to the National Institute of Mental Health, which puts it at around 2.6% of adult population. The symptoms of bipolar disorder, as well as its causes, vary from person to person. Treatment is also personalised, depending on your individual responsiveness to both medication and therapy.

Signs and symptoms of bipolar disorder

Much like depression, bipolar disorder can be incredibly hard to diagnose, and Dr Mark Winwood recommends you do not try to  diagnose it yourself. It affects people differently, and all symptoms do not apply to all cases, though there are a number of common signs that can point towards the illness.

Common signs of mania and hypomania

  • Highly-increased energy and activity
  • Erratic thoughts
  • Very fast speech patterns
  • Little sleep, and restlessness
  • High levels of irritability
  • Low appetite
  • Provocative behaviour, often bordering on intrusive
  • High self-belief in powers or abilities
  • Spending sprees


  • Long-lasting sad and empty mood
  • Low energy; feelings of fatigue, or being slowed down
  • Overriding feelings of helplessness, guilt and worthlessness
  • Sleeping too much, or little sleep, due to restlessness
  • Difficulty with memory, concentration, and making decisions
  • Major changes to appetite, possibly resulting in weight loss or gain
  • Suicidal thoughts, and suicide attempts.

Visit our specialist depression page for more in-depth information

For more information about the signs and symptoms of depression visit our mental health centre.

Additional symptoms

  • Delusions and illogical reasoning
  • Hallucinations.

Types of bipolar disorder

There are four types of bipolar disorder; these simply refer to different symptoms, and do not reflect severity of the condition:

Bipolar I

  • Experiencing at least one high or manic episode, which goes on for over a week
  • Manic episodes last three to six months
  • Possibility of only experiencing manic episodes
  • Depressive episodes outlast manic ones, and can go on for six to 12 months

Bipolar II

  • Experiencing more than one episode of severe depression
  • Manic episodes remain mild – these are referred to as "hypomania"

Rapid cycling

  • Referring to those who experience four mood swings in a 12-month period
  • Affects around 10% of those with bipolar disorder
  • Can apply to those with both types


  • Mood swings are not as severe
  • However, they can last longer

Causes of bipolar disorder

We still don’t know what causes people develop bipolar disorder, but there seem to be some common factors, which include:

Environmental and social factors

As with depression, bipolar disorder can be triggered by distressing or stressful life events, such as childhood abuse.


  • If you have immediate family members with bipolar disorder, you are five to ten times more likely to develop it than someone who does not, according to mental health charity, Rethink.

Chemicals in the brain

Diagnosing bipolar disorder

If your GP believes you might have bipolar disorder, they will refer you to a psychiatrist.

Your psychiatrist will then assess you, questioning the extent to which bipolar disorder could be affecting your life. You will be asked about specific symptoms and triggers, when you first experienced them, and how long they last for. They will want to know how you respond in the build up to the; extreme mania or; depressive episodes. You will also be asked about your family history and medical background.

Treatments for bipolar disorder

Without treatment, bipolar disorder-related episodes can last for between three and six months (mania) and six and 12 months (depression). With treatment, both types of episode can be limited to around three months.

Bipolar disorder is treated with a combination of approaches, including:

  • Preventative medication to prevent mania, hypomania and depression – often referred to as mood stabilisers, taken daily over the long term.
  • Responsive medication to treat symptoms when they appear.
  • Psychological treatment including talking therapies, like Cognitive Behavioural Therapy (CBT) which deal with depression and can improve personal relationships.
  • Lifestyle changes, including exercise, activity planning, dietary amendments and a focus on sleep patterns.
  • As with all mental health issues, don’t expect a quick fix solution. Following the medical advice of your doctors and making a few lifestyle changes should show positive results over time.

    If you have a bipolar-related question, don't hesitate to ask our experts for specific support

Sources and further reading