Bipolar disorder

While we all experience mood changes in response to life’s events, some people’s moods fluctuate up and down much more than usual. People with bipolar disorder can have extreme moods of feeling really high, very active and euphoric (‘manic’); or feeling really low (‘depression’). When these shifts in moods cause changes in how you’re behaving and how you are able to function in your everyday life, it’s important to get help.

Bipolar disorder is a chronic mental health condition with strong changes in mood and energy. One in 50 (1.8%) adult Australians experience bipolar disorder each year.

People experiencing bipolar disorder can have:

  • depressive episodes: low mood, feelings of hopelessness, extreme sadness and lack of interest and pleasure in things
  • manic or hypomanic episodes: extremely high mood and activity or agitation, racing thoughts, little need for sleep and rapid speech.

These changes in mood can last a week or more, and affect our thoughts and behaviour.

Bipolar disorder needs long-term management, which may include medication and psychological therapies. Bipolar disorder affects how we are able to function in our everyday life. Untreated, it makes it hard to consistently cope at work, home, school or socially.

People experience bipolar disorder in different ways. The pattern of mood swings is different for each person with bipolar disorder.

When someone is experiencing bipolar disorder, their behaviour and thoughts can be beyond their own control.

Friends, family and workmates can often be the ones to notice first.

What are the early warning signs of bipolar disorder?

One early bipolar symptom may be hypomania. When someone is hypomanic, they can feel great, highly energetic and impulsive.

Common early warning signs for hypomania and mania, include:

  • not sleeping (the most commonly experienced sign)
  • agitation, irritability, emotional intensity
  • energised with ideas, plans, motivation for schemes
  • intense expression laden behaviour with implied extra meaning
  • inability to concentrate
  • rapid thoughts and speech
  • spending money more than usual
  • increased sexual drive, flirtatiousness
  • increasing incidence of paranoid thoughts
  • neglecting to eat, losing track of time
  • reading extra symbolism into words, events, patterns (seeing ‘codes’)
  • increased use of telephone or writing – making contact with many people
  • insistent and persuasive
  • increased intake – or binges – of alcohol and/or drugs
  • arguments with friends or family
  • increased ‘driven’ activity without stopping to eat, drink or sleep
  • increased interest in religious/spiritual ideas or themes
  • taking on more work or working to extremes in hours or projects.

Some common early warning signs of bipolar depression, include:

  • change in sleep patterns – insomnia, or excessive sleeping
  • fatigue
  • staying up late to watch TV or work on projects
  • increased irritability
  • loss of concentration
  • lack of motivation
  • withdrawal – avoiding social contact, not answering phone, cancelling social activities
  • change in eating habits – loss of appetite, or overeating
  • reduced libido
  • increased anxiety and feelings of worthlessness
  • loss of interest in leisure activities and hobbies
  • listening to sad/nostalgic music
  • taking sick days
  • procrastinating and putting off responsibilities
  • bursting into tears for no apparent reason
  • thoughts of suicide.
  • If you recognise some of these changes in behaviour, it’s important to find help with a mental health professional.

Symptoms of bipolar disorder

Someone with bipolar disorder has episodes of depression and highs (feeling ‘hyper’ or ‘wired’). During the ‘highs’ they might feel like things are speeding up, having thousands of thoughts and ideas, and they may feel invincible or behave recklessly.
Bipolar symptoms during a manic phase may include:

  • feeling incredibly ‘high’ or euphoric
  • delusions of self-importance
  • high levels of creativity, energy and activity
  • getting much less sleep or no sleep
  • poor appetite and weight loss
  • racing thoughts, racing speech, talking over people
  • highly irritable, impatient or aggressive
  • inappropriate sexual activity or risk taking
  • dressing more colourfully and being less inhibited
  • impulsiveness and making poor choices in spending or business
  • grand and unrealistic plans
  • poor concentration, easily distracted
  • delusions, hallucinations.

Bipolar symptoms during a depressed phase may include:

  • feelings of sadness or hopelessness
  • loss of interest in usually pleasurable activities
  • withdrawal from family and friends
  • sleep problems (often excessive sleep)
  • loss of energy, feeling exhausted
  • physical slowing
  • low self-esteem
  • feelings of guilt
  • problems concentrating
  • suicidal thoughts.

Bipolar disorder can be difficult to diagnose as:

  • its onset is often marked by a depressive period and it can therefore be misdiagnosed as depression
  • depressive symptoms are common in bipolar disorder – usually more prevalent than hypomanic or manic symptoms
  • ‘mixed mood’ episodes are common. These might obscure detection of mania and hypomania, as people report more depressive symptoms when seeking treatment.

For some people, it can take years before their illness is accurately diagnosed and treated. Mental health professionals should carefully assess previous episodes of mania or hypomania when working with depressed patients. Some patients with treatment-resistant unipolar depression may possibly have misdiagnosed bipolar disorder.

Getting help early for bipolar disorder is important

It’s very important to get help for someone you are concerned may have bipolar disorder or another mental health condition, or if you recognise the signs in yourself. We can’t diagnose bipolar disorder on our own. Accurately diagnosing bipolar disorder needs to be done by a skilled mental health professional. Make sure you see your GP. We can talk to you about your concerns, and get you help from a psychiatrist or other mental health professional. Bipolar doesn’t go away by itself. It needs long-term management. There are well-trained professionals to help you manage bipolar disorder and other mental health conditions.

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