Everyone’s mood changes at different times in their lives. If you have bipolar disorder, you may experience periods when your state of mind changes dramatically. This is when you have a period of being depressed, manic or hypomanic. In between these, you’ll have stable or neutral periods, often for several years.
These periods are referred to as mood episodes or states. During a manic or hypomanic episode, you’re considerably more active than usual and may feel extremely elated. Conversely, you may have depressive episodes when you’re constantly down and may feel that your activity level falls dramatically.
The way these episodes cycle can vary from person to person depending on the type of bipolar disorder you have.
At least during the early stages of the condition, these episodes can be triggered by external events, stress and the general demands of life.
The first symptoms usually appear during adolescence or young adulthood. The condition is lifelong in the sense that you remain at risk of experiencing new episodes, but with treatment you can avoid such episodes for long periods of time. The risk of developing bipolar disorder at some point in life is one to two percent and is about the same worldwide.
Mania and hypomania can lead to a loss of judgment, affecting relationships, work and finances. For example, you may start several projects, become euphoric and overtly social and do things that may have more or less serious consequences. You’ll often be extremely active and need very little sleep. You’ll have a lot more self-confidence than normal, and you may get irritated if someone questions your brilliant ideas, infatuations, social life and all the projects you’ve started.
Hypo comes from Greek and means under, below. While the symptoms of hypomania and mania are similar, mania is more severe. If you’re manic, you can easily lose your sense of reality and even experience psychosis. When hypomanic, you don’t lose your sense of reality and the symptoms are less severe. Manic and hypomanic episodes are commonly followed by depression. This depression can be deep enough to give rise to suicidal thoughts and plans. Sometimes, they’re severe enough that you try to take your own life.
The main risk factor for bipolar disorder is genetic. Accordingly, other family members or relatives are often affected as well.
There are subtypes of bipolar disorder, most commonly divided into bipolar 1 and bipolar 2. With bipolar 1, you’ve experienced at least one manic episode and generally depressive episodes as well. With bipolar 2, you’ve experienced hypomanic and depressive episodes but not a more severe manic episode.
If you suspect you have bipolar disorder, contact a psychiatric clinic. They’ll make a preliminary assessment. You’ll then undergo a thorough assessment to find out whether you have bipolar disorder.
Effective preventive treatment is available, and it’s important that you embrace it as the condition can affect your entire life and the risk of suicide is high. You need medication, to both stop the episodes and prevent the risk of new ones. Both you and those around you need to be aware of your condition and to learn to recognize the early signs to reduce the risk of episodes. This is why training is usually offered to both you and your family.
A productive dialogue with your healthcare provider is key. Some people need psychotherapy. Another way to prevent new episodes is to have an action plan in place in case you or those around you notice early signs of an impending episode. You may also need to go on sick leave for a while, and hospital care may also prove necessary.
Reviewed by: Mikael Landén, professor of psychiatry and university hospital chief physician.
Last edited 2023-12-07