What are the symptoms of bipolar disorder?

Most of the time, people with bipolar disorder have depression, with the same symptoms as unipolar (major) depression. Bipolar depression often begins before age 25—sometimes in the teen years—with symptoms such as too much sleep or too large an appetite. The other side of bipolar disorder is a period with symptoms of mania, often called a "manic episode." Manic episodes are often portrayed in the media as wonderful highs, where people feel great and even godlike. In reality, most manic "highs" make a person irritable and are mixed with depressive symptoms. Bipolar disorder is diagnosed when a person has had at least one manic episode.

The frequency of episodes—often called "cycling"—is different for each person. People with bipolar disorder have periods of normal moods in between times of having depressive symptoms, manic symptoms, or the combination.

Over the course of a person's life, "episodes" of mood symptoms can occur every few years or as frequently as mood shifts that cycle throughout the day. A depressive episode and a manic episode can also occur at the same time. This is called a "mixed episode." These are particularly uncomfortable and severe.

For a few weeks before an episode, you might notice small changes in your mood or behavior. If you find ways to manage these, you can help prevent the episode. Warning signs include subtle shifts in your mood, sleep patterns, or the way you deal with people. Family or friends might notice these symptoms earlier than you do. Enlist their help in spotting them—so you can work to avoid a relapse.

Below, you'll find a list of typical behaviors exhibited by those with bipolar disorder. If you have been exceptionally excited or active for a week at a time and check three of the symptoms below, talk with your healthcare provider about bipolar disorder.

  • Exaggerated optimism and self-confidence
  • An inflated perspective about your abilities and qualities
  • Racing thoughts
  • Brisk speech
  • Impulsive behavior
  • Bad decision-making
  • Reckless behavior (shopping sprees, irresponsible driving choices, rash business decisions, sexual promiscuity)
  • Experiencing delusions (holding untrue beliefs) and hallucinations (seeing and/or hearing things that aren't there)
Keith Star
Psychology Specialist

A person with manic-depression may experience moods that shift from high to low and back again in varying degrees of severity. The two poles of bipolar disorder are mania and depression.

Dr. John Preston, PsyD
Psychology Specialist

There are a number of symptoms that often accompany bipolar I and II. Technically, these are not mood swings per se, but they are dominant features seen in many cases of bipolar disorder and are important to understand.

Major bipolar disorder symptom patterns include:

  • Depression
  • Mania
  • Hypomania
  • Psychotic symptoms
  • Paranoid symptoms
  • Intense anger and irritability
  • Anxiety
  • Feeling overstimulated/overwhelmed
  • Problems with maintaining focus, attention, and concentration
  • Suicidal thoughts and impulses
  • Self-destructive behaviors
  • Hypochondria
Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner (The New Harbinger Loving Someone Series)

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Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner (The New Harbinger Loving Someone Series)

Maintaining a relationship is hard enough without the added challenges of your partner’s bipolar disorder symptoms. Loving Someone with Bipolar Disorder offers information and step-by-step advice...
Donna Hill Howes, RN
Family Practitioner

People who have bipolar disorder occasionally experience dramatic and extreme mood swings. At the high end, known as mania, a person with bipolar disorder may have an elevated or excited mood and become talkative, restless, have little interest in sleep, make unrealistic plans, have grandiose ideas about one's self, and engage in reckless or dangerous behavior, such as going on wild spending sprees, taking part in risky activities, or abusing drugs. Mania can alternate with periods of depression, during which the person will become sad and hopeless. During the depressed phase, a person with bipolar disorder may talk about or attempt suicide. People with bipolar disorder experience periods of remission, during which they feel neither manic nor depressed. Some people experience a condition called mixed bipolar disorder. This may cause a person to feel symptoms of mania and depression at the same time or in rapid sequence. For instance, a person experiencing mixed bipolar disorder may feel deeply depressed, but have racing thoughts.

Ms. Julie A. Fast
Mental Health Specialist

Bipolar disorder is an illness that affects a person’s ability to regulate their moods. Bipolar disorder is easy to understand as the symptoms stay the same for everyone. But it’s a very difficult illness to treat because the symptoms differ in amount and intensity for each person.

There are four main symptoms of bipolar disorder:

  • Mania: A chemically created "up" swing that can be either euphoric (Woo hoo! This is wonderful! Life is wonderful! I am the most beautiful person in the room!) or the nasty dysphoric mania where the person has a down mood and is very agitated. People in dysphoric mania are often irritated, can’t sleep, feel miserable and get angry a lot.
  • Depression: A chemically created down swing. Most people are familiar with depression. The hopelessness, sadness, belief that things will never get better, irritation, negativity, crying, lethargy, sleeping too much, getting to sleep but waking up too early, unable to work due to slowness, apathy, slumped body language, isolation and an overall feeling that the world is an unhappy, lonely, uncaring and often unkind place. When this goes too far, suicidal feelings can take over a person’s life. Why is bipolar depression so difficult to treat? Bipolar depression is very complicated when compared to basic depression (called unipolar depression). Unipolar responds very well to medications and therapy. Bipolar depression has such a mix of other bipolar symptoms it’s like cloudy water where you just can’t separate what is causing what. Also, anti-depressants can’t be used alone to treat bipolar depression as they cause mania.
  • Anxiety: 90 percent of people with depression have anxiety and all people with bipolar disorder have depression - so it’s easy to see that anxiety is a main symptom of bipolar and must be recognized and treated carefully.
  • Psychosis: This is the most difficult of all of the bipolar symptoms to understand. In fact, most people have no idea that psychosis can be a large part of the illness, especially in full-blown mania. Psychosis has two components: hallucinations where a person has a sensory experience that is not real such as seeing things and hearing voices and delusions where a person has a false belief about something such as feeling a direct communication with a deity or believing that the TV is send out special messages from the government.

These are the symptoms in a nutshell. Did you know there were so many?

Symptoms of bipolar disorder include major mood swings. One moment you might be on Cloud 9, giddy, or in a state of euphoria. And then all of the sudden, without anything triggering it, you can feel incredibly sad, hopeless, or even suicidal. The shifts can happen a few times a year or even a few times a day. You may experience intense feelings that last almost all day for two or three weeks or even longer. You feel like you can do the work of three people, and sometimes even do. You can also be agitated or irritable. You may even talk a mile a minute or try to do a lot of things at once, including things you typically wouldn’t or shouldn’t do (like spending a lot of money, talking to random people on the street, or engaging in risky sexual activity). Your “wired” feeling may make it hard for you to rest and sleep.

In contrast, during a depressive period, you experience intense sad and hopeless feelings that last almost all day for two or three weeks, or even longer. You may sleep or lie in bed for extended periods. These feelings can sap your energy, causing you to feel tired. You may become forgetful and lose interest in activities you once enjoyed. Being “down” (as in rock-bottom down, not just sad about a bad grade or a breakup) may also cause you to worry a lot and keep you from sleeping.

If you have experienced any of these symptoms and are concerned, talk to your doctor ASAP.

The symptoms of bipolar disorder can be divided into two categories: the highs of mania, and the lows of depression.

Symptoms of mania include elation, euphoria, high self-regard, very fast speech, more physical activity than usual, less need for sleep, great optimism, risk-taking, and poor judgment. Less severe than mania, hypomania involves a productive and positive state where people still may make risky decisions. Symptoms of mild to moderate depression include feeling hopeless and sad, fatigue, nervousness, irritability, loss of interest in day-to-day matters. Severe depression can include thoughts or actions of suicide.

People with bipolar disorder may sometimes experience psychosis, or a lack of connection to reality. Severe depression or mania can lead one to have hallucinations—hearing voices that don't really exist - or delusions - strongly believing in things that aren't true.

Dr. Jeffrey Gardere, PhD
Psychology Specialist

The main symptoms of bipolar disorder include wild mood swings of feeling very depressed, then having a manic phase where you feel very superior and energetic. Watch as psychologist Jeffrey Gardere, PhD, explains the symptoms of bipolar disorder.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.