Bipolar disorder

What bipolar disorder actually is

Bipolar disorder is a mood disorder defined by shifts between two kinds of episodes. On one side are depressive episodes, with low mood, loss of interest, low energy, and the other features of depression. On the other side are periods of mania or hypomania, where mood and energy run unusually high or irritable.

During a manic episode, a person may feel euphoric or on top of the world, need far less sleep, talk rapidly, have racing thoughts, and act on impulse in ways that are out of character, such as overspending or taking risks. Mania is severe enough to disrupt life and sometimes requires hospitalization, while hypomania is a milder version that’s noticeable but less impairing. By clinical definition, a manic episode lasts at least a week, and a hypomanic episode at least four days.

The pattern of episodes varies. Some people have long stretches of stable mood between episodes, while others cycle more frequently. The distinction between mania and hypomania is part of how clinicians separate the different forms of bipolar disorder.

What bipolar disorder can feel like

During depressive episodes, the experience can mirror clinical depression, with heaviness, hopelessness, and difficulty doing everyday things. During manic or hypomanic periods, people may feel energized, creative, and unstoppable at first, which is part of why these episodes can be hard to recognize as a problem in the moment.

The shifts can be disorienting for the person and confusing for the people around them. After a manic episode, many feel regret or exhaustion as they take stock of decisions made while their judgment was altered. Sleep is often one of the earliest things to change in either direction.

What bipolar disorder isn’t

Bipolar disorder isn’t ordinary mood swings or simply being moody. The mood changes are distinct episodes that last days to weeks and represent a clear shift from someone’s usual functioning.

It also isn’t the same as major depressive disorder, even though the depressive episodes can look identical. The presence of mania or hypomania is what sets bipolar disorder apart, and that difference matters a great deal for treatment. Some medications used for unipolar depression can be problematic in bipolar disorder, which is why an accurate diagnosis is so important.

Related terms you’ll see next

Depression describes the low-mood side of bipolar disorder. Major depressive disorder is the unipolar condition that bipolar disorder must be distinguished from. Insomnia and changes in sleep are often early signs of an episode. Dopamine is one of the brain chemicals studied in mood regulation.

When to seek professional care

If you’ve noticed periods of unusually high energy, reduced need for sleep, and impulsive behavior, especially alongside episodes of depression, an evaluation is worthwhile. A clinician can sort out whether the pattern fits bipolar disorder, which guides treatment in an important way. Bipolar disorder is manageable with care. If you’re having thoughts of suicide or self-harm, seek help right away. If you’re in crisis, call or text 988 in the United States.