Bipolar disorder: when moods swing between extremes

What is bipolar disorder?

Bipolar disorder is a condition in which periods of abnormally elevated mood (mania or hypomania) alternate with periods of depression. The mood swings are much larger than everyday ups and downs and last from days to weeks or longer.

• Bipolar I disorder: mania severe enough to seriously disrupt daily life or require hospitalization.
• Bipolar II disorder: milder hypomania alternating with severe depression.

Signs of mania

• Barely sleeping but not feeling tired
• Talking more and faster, with racing thoughts
• Inflated self-confidence, feeling you can do anything
• Overspending, risky investments, dangerous behavior
• Becoming easily irritated or aggressive

Why it matters to tell it apart from depression

People with bipolar disorder often first seek help during a depressive episode, so it is easily mistaken for depression. But using antidepressants alone in bipolar disorder can trigger mania, so always tell your doctor if you have had periods of elevated mood.

Treatment and relapse prevention

Mood stabilizers (such as lithium or valproate) and some antipsychotics are the core of treatment. Bipolar disorder often recurs, so continuing treatment even after symptoms improve is important.

• Regular sleep matters most. All-nighters and sleep loss can trigger mania.
• Avoid alcohol and stimulants.
• A mood diary helps you spot early warning signs of relapse.
• Agree with your family in advance: "If we see these signs, we call the doctor."