Bipolar disorder

Bipolar affective disorder is a mental health condition characterised by extreme changes in mood. Your mood can vary from excitement and elation (known as mania) to depression and despair. Each mood may last several weeks before swinging to the other extreme.

You may also have mixed moods. For example, you might feel depressed but at the same time restless and overactive. In between episodes of mood swings you might not have any symptoms at all.

Bipolar affective disorder is sometimes just called bipolar disorder. It used to be known as manic depression.

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There are different types of bipolar disorder:

  • Bipolar affective disorder I is usually diagnosed if you’ve had at least one episode of elevated mood that's lasted for at least a week. You might also have periods when you feel depressed.
  • Bipolar affective disorder II is usually diagnosed if you have one or more periods of feeling really depressed, followed by a milder manic episode (hypomania).
  • Cyclothymia or cyclothymic disorder is usually diagnosed if your mood swings are not severe enough to be diagnosed with bipolar affective disorder (I or II) but they last longer.

Your condition may be described as ‘rapid cycling’ if your mood swings happen very quickly at least four times over a year. It isn’t classified as a separate type of bipolar disorder. It can be difficult to diagnose as you may experience similar symptoms if you have other mental health problems.

What does it feel like to have bipolar disorder?

Your experiences of bipolar disorder will vary depending on your mood. You may experience some, or all, of the following.

Mania and mild mania (hypomania)

If you experience mania, you may:

  • feel incredibly happy and have an unusually elevated mood
  • be irritable and sometimes aggressive
  • be more talkative, and talk very fast
  • be easily distracted
  • not think through your behaviour or actions
  • not feel as if you need much sleep
  • have more interest in sex
  • behave in ways you’d usually think were quite extreme - such as going on a spending spree or devising extravagant or impractical schemes

During an episode of mania, you may not be aware of any changes in your behaviour. Your friends, family or colleagues may be more likely to notice changes. However, it’s possible to learn to notice signs that an episode may be starting and seek help earlier.


If you experience depression, you may:

  • feel sad and negative about life
  • lose interest in others, and the things around you
  • feel worthless and lose confidence in yourself
  • feel unable to make decisions
  • have difficulty sleeping
  • have less energy, and feel tired
  • isolate yourself from your friends
  • think of suicide
  • feel guilty
  • eat more or less than you normally would

Mixed episodes

You may experience symptoms of mania and depression at the same time or rapidly alternate between them (within a few hours). For example, you may feel sad but also have lots of energy.


During an episode of mania or depression you may also experience:

  • Delusions. You may have strong beliefs that no one else agrees with – for example you may feel very paranoid.
  • Hallucinations. You may hear, see, smell or feel things that other people don’t.

Not everyone with a diagnosis of bipolar disorder experiences psychosis.

What causes bipolar disorder?

The exact reasons why some people develop bipolar disorder aren't fully understood yet. Researchers think that these things may make you more likely to develop it:

  • If you have a close relative with bipolar disorder.
  • If you experienced physical, sexual or emotional abuse as a child.
  • Problems with the way chemicals are transmitted in your brain may play a part.
  • Stressful or traumatic events are unlikely to cause bipolar disorder but if you have the condition they may trigger new episodes.

What treatments are available for bipolar disorder?

Bipolar disorder can last a long time, sometimes for the rest of your life – but treatments can keep your mood constant and control your symptoms.

  • Self-help. Tracking your mood and ensuring you stick to a regular routine can help.
  • Medication. Different medications work for different people. You may be prescribed anti psychotics, mood stabilisers or antidepressants.
  • Talking therapies. See our information on talking therapies.
  • Hospital treatment. If your symptoms are very severe, you may need to go into hospital.

For more information on treatments, see our information on common treatments and support.

We also have more detailed information on bipolar disorder.

Bipolar UK is a charity supporting those affected by bipolar disorder. They recently received a grant from the Bupa UK Foundation.

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  • Produced by Clare Foster, freelance health editor, and Nick Ridgman, Head of Health Content, Bupa UK, September 2017
    Next review due September 2020

    Bupa UK expert reviewers:

    • Naomi Humber, Psychology Services Manager, EAP
    • Stuart Haydock, Resilience Lead, Health Clinics
    • Sarah Deedat, Head of Behaviour Change

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