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Bipolar disorder

What is bipolar disorder?

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Bipolar disorder is a mental illness where you have extreme changes in mood and energy levels. These episodes can be short, or they can last for months.

Bipolar mood swings are much more extreme than most people’s experiences of feeling happy or sad. People with bipolar go through extreme lows of deep depression and suicidal thoughts, and extreme highs of intense excitement and happiness. The highs are called mania and hypomania.

Bipolar disorder can affect anyone, no matter your age, gender or background. In the UK, over a million people have the condition. Symptoms usually start when you’re a teenager or young adult, often before the age of 21. But you can develop bipolar later on too.

Living with bipolar is tough and can seriously impact your life. But with the right treatment and help, you can figure out how to handle your condition.

Bipolar UK’s Mood Scale

  • People with bipolar have mood swings that are way more extreme than most people’s everyday emotions. Bipolar UK’s mood scale helps to explain the difference. It goes from 0-10, with 0 being severe depression, and 10 being mania and psychosis. People without bipolar usually sit between 4 and 6 on the scale. People with bipolar range from 0-10.

Symptoms of bipolar disorder

The most common symptoms of bipolar disorder are:

These affect people in different ways and in different patterns. You might have more highs than lows, or the other way around. Or there might be times where your mood feels stable.

Some people have more than one of these symptoms at the same time, like experiencing both depression and mania. This is called a ‘mixed state’ or ‘mixed episode’. In a mixed episode, you might feel very energised or excited as well as upset or irritable, which can make it more difficult to manage or understand your emotions.

A small number of people with bipolar disorder go through something called ‘rapid cycling’. That’s when your mood quickly swings between high and low again and again.

During extreme mood swings, you can also have psychosis. This is when you experience things that seem very real to you at the time but aren’t actually happening. This could be:

  • hallucinations, like hearing voices
  • delusions, like believing you are rich and powerful
  • extreme paranoia, like believing someone is following you
Find out more in our guide to psychosis

Hypomania and mania are periods of time when you have an unusually elevated mood, like feeling really energetic and excited for a few days, weeks or more. Mania is more severe than hypomania and lasts longer. For an episode to be called mania, it has to last a week or more. For an episode to be called hypomania, it only needs to last four days or more. Symptoms of mania and hypomania include:

  • feeling euphoric (intense excitement and happiness)
  • feeling very confident
  • becoming very creative or productive
  • feeling irritable
  • talking a lot or thinking very quickly
  • having difficulty sleeping or sleeping very little
  • making impulsive decisions, especially with money and relationships
  • taking risks with your safety or doing things that could cause you harm
Find out more about mania and hypomania

Depression affects everyone with bipolar differently. You might get symptoms that are mild or get them quite severely. Symptoms of depression include:

  • feeling hopeless and tearful
  • feeling really tired
  • getting aches and pains
  • avoiding things you normally enjoy, like hanging out with friends
  • changes to your appetite and eating
Find out more about depression
When you have a manic episode, it’s like you’re on a train going a million miles an hour and you just can’t stop it.

Types of bipolar disorder

There are three common types of bipolar disorder. Each type describes the moods you experience and how intensely you experience them.

  • Type 1

    People experience depression, hypomania, and mania.

  • Type 2

    People experience long periods of depression and hypomania.

  • Cyclothymia

    People experience periods of depression and heightened mood for at least two years.

How to get help for bipolar disorder

If you think you might have bipolar disorder, speak to your GP. GPs can’t diagnose bipolar themselves, but they can refer you to a specialist who can.

Before going to the GP, keep a mood diary for a few weeks to see if there are any patterns in your mood changes. Show your mood diary to your GP to help you explain what you’re experiencing. Bipolar UK have a free mood tracker app that you can use.

If your GP thinks you might have bipolar disorder, they’ll refer you to a specialist. If you’re under 18, this’ll be Child and Adolescent Mental Health Services (CAMHS). If you’re over 18, it’ll be your local community mental health team (CMHT).

Read our guide to CAMHS

If your symptoms are very severe, and there’s a danger you might self-harm or hurt others, you might be admitted to hospital. This could happen during an episode of mania or depression, when the spaces and people around you can be a risk to your safety. In hospital, you can be kept safe from harm and get the treatment you need.

Being sent to hospital can be really scary, especially if you didn’t choose to go yourself. Knowing more about what it’s like to be admitted to hospital and knowing your rights can help.

Read our guide to inpatient care
When you’re having a manic episode, it’s not that you’re a risk. It’s that the world’s a risk for you. You need to be safeguarded from the world because you don’t have any judgement over what’s risky or dangerous.

Getting a diagnosis can be tricky

Diagnosing bipolar isn’t straightforward and it can take a while. It’s hard because it involves changes to your mood that happen over a really long time. Plus, bipolar can look similar to other mental health conditions. For example, if you’ve had a depressive episode but not yet experienced a manic or hypomanic episode, your doctor might diagnose you with depression. Or sometimes physical health conditions can cause similar symptoms to mania, like thyroid problems.

If you think you have bipolar disorder and your doctor has missed it, discuss this with them. You can also tell them if you disagree with their assessment in any way. And if you feel like you’re not being heard, ask for a second opinion.

Getting a diagnosis is hard but it's still important to get support. Most people who have bipolar say that getting a diagnosis made things better. So reach out for help – it could make all the difference.

Treating bipolar disorder

When you get a diagnosis, your doctor will support you with all the next steps. Here are some of the options you’re likely to be offered.

Medication is often the key to treating bipolar disorder.
What medication you’re offered will depend on how severe your symptoms are and the type of bipolar you have. You’re most likely to be prescribed mood stabilisation or anti-psychotic medications, like:

Find out more about getting and taking medication

Alongside medication, your doctor might suggest therapy or counselling to help you manage your bipolar in the long term. In therapy sessions, you’ll get help to understand and change your thoughts and behaviours, develop coping strategies and set goals for keeping well. It can be an effective way of managing your depression and helping you maintain a stable mood.

One of the more common types of therapy you might get referred for is cognitive behavioural therapy (CBT). There’s evidence that this can be effective in treating depression and making it less likely that you’ll become depressed again.

Find out more about counselling and therapy

Tips on self-management

If you have bipolar, there are things you can do yourself to help manage your condition. It might be difficult at times to stick to these, but try not to blame yourself for this – managing bipolar isn’t easy. Be patient with yourself and recognise the steps you’ve already taken to manage a difficult condition. Remember loads of people with bipolar live happy and healthy lives. Getting the right support can help you do the same.

Check out some tips and advice for managing bipolar disorder from other young people with the condition.

  • I find stress and lack of sleep are the biggest causes of mania and hypomania for me. If you’re working, take time off work to help you reduce stress. And make sure you get enough sleep or talk to your GP about taking sleep medication.
  • If you’re taking medication, ask others to help you with making sure you take it at the right times. There are also lots of apps that you can use to remind you.
  • Ask your family members to help out with things like cooking to help take the load off.
  • Get out of the house and go for a walk. This will help you to feel calm.

Supporting someone with bipolar disorder

A young Black woman in a wheelchair and an older Black woman sitting on a bench in the park. They are talking about something serious.

If you’ve got a friend or family member who has bipolar, the impacts of this can have a big effect on you. Alongside them, you might also be suffering from some of their actions and behaviours during an episode.

People with bipolar can behave recklessly or thoughtlessly when they’re unwell. It’s not always easy to offer support or be sympathetic towards someone who you feel has treated you badly, and it can be difficult not to take their behaviour personally. But the more you understand about the illness, the more you’ll be able to understand their behaviour and offer the right support. Here are some things you can do to help.

Finding out more about the condition will help you to better understand your loved one’s behaviour and how you can help them. Reading this guide is a great first step. Bipolar UK also has lots of helpful information.

Talking to people who have bipolar, and their families and friends, can really help you understand the condition. They can share their experiences and strategies they have found helpful. Bipolar UK runs support groups open to friends and family members as well as people with the condition.

Find a support group

There’s a lot you can do to support someone who is trying to self-manage their condition, like:

  • working together with them to recognise and spot early warning signs and triggers
  • creating an action plan together so everyone knows what to do when the early warning signs appear

It’s not uncommon for people with bipolar to feel like they’re being criticised or controlled by family and friends, even if you’re trying to act in their best interests. Keep communication open and try your best to be understanding of their feelings, so that you can find the right balance of support. Make sure you discuss and agree plans when your loved one is well, so that any action you take can properly address both your needs.

To be able to best support your loved one, open communication, joint problem-solving and trust are crucial. But this can take time and practice. Family therapies and relationship counselling can help support you through this.

People with bipolar can have difficulty accepting that they need medication or remembering to take it. When they’re having a manic episode, symptoms can lead them to think they’re doing well and don’t need medication. It’s also tempting to believe that when their mood is stable, they won’t have another episode, which could lead them to stop taking their medication too soon.

Any decisions around medication should be made with a doctor. If your loved one is well at the time, they can be involved in this decision. But there may be times when they’re having a manic or depressive episode and you’ll need to speak to the doctor for them. Make sure this is part of your agreed action plan that you made together when they were well.

Remember that having a friend or family member with bipolar can impact your own mental health, so look after yourself. Having your own interests and continuing to lead your own life can help you offer a more balanced level of support. It can also support you to be in a better place, so you can deal with any difficulties more calmly.

You can find more tips on looking after yourself in our guides.

Get help now

If you're struggling with your mood or behaviour, you are not alone. Here are some services that can really help you.

  • Bipolar UK

    Provides information and a peer support service for people affected by bipolar, including friends and family. Find a local support group.

  • Samaritans

    Whatever you're going through, you can contact the Samaritans for support. N.B. This is a listening service and does not offer advice or intervention.

    Opening times:
  • Childline

    If you’re under 19 you can confidentially call, chat online or email about any problem big or small.

    Sign up for a free Childline locker (real name or email address not needed) to use their free 1-2-1 counsellor chat and email support service.

    Can provide a BSL interpreter if you are deaf or hearing-impaired.

    Hosts online message boards where you can share your experiences, have fun and get support from other young people in similar situations.

    Opening times:
  • The Mix

    Free, short-term online counselling for young people aged 25 or under. Their website also provides lots of information and advice about mental health and wellbeing. 

    Email support is available via their online contact form.

    They have a free 1-2-1 webchat service available during opening hours.

    Opening times:
    4pm - 11pm, Monday - Friday

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