Everyone has “moods”, high and low, and this is a good thing. A person’s mood can change from day to day or multiple times in a day, and be affected by any number of things – events, interactions with other people, good or bad news, how much you’ve eaten or exercised, the weather, how much sleep you got, etc.

If you imagine mood to be like a sliding scale, with zero being the lowest mood possible (profound grief or numbness), and 10 being the highest mood (mania or euphoria), people typically move up and down the middle portion of this scale.

If someone has a mood disorder, like bipolar disorder, it means that there is an issue with how they are experiencing moods. To understand bipolar disorder, a good first step is to understand what depression is, and what manic episodes are.

Depression: Intense and prolonged feelings of sadness, apathy and/or low energy.

Manic episode or “mania”: An intense “high” or elevated mood. It is described by some as being full of energy, feeling euphoria or frenzied and even invincible. It can also be displayed as anger. When someone feels like this for a prolonged period of time, it might be a manic episode.

Hypomania: This could be described as a “less severe” form of mania. When experiencing hypomania, a person may have a lot of energy and an elevated mood, but their life usually is not seriously disrupted. Hypomania can progress to a full-blown manic episode or a severe depression.

When someone cycles between periods of mania, hypomania and/or depression for no obvious reason, they might be diagnosed with a type of bipolar disorder.

It is not:

• “Just a phase” or something someone can “snap out of”.
• A sign or result of low intelligence or weakness.
• A result of poor parenting or life choices.
• Always caused by an event or definitive “reason”.

Below is a list of signs and symptoms for bipolar disorder. The following list should not be used to diagnose yourself or someone else. It is only intended to provide general information. If you think you might be experiencing a mental illness, you should see your doctor.

These signs can be explained by a number of factors or other illnesses, and anyone at some point or another may feel or behave in these ways whether they have a mental health issue or not. You may see behaviours and feelings described here that everyone has at times.

Important: There are a wide range of symptoms that a person can experience when they have bipolar disorder, and each person may experience them differently. Two different people could have a form of bipolar disorder, but experience it completely differently. No two people are the same.

There are actually two types of bipolar disorder. Someone with bipolar type I will cycle between manic and depressive episodes. Someone with bipolar type II will cycle between depression and episodes of “hypomania”.

Because bipolar disorder is about cycling between depressive and, hypomanic or manic episodes, it might be helpful to look at the symptoms of all:

Depressive Phase/Episode:

Physical Changes:

• Reduced energy, becoming easily tired.
• Feeling less active or not active at all.
• Changes in weight and appetite – eating too little or too much
• Irritability or restlessness.
• Sleep disturbances – trouble sleeping, or sleeping too much.
• Stomach or digestion problems.
• Loss of interest in sex.
• Physical symptoms with no physical cause e.g; headaches, muscle aches and pains.

Changes in Thinking:

• Thinking is slowed down, difficulty thinking, concentrating or remembering.
• Difficulty making decisions, avoiding making decisions.
• Thoughts of being a failure, critical or judgemental toward oneself.
• Obsessive thoughts, sense of impending doom or disaster, feeling like something bad is going to happen.
• Persistent thoughts of death, suicide or attempts to hurt oneself.

Changes in Feeling:

• Depressed/low mood, intense sadness or frequent crying.
• Loss of interest in activities that were once a source of pleasure.
• Loss of interest and enjoyment in work, hobbies, people.
• Decreased interest in and enjoyment from sex.
• Feelings of uselessness, hopelessness, excessive guilt, and worthlessness.
• Feeling numb, empty or an absence of feelings.
• Feeling detached from life or others.
• Reduced confidence and self-esteem.
• Impatience, anger, aggression or irritability, even over small matters.

Changes in Behaviour:

• Social isolation, withdrawal from work, school, friends, hobbies.
• Neglecting duties such as homework, housework, or paying bills.
• Decrease in physical activity and exercise.
• Decrease in self-care (not showering, grooming, eating etc.).
• Self-harming behaviours and/or risky behaviour (reckless driving, unprotected sex, etc.).
• Increased use of alcohol or drugs (prescription and/or non-prescription).

Manic Phase/Episode:

A manic phase can come on very quickly, sometimes within a single day, or can build slowly. Manic episodes can last for hours, weeks or months:

• A sudden feeling of exhilaration and giddiness that increases in intensity – an excessively good mood with no real “reason”.
• Extreme optimism, which can lead to poor decisions or a lack of judgement (e.g. spending all your money on lotto tickets).
• Extreme self-confidence can reach the point of delusions (e.g. believing that you can talk to God).
• Feeling invincible, unstoppable.
• Excessive plans or participation in a very large number of activities – failing to recognize that there is not enough time in the day to complete everything.
• Reckless/poor judgement and increase of risky activities (e.g. reckless driving, spending sprees, increased intake of alcohol or other drugs or risky/unusual sexual activity, etc.).
• Racing thoughts and ideas -thoughts race uncontrollably, words spill out in a non-stop rush, ideas change abruptly from topic to topic, disorganized speech and thoughts.
• Decreased need for sleep – going for days with little or no sleep without feeling tired.
• Distractibility; focus on small, irrelevant details.
• Sudden irritability, rage, paranoia, emotional outbursts.
• For some, a manic episode can cause someone to lose touch with reality which can progress to delusions and/or hallucinations.

Hypomania: People who have bipolar II disorder experience episodes of hypomania. This could be described as a “less severe” form of mania. When experiencing hypomania, a person may have a lot of energy and an elevated mood, but their life usually is not seriously disrupted. Hypomania can progress to a full-blown manic episode or a severe depression.

Like other mental health issues, bipolar disorder and how it is experienced will differ from person to person. Because each case is unique, the treatment will likely be unique for each individual.

Treatment for bipolar disorder may include a combination of strategies. Most often, a treatment strategy will include trying medication paired with psychotherapy. Every person is different, so if medication is used, it may take a while to find the medication that works best for you. Individual or group counselling may also be helpful. Some people may need to spend time in a hospital, while others may find outpatient clinics more helpful.

Sometimes, while a person is living with bipolar disorder, part of the treatment might be about treating individual symptoms on a temporary or ongoing basis to make someone feel more comfortable while they try to get better. For instance, if someone is having trouble sleeping, a doctor might suggest treatment strategies to help that person get some sleep.

Family members of someone who has bipolar disorder may participate in therapy or support groups, or benefit from learning about it and ways to support their loved one at home.

If you have to wait to get an appointment, there are many places that offer support while you wait. Find out where to call in your area.

Along with treatment from your doctor or therapist, there are things you can do to help and support your own recovery.

Every story is different, and sometimes people need to try different types of supports before they find the right plan for them. Be patient, and don’t give up.

A person living with bipolar disorder, like any other person, will benefit from maintaining wellness and having good supports in their life. 

Supporting someone with any type of serious illness can be challenging. Ways to help and support a friend or loved one who is living with bipolar disorder:

• Know the signs and symptoms of bipolar disorder
• Encourage professional help for your friend when needed (see Help Section)
• If your friend is in the hospital, go and visit them if you are able. The hospital may be scary and overwhelming for them and a friendly face can help. Make sure to ask about visitor rules first.
• Help your friend to avoid triggers like substances or situations that can cause them to relapse or feel unwell.
• Treatment is a process. Medications and therapy can take time to help. Be aware of this and try to be supportive as your friend adjusts.
• Be a sounding board. Listening without judgement and without trying to “fix” their problems can be incredibly helpful.
• Stay calm and don’t take things personally. Sometimes bipolar disorder can really distort how someone perceives conversations or situations. How someone reacts or communicates when they have bipolar disorder may be confusing, distressing or even hurtful at times. They may be feeling overwhelmed and acting out, and it’s probably not about you.
• When someone is having a manic episode, it can be hard to communicate effectively with them. Stay calm, give brief answers and be firm. Try postponing conversations that are getting out of hand or becoming problematic and try not to get involved in an argument.
• Some people who are experiencing a manic episode get caught up in making plans and engaging in lots of activities/projects. Avoid getting swept up in this and committing to helping them with these. Try gently suggesting that they stop and think, and postpone plans that seem risky.
• Someone experiencing a manic episode needs to be encouraged to seek help from their doctor, who may be able to help them relax and get some sleep. It may be difficult, but try and encourage them to get this help.
• When your friend is relatively well and calm (e.g. not experiencing a manic episode) have a conversation with them about limits and boundaries. This might include trying to head off risky behaviour (setting limits on how money is spent, creating a list of rules around other risky behaviours) and personal boundaries (creating limits on how late they can call you, talking about behaviours that cross the line).
• Ask your friend how else you can help. It may be as easy as just providing a distraction, asking them to do simple, relaxing things with you (like hanging out, watching a movie etc.).
• Some people need time to themselves, while others might need to spend time with people. Be supportive and try to resist the temptation to tell them what you think they need to do.
• Set some boundaries for yourself, and take care. You can’t help someone if you’re feeling overwhelmed yourself.

See the Help Section for more info about helping a friend and self care.