Bipolar Disorder

What the mood episodes look like

Manic episodes bring reduced sleep, racing thoughts, inflated self-confidence, rapid speech, and impulsive decisions. Hypomanic episodes are milder versions of the same state. Depressive episodes look much like major depression: low energy, poor concentration, loss of interest, and sometimes thoughts of self-harm. A mixed episode can include features of both poles at once, which is often the most distressing presentation. Some people cycle rapidly (four or more episodes per year); others have long stable stretches.

How bipolar disorder is treated

Treatment usually combines a mood stabiliser with an antipsychotic to cover both poles. Valproic acid is one of the most widely used stabilisers for mania and mixed states. Lamotrigine is preferred for the depressive phase and maintenance. Lithium remains a cornerstone for classic bipolar I. For acute mania or agitation, atypical antipsychotics such as quetiapine, olanzapine, risperidone, and ziprasidone are frequently added, and quetiapine has strong evidence for the depressive phase too. Combination regimens are common because no single agent covers the full illness.

Living with the condition

Regular sleep schedules, stress reduction, and avoiding alcohol and stimulants all reduce episode frequency. Mood-tracking apps and a consistent routine help people and their doctors spot early warning signs before a full episode develops. In Japan, South Korea, and Singapore, structured psychoeducation programmes delivered alongside medication have shown better long-term outcomes than medication alone.

If you or someone you know is in a mental health crisis, contact a local crisis line or go to the nearest emergency department without delay.