Bipolar Disorder Symptoms

Quick Glance: Common Bipolar Disorder Symptoms

Common symptoms of bipolar disorder may include:

• Unusually elevated, energetic or irritable mood

• Increased energy or activity

• Reduced need for sleep without feeling tired

• Rapid speech or racing thoughts

• Increased self-confidence or an inflated sense of self-worth

• Impulsive or risky behaviour, such as excessive spending

• Persistent sadness, hopelessness or emptiness

• Loss of interest, low energy or difficulty concentrating

Symptoms of Bipolar Disorder That Should Not Be Ignored

Certain changes in mood, sleep, energy or behaviour may indicate a significant bipolar disorder mood episode. The table below highlights symptoms of bipolar disorder that should be assessed by a healthcare professional, particularly when they are unusual for the person, persist for several days or interfere with daily functioning:

Why Do Bipolar Disorder Symptoms Occur?

The exact biological cause of bipolar disorder is not fully understood. Genetic factors, brain function and other biological, psychological and environmental factors may influence how bipolar disorder develops and how mood episodes occur.

During manic or hypomanic episodes, changes in mood are accompanied by increased energy, activity, reduced need for sleep, rapid thinking and changes in behaviour. During depressive episodes, mood, energy, interest and activity may decrease, which can lead to tiredness, poor concentration, changes in sleep and appetite, and feelings of hopelessness. 

Changes in sleep patterns and stressful life events may also trigger or worsen mood episodes in some people.

Symptoms of Bipolar Disorder That Require Immediate Medical Attention

Some symptoms of bipolar disorder require urgent medical assessment, particularly when there is a risk of harm or a severe loss of contact with reality. Immediate medical attention may be needed for:

• Thoughts, plans or actions related to suicide or serious self-harm

• Hallucinations, delusions or severe loss of contact with reality

• Severe confusion or disorientation

• Extreme agitation or behaviour that cannot be kept safe

• Severe mania with markedly impaired judgement or dangerous behaviour

• An immediate risk of serious harm to another person

• Severe self-neglect resulting in an inability to meet essential needs such as food, fluids or personal safety

Symptoms of Bipolar Disorder Based on Type

The table below summarises the characteristic symptoms associated with the main recognised types of bipolar disorder:

Symptoms of Bipolar Disorder in Children

Bipolar disorder can occur in children and young people, although symptoms can vary by age. Ordinary mood changes are common during childhood and do not by themselves indicate bipolar disorder. Persistent or distinct changes in mood, energy, sleep and behaviour should be assessed by an appropriately qualified healthcare professional.

Symptoms of bipolar disorder in children may include:

• Distinct periods of unusually elevated or irritable mood

• Markedly increased energy or activity

• Reduced need for sleep

• Rapid or excessive talking

• Racing thoughts or difficulty concentrating

• Inflated self-confidence or self-esteem

• Impulsive or risky behaviour

• Persistent sadness or irritability during depressive episodes

• Loss of interest in usual activities

• Low energy or tiredness

• Changes in appetite or sleep

• Feelings of hopelessness

• Thoughts of death or suicide

Can You Have Bipolar Disorder Without Symptoms?

Yes, a person with bipolar disorder can have periods between mood episodes when symptoms are minimal or absent and their mood returns closer to their usual baseline. These symptom-free periods can last for weeks, months or longer.

Hypomania may also go unnoticed because a person may initially feel more energetic, productive or confident rather than unwell. Family members or close friends may notice changes in sleep, activity or behaviour before the person recognises them.

Bipolar II disorder can also go unrecognised for longer because people may seek help for depressive episodes, while hypomanic periods are overlooked. Healthcare professionals consider the person's pattern of symptoms over time rather than only their current mood.

When Can Bipolar Disorder Symptoms Become Life-Threatening?

Severe bipolar disorder episodes can become life-threatening when they involve an immediate risk of harm, severe loss of contact with reality or an inability to meet essential needs.

The table below explains serious situations that can occur during severe bipolar disorder episodes and why they require urgent intervention:

How are Bipolar Disorder Symptoms Diagnosed?

There is no single blood test or brain scan that can diagnose bipolar disorder. A healthcare professional assesses the person's symptoms, their duration and severity, changes in mood and behaviour over time, and their medical and family history to diagnose bipolar disorders. Physical examinations or laboratory tests may also be used to rule out other conditions that can cause similar symptoms.

The table below summarises the main assessments used when evaluating symptoms of bipolar disorder: