The National Institute of Mental Health describe the main symptoms of bipolar disorder as alternating episodes of high and low mood. Changes in energy levels, sleep patterns, ability to focus, and other features can dramatically impact a person’s behavior, work, relationships, and other aspects of life. Most people experience mood changes at some time, but those related to bipolar disorder are more intense than regular mood changes, and other symptoms can occur. Some people experience psychosis, which can include delusions, hallucinations, and paranoia. Between episodes, the person’s mood may be stable for months or years, especially if they are following a treatment plan. Treatment enables many people with bipolar disorder to work, study, and live a full and productive life. However, when treatment helps a person feel better, they may stop taking their medication. Then, the symptoms can return. Some aspects of bipolar disorder can make a person feel good. During an elevated mood, they may find they are more sociable, talkative, and creative Trusted Source. However, an elevated mood is unlikely to persist. Even if it does, it may be hard to sustain attention or follow through with plans. This can make it difficult to follow a project through to the end.

According to the International Bipolar Association, symptoms vary between individuals. For some people, an episode can last for several months or years. Others may experience “highs” and “lows” at the same time or in quick succession. In “rapid cycling” bipolar disorder, the person will have four or more episodes within a year.

Mania or hypomania

Hypomania and mania are elevated moods. Mania is more intense than hypomania. Symptoms can include:

• impaired judgment
• feeing wired
• sleeping little but not feeling tired
• a sense of distraction or boredom
• missing work or school
• underperforming at work or school
• feeling able to do anything
• being sociable and forthcoming, sometimes aggressively so
• engaging in risky behavior
• increased libido
• feeling exhilarated or euphoric
• having high levels of self-confidence, self-esteem, and self-importance
• talking a lot and rapidly
• jumping from one topic to another in conversation
• having “racing” thoughts that come and go quickly, and bizarre ideas that the person may act upon
• denying or not realizing that anything is wrong

Some people with bipolar disorder may spend a lot of money, use recreational drugs, consume alcohol, and participate in dangerous and inappropriate activities. For more on the differences between mania and hypomania, click here. What are the early signs of bipolar disorder in children and teens?

Depressive symptoms

During an episode of bipolar depression, a person may experience:

• a feeling of gloom, despair, and hopelessness
• extreme sadness
• insomnia and sleeping problems
• anxiety about minor issues
• pain or physical problems that do not respond to treatment
• a sense of guilt, which may be misplaced
• eating more or eating less
• weight loss or weight gain
• extreme tiredness, fatigue, and listlessness
• an inability to enjoy activities or interests that usually give pleasure
• difficulty focusing and remembering
• irritability
• sensitivity to noises, smells, and other things that others may not notice
• an inability to face going to work or school, possibly leading to underperformance

In severe cases, the individual may think about ending their life, and they may act on those thoughts. Is it bipolar disorder or depression? Find out more.

Psychosis

If a “high” or “low” episode is very intense, the person may experience psychosis. They may have trouble differentiating between fantasy and reality. According to the International Bipolar Foundation, psychosis symptoms during a high include hallucinations, which involve hearing or seeing things that are not there and delusions, which are false but strongly felt beliefs. A person who experiences delusions may believe they are famous, have high-ranking social connections, or have special powers. During a depressive or “low” episode, they may believe they have committed a crime or are ruined and penniless. It is possible to manage all these symptoms with appropriate treatment.