The main symptoms of bipolar disorder are mood swings. The mood swings range from extreme happiness (mania) to extreme sadness (depression). The episodes of mania and depression can last several weeks or more. Some people with the condition can swing from highs to lows quickly, without having a normal period in between. This is called rapid cycling.

In the depressive (low) phase symptoms may include:

• feeling sad and hopeless,
• lack of energy,
• finding it difficult to concentrate and remember things,
• loss of interest in everyday activities,
• feelings of emptiness or worthlessness,
• feelings of guilt and despair,
• feeling pessimistic about everything,
• self-doubt,
• difficulty sleeping and waking up early, and
• suicidal thoughts.

The manic (high) phase usually comes after 2-4 periods of depression and may include:

• feeling extremely happy, elated or euphoric,
• talking very quickly,
• feeling full of energy,
• feeling full of self-importance,
• feeling full of great new ideas and having important plans,
• being easily distracted,
• being easily irritated or agitated,
• not sleeping,
• not eating, and
• doing lots of pleasurable things which often have disastrous consequences e.g. spending a lot of money which you cannot afford.

It you have bipolar disorder, you may be unaware that you are having a manic phase and, after it is over, you may be shocked at your behavior. However, at the time, you may think others are being very negative or unhelpful.

Some people with bipolar disorder have more frequent and severe episodes than others. Due to the extreme nature of the condition, it may be difficult to hold down a job and relationships may become strained. There is also an increased risk of suicide.

During episodes of mania and depression, you may experience strange sensations, such as seeing, hearing or smelling things that are not there (hallucinations). You may also believe things that seem irrational to other people (delusions). This is known as psychosis or a psychotic episode.