Bipolar signs and symptoms
The signs and symptoms of bipolar disorder are unique to each individual.
To try to explain this complex condition, the Bipolar UK community uses a Mood Scale – where 0 is low and 10 is high.
People living without a mood disorder experience thoughts, feelings and behaviours that sit in the middle of the scale (from 4 to 6).
People living with bipolar experience a much wider range of thoughts, feelings and behaviours, which are the symptoms of bipolar.
Bipolar symptoms on the Mood Scale
The ‘high’ symptoms of bipolar are listed as 7, 8, 9 and 10 on the scale.
The ‘low’ symptoms of bipolar are listed as 3, 2, 1 and 0 on the scale.
- Mania (9, 10)
- Hypomania (7, 8)
- Depression (2, 3)
- Suicidal thinking (0, 1)
- Mixed features (high and low symptoms at the same time)
- Psychosis (0, 1, 9, 10)
Mania (9 and 10 on the Mood Scale)
Mania is officially described as an ‘elevated, expansive and irritable mood with changes in energy and activity levels’.
Someone experiencing mania may have no insight into how unwell they are. This may mean they have no idea how vulnerable they may be in certain situations, or how challenging their behaviour can be for their family and friends.
People living with bipolar tell us that experiencing mania can be very scary.
When someone is experiencing the symptom of mania, this is a psychiatric emergency. Treatment and support is needed urgently to keep them safe.
Mania
How someone may feel:
- Very excited and full of energy
- Extremely confident and superior to others•
- Increased sexual desire
- Irritable and suspicious of people
- Invincible, and unable to be harmed
- As if thoughts are speeded up
What someone may do:
- Talk a lot very quickly
- Find it impossible to keep still
- Sleep very little, or not sleep at all
- Make impulsive decisions and take risks
- Spend recklessly, give money away and/or gamble
- Say inappropriate or rude things (without realising how this affects others)
- Have angry outbursts
Hypomania (7 and 8 on the Mood Scale)
Hypomania is the stage between a balanced, happy mood and mania. Doctors describe it as ‘a distinct period of abnormally and persistently elevated mood’.
People living with bipolar tell us that experiencing hypomania can sometimes feel very pleasurable. However, if it is left untreated, it can become more intense and lead to mania.
Noticing and managing the symptoms of hypomania before they get worse and turn intomania is one of the main challenges for people living with bipolar.
Hypomania
How someone may feel:
- Energetic, as though they have an ongoing adrenaline rush
- Happy, with a strong sense of wellbeing
- More sexually aroused than usual
- Confident
- Creative
- Irritable and easily distracted
What someone may do:
- Talk a lot, and interrupt people
- Be very friendly to strangers
- Have sexual encounters that are out of character
- Not sleep much
- Become very creative and productive
- Drink more tea, coffee or alcohol than usual
Depression (0, 1, 2 and 3 on the Mood Scale)
Depression affects everybody with bipolar differently, but typical symptoms include feeling sad, hopeless or tearful most of the time, and a lack of interest in activities that were enjoyable before.
People living with bipolar tell us that they can sometimes hide a ‘mild’ episode of depression (ranked 3 on the Mood Scale) from even their closest loved ones, which is exhausting.
However, if someone’s symptoms of depression get worse, they may start to struggle with self-care and become unable to work, look after their family or socialise.
Suicidal thinking can be a common symptom of low mood in bipolar, and if left untreated, it can lead to suicide.
Depression
How someone may feel:
- Hopeless, sad and tearful
- Tired or exhausted
- Worthless and guilty
- Uninterested in everything
- Agitated and anxious
- Physical aches and pains
- Like a burden
- As though life is no longer worth living
What someone may do:
- Cancel plans and social activities
- Sleep a lot, or having trouble sleeping
- Eat too little or too much
- Misuse alcohol or other substances
- Avoid sex
- Focus on difficult or upsetting things
- Find it hard to make decisions
- Self-harm, or take their own life
Psychosis (0, 1, 9 and 10)
At either ends of the Mood Scale, both extreme mania and deep depression can develop into psychosis.
Research suggests that more than half of people with bipolar disorder will experience psychosis at some point.
Psychosis is a symptom of bipolar, not a diagnosis. It is when someone experiences delusions and hallucinations, and experiences reality very differently to the people around them. Sometimes this is called a ‘psychotic episode’.
When someone is seeing, hearing, feeling and/or understanding everything differently, this is a psychiatric emergency and they need urgent treatment and support to keep them safe.
Psychosis
How someone may feel:
- Terrified, anxious or unsafe
- Angry that others aren’t experiencing their version of reality
- Exhausted and overwhelmed
- As though they can't trust anyone, even their loved ones
- Confused about what’s happening
What someone may do:
- Believe they have superhuman powers, that the TV is talking to them or that they’re on a mission from God
- Hear, see, taste, smell or feel things that aren’t there
- Not recognise, or refuse to see, their loved ones
- Stop sleeping or wake up a lot during the night
- Self-harm, or take their own life
Bipolar with mixed features
Bipolar with mixed features, also known as a mixed state, is when someone experiences both high and low symptoms at the same time.
This means they may have the symptoms of mania (irritability, high energy, racing thoughts, overactivity) along with symptoms of depression (sadness, loss of interest, low energy, feelings of guilt and worthlessness, thoughts of suicide).
Research shows that someone with mixed features of bipolar is likely to experience longer periods of depression and has a higher risk of suicide.
Mixed features
How someone may feel
- Irritable and easily distracted
- Agitated and anxious
- Sad, tearful and exhausted
- Guilty and worthless
- Fearful of others
- Uninterested in everything
What someone may do
- Talk a lot and find it hard to keep still
- Cancel plans and social activities
- Find it hard to make decisions
- Say inappropriate or rude things (without realising how this affects others)
- Focus on difficult or upsetting things
- Self-harm, or take their own life
Bipolar UK is here for you
Being diagnosed with bipolar, or waiting for a diagnosis, can be stressful and overwhelming. But you’re not on your own.
We’re here for you with a range of support and resources, and a community that understands.
Get support
We provide free peer support calls, groups and online conversations to anyone affected by bipolar.
Get support hereStay connected
Sign up for weekly updates in your inbox on the latest news, events, campaigns and ways to get involved.
Sign up hereLearn more
Take our free 20-minute eLearning course to help you understand what bipolar disorder is – and isn’t.
Find out more