Overview
Bipolar disorder is a mental health condition characterised by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The episodes can last days to months and can significantly disrupt relationships, work, and daily functioning.
How common is it?
Bipolar disorder affects people of different backgrounds and often begins in adolescence or early adulthood. Estimates vary with the diagnostic definition and population studied.
Causes and risk factors
Bipolar disorder results from a combination of genetic predisposition and environmental triggers. Brain chemistry and circadian rhythm regulation are also involved.
Common risk factors
- Family history of bipolar disorder increases risk
- Stressful life events or trauma as triggers
- Drug or alcohol misuse (particularly cannabis)
- Disrupted sleep patterns
- Major life changes
Symptoms
- Periods of elevated mood, energy, and reduced need for sleep (mania)
- Feeling unusually self-confident or grandiose during high episodes
- Rapid speech and racing thoughts
- Impulsive or reckless behaviour during high episodes (spending, sexual risk-taking)
- Deep depression between highs: low mood, loss of interest, fatigue
- Suicidal thoughts during depressive episodes
- Irritability at any phase
When to see a doctor
Seek urgent help if someone appears manic (not sleeping, extremely reckless) or is expressing suicidal thoughts. See a doctor if you experience unexplained periods of elevated mood followed by significant depression.
Diagnosis
A psychiatrist takes a detailed history, often over several consultations. Mood diaries help track patterns. Physical causes of mood changes (thyroid problems, medications) are ruled out with blood tests.
Treatments
Mood stabilisers
Lithium is an important long-term treatment and needs blood-level, kidney, thyroid and calcium checks. Lamotrigine is used for selected depressive or maintenance treatment, not acute mania. Valproate has major reproductive risks: in the UK, new use under 55 generally requires two specialists and pregnancy-prevention safeguards apply where relevant. Never stop treatment without specialist advice.
Antipsychotic medication
Antipsychotics such as quetiapine or olanzapine may treat mania and help prevent further episodes. Choice depends on the individual; weight, blood glucose and lipids need monitoring, particularly with diabetes.
Psychological therapies
Structured psychoeducation about the condition, CBT, and family therapy help people recognise early warning signs of episodes and improve adherence to medication.
Self-care and lifestyle
- Maintain a regular sleep schedule even at weekends, as sleep disruption can trigger episodes
- Avoid alcohol and recreational drugs, which destabilise mood
- Keep a mood diary to identify personal early warning signs
- Build a crisis plan with trusted people for when early warning signs appear
Prevention
Bipolar disorder cannot be prevented, but recognising the condition early and starting mood-stabilising treatment significantly reduces the frequency and severity of episodes.
Sources for targeted updates
Updated: 24 October 2026. Targeted corrections to frequency, risk factors, treatment, key facts. This update covers the named sections; a full review of the remaining guide is pending.