A breakdown
Bipolar Disorder
Distinct shifts between depressive lows and manic / hypomanic highs.
Overview
Bipolar disorder involves episodes of mania (or hypomania in Bipolar II) and depression, separated by periods of stability. It is lifelong but very manageable with the right medication, routine, and self-knowledge. Many people with bipolar lead full, creative, ambitious lives.
Common signs
- Mania: elevated/irritable mood, reduced need for sleep, racing thoughts, impulsivity, grandiosity
- Hypomania: a milder, often pleasant-feeling version of the above
- Depression: low mood, fatigue, anhedonia, sometimes suicidal thoughts
- Mixed episodes: depressive and manic symptoms together — high risk
- Sleep changes are often the first warning sign of an episode shift
What helps
Lithium remains gold-standard for bipolar I; valproate, lamotrigine and atypical antipsychotics are options — psychiatrist-led.
Identify your personal warning signs and write a relapse-prevention plan with a loved one.
Sleep, wake, eat, light and movement at consistent times — IPSRT (interpersonal social rhythm therapy) is built on this.
Bringing trusted people into your care plan reduces relapse rates significantly.
Daily practices
Small, repeatable habits — not a checklist to fail at.
- 01Track sleep — under 6 hours for 2+ nights is a yellow flag
- 02Same wake-up time, every day, even after a low night
- 03Limit screens/social media when elevated — the dopamine amplifies
- 04Have a 'cool-off' rule: no big purchases / decisions / messages in 24h
When to reach out today
These are signals to contact your care team, GP or a crisis service — today, not next week.
- Reduced sleep, racing thoughts and risky impulses are stacking up — call your team early
- Mixed-state suicidal ideation
- Psychotic features (paranoia, hallucinations)
Keep reading
Information shaped by NICE, NHS, Mind, and peer-reviewed clinical guidelines. Not a substitute for personalised medical advice.