Bipolar disorder, which used to be known as manic-depressive disorder, causes unusual shifts in mood, energy, activity levels, and ability to carry out day-to-day tasks. Symptoms of the disorder can be severe and are different from the normal ups and downs that most people experience from time to time. Left untreated, the symptoms of bipolar disorder can result in damaged relationships, poor school or work performance, and even suicidal thoughts or actions.

People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” Each mood episode represents a drastic change from a person’s usual mood and behavior. An overly excited or energetic state is called a manic episode and an extremely sad or hopeless state is called a depressive episode. Sometimes a mood episode includes symptoms of both mania and depression and is called a mixed episode. Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood.

Symptoms of a manic episode

Feelings: Overly happy Unusually outgoing Overly capable; invincible Extremely creative Unusually adventurous Highly irritable Physical Experiences: Difficulty sleeping Excessive energy Restlessness Increased heart rate

Thoughts and Thought Patterns: Fast and racing thoughts “I can do anything!” Tangential; jumping from one topic to another Easily distracted Behavior Patterns: Starting multiple new projects Failing to finish tasks Impulsivity High risk behaviors, including sex or drugs/alcohol Carelessness with money; gambling Failure to manage responsibilities

Symptoms of a depressive episode

Feelings: Sadness Hopelessness Loss of interest in activities Confusion Difficulty with concentration or memory Worthlessness Physical Experiences: Slowed movements Loss of appetite; stomach aches Fatigue Headaches

Thoughts and Thought Patterns: Slow and confused thoughts “I’m a failure” Overly pessimistic thoughts “I wish I were dead” Difficulty making decisions Behavior Patterns: Poor school/work attendance Failure to complete assignments Talking about death/suicide Poor appetite Social withdrawal Sleep difficulties; too much or too little Poor personal hygiene

What to do if you think you have bipolar disorder

The most effective treatment for bipolar disorder is a combination of medication and psychotherapy. It is important to get an accurate diagnosis, so make an appointment to be evaluated by a mental health professional. Follow up with the treatment plan that you and your provider(s) design. Some components of this plan will likely require you to:

• Get into a regular schedule or rhythm. This should include sleep, personal hygiene, meals, study time, and social outlets/activities. Regular daily routines and sleep schedules may help protect against mood fluctuations.
• Keep a daily journal or log of your mood, activity level, sleep and eating patterns. Share this with your treatment provider(s) for help in guiding your progress.
• If you are taking medication for treatment, follow the prescription precisely and don’t stop taking the medication. Expect your symptoms to improve gradually, not immediately.
• Manage your stress effectively. Experiment with new ways to relax. High stress levels can prompt or worsen mood episodes.

What to do if someone you care about has bipolar disorder

Like other serious conditions, bipolar disorder can be difficult for spouses/partners, family members and friends. Dealing with the behavioral problems of persons with bipolar disorder, such as the wild spending sprees of manic episodes or the extreme social withdrawal of depressive episodes, is challenging. It can be difficult to know how to step in and help, and when to set firm boundaries. It is important that loved ones and caregivers make time for self-care. Counseling can provide helpful guidance and support.

Self-help with TAO

Therapy Assistance Online (TAO) is a platform of free self-help educational modules to help you learn about and change how you think and feel. 

* If you suspect you have bipolar disorder, we recommend that you make an appointment with a counselor and use these self-help modules as needed.

The Following Modules are Helpful for Bipolar Disorder:

• Improving Your Mood Module 1: Behavioral Activation
• Leave Your Blues Behind Module 2: Understanding Stress & Relaxation
• Leave Your Blues Behind Module 3: Unhealthy & Healthy Thoughts
• Leave Your Blues Behind Module 6: Relationships, Lifestyle & Problem Solving
• Improving Your Mood: Modules 2: Make an Activation Plan & Identifying Values