Bipolar disorder is characterised by episodes of mania or hypomania and episodes of depression.
Mania and hypomania
Mania and hypomania are unusual and persistent periods of elevated mood (‘highs’) and increased activity or energy which may also involve:
- exaggerated self-esteem or feelings of grandiosity
- reduced need for sleep
- rapid thought and speech, which is often difficult to follow
- high distractibility
- increased activity
- risky, implusive or inappropriate behaviour
- agitation, restlessness, and feeling on edge.
The core features of mania and hypomania are almost identical. However, manic episodes are more severe and last longer (episodes last at least seven days), cause severe problems in the person’s relationships or work life, can lead to highly risky behaviours, and may involve psychotic experiences such as delusions and hallucinations. Due to the risks associated with a manic episode, hospitalisation is often necessary.
Hypomania is described as a milder form of mania as it is shorter in duration (at least four days), there are no psychotic features, and the severity of symptoms does not require hospitalisation.
Depression
Depressive episodes are characterised by one or both of the following:
- feelings of sadness, emptiness or low mood that lasts for most of the day, nearly every day
- loss of interest or pleasure in almost all activities, even those usually enjoyed.
These symptoms are experienced most of the time for at least two weeks, along with several other symptoms over the same period that include:
- changes to appetite and sleep
- worry and negative thinking (e.g., hopelessness, guilt)
- agitation and restlessness
- fatigue or loss of energy
- thoughts about suicide
- trouble concentrating or making decisions.