Bipolar disorder

Bipolar disorder causes episodes of markedly elevated or irritable mood and energy, and often depressive episodes too. These are more than ordinary mood swings: sleep, thinking, behaviour, relationships, money, work and safety may change significantly.

• In mania, the change is severe, usually lasts days and causes significant impairment, danger or sometimes psychosis. Hypomania is less severe, but still clearly different from normal.
• Depressive episodes cause low mood or loss of interest, low energy, guilt, concentration problems and sometimes thoughts of death.
• Mixed features mean depressive and manic symptoms occur together or alternate rapidly; this can involve intense agitation and risk.
• Diagnosis requires a careful history of episodes over time. Lack of sleep, substances, medicines, thyroid disease and other mental health conditions may look similar or trigger symptoms.
• Treatment usually combines medication, education about the condition, a regular sleep–wake pattern, psychological support and a personal crisis and relapse plan.
• Do not stop mood medicines suddenly. Withdrawal and relapse can be severe, and some medicines require gradual reduction and blood tests.
• Pregnancy or plans to become pregnant require specialist medication review before conception; some medicines can seriously harm an unborn child.
• Call 912 for immediate danger to yourself or others, severe psychosis, life-threatening behaviour or inability to meet basic needs.