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Mental health

Bipolar disorder: signs, assessment and support

Extreme highs and lows that go well beyond normal ups and downs. How bipolar disorder is diagnosed and managed, and how to look after yourself.

Last reviewed 24 October 2026 Sources include the NHS, the HSE, and NICE For the UK and Ireland

What is it?

Bipolar disorder is a mental health condition where your mood swings between extreme highs (mania or hypomania) and extreme lows (depression). These episodes usually last days or weeks, sometimes longer. In between, many people have long stretches where their mood is stable.

It can’t be cured, but there are treatments that help manage it, and with treatment episodes usually improve.

Common signs

Everyone’s pattern is different. Some people have more lows than highs, and some have symptoms of both at once.

  • Highs. Feeling very happy, excited or irritable, lots of energy and little need for sleep, racing thoughts and fast talking, feeling overly confident, and doing risky or out-of-character things, like spending lots of money.
  • Lows. Feeling sad, hopeless or worthless, no energy, losing interest in things you enjoy, sleeping too much or too little, avoiding people, and sometimes thoughts of suicide or self-harm.

At the extremes, some people hear or believe things that aren’t real. During a high, you might not realise anything is wrong, and only see it afterwards.

What can cause it

The exact cause isn’t known. You’re more likely to have it if a parent, brother or sister has it. Childhood trauma, very stressful events, and recreational drugs such as cannabis or cocaine can all raise the chances.

How it can affect everyday life

Big swings in mood can put a strain on work, money and relationships, especially decisions made during a high. There’s also a higher risk of suicide. If you’re having thoughts of ending your life, please talk to someone today.

Getting assessed

See your GP if you have extreme mood changes that last a long time or affect your everyday life. If they think it could be bipolar disorder, they’ll refer you to a psychiatrist, who will ask about your moods, behaviour, health and family history.

It can take time to diagnose, because it affects everyone differently and looks like other conditions. It helps to bring someone who has seen your moods change, or notes on what happened and when.

Treatment and support

A specialist will work with you on a plan. Most people are treated without needing to stay in hospital.

  • Medicines to steady your mood. Such as lithium, which needs regular blood tests, or other mood stabilisers. Some you take all the time, others only when symptoms get worse.
  • Talking therapy. Such as cognitive behavioural therapy (CBT).
  • Lifestyle support. Especially sleep and routine.

Don’t stop taking your medicine without talking to your doctor, even if you feel well.

Bipolar UK runs support groups and an online community in the UK. In Ireland, Aware supports people with bipolar disorder and depression, and their loved ones, on freephone 1800 80 48 48.

Things that can help day to day

Learning what sets off your highs and lows makes a real difference. Common triggers include stress, lack of sleep and being too busy.

  • Keep a regular routine and get plenty of sleep.
  • Avoid recreational drugs, and go easy on alcohol and caffeine.
  • Avoid shift work, very long hours and night flights across time zones if you can.
  • Eat well and exercise regularly.
  • Agree a plan with someone you trust for what to do if they notice a high or low starting.

Myths and common questions

“Everyone’s a bit bipolar.” Normal ups and downs are not bipolar disorder. The episodes are far more extreme and last much longer.

“The highs are the good bit.” Highs can feel great at the time but often lead to decisions people regret, and can tip into psychosis.

“There’s nothing you can do about it.” Bipolar disorder can’t be cured, but treatment and knowing your triggers help many people keep their moods steadier.

Where to get help

You don't have to have it all worked out before you reach out. Your GP is a good first step, and these can help too.

Sources

  1. NHS: Bipolar disorder
  2. HSE: Bipolar disorder
  3. HSE: Bipolar disorder treatment
  4. Bipolar UK
  5. Aware
  6. NICE: Bipolar disorder: assessment and management (CG185)

This page is information to help you find your way, not medical advice. If you're unsure what's right for you, talk to a GP or pharmacist. What this site is and isn't.

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