Bipolar Disorder

Key facts

• Bipolar disorder is a chronic mental health condition marked by swings between elevated mood states (mania or hypomania) and depressive episodes; it affects roughly 1 to 2% of adults worldwide.
• Manic episodes bring reduced sleep, racing thoughts, inflated confidence, rapid speech, and impulsive decisions; depressive episodes look much like major depression.
• Treatment usually combines a mood stabiliser, such as valproic acid, lamotrigine, or lithium, with an antipsychotic like quetiapine, olanzapine, risperidone, or ziprasidone.
• Anyone in a mental health crisis should contact a crisis line or go to the nearest emergency department without delay.

What the mood episodes look like

Manic episodes bring a reduced need for sleep, racing thoughts, inflated self-confidence, rapid speech, and impulsive decisions. Hypomanic episodes are milder versions of the same state. Depressive episodes look much like major depression: low energy, poor concentration, loss of interest, and sometimes thoughts of self-harm. A mixed episode can combine features of both poles at once, often the most distressing presentation. Some people cycle rapidly, four or more episodes a year, while others go through long stable stretches between episodes.

How it is treated

Treatment usually combines a mood stabiliser with an antipsychotic to cover both poles of the illness. Valproic acid is one of the most widely used stabilisers for mania and mixed states. Lamotrigine is preferred for the depressive phase and for maintenance. Lithium remains a cornerstone treatment for classic bipolar I disorder. For acute mania or agitation, atypical antipsychotics such as quetiapine, olanzapine, risperidone, and ziprasidone are frequently added, and quetiapine also has strong evidence for the depressive phase. Combination regimens are common, since no single medicine covers the full range of the illness.

Living with the condition

Regular sleep schedules, stress reduction, and avoiding alcohol and stimulants all help reduce how often episodes occur. Mood-tracking and a consistent daily routine help people and their doctors spot early warning signs before a full episode develops. Structured psychoeducation programmes, delivered alongside medication, have shown better long-term outcomes than medication alone.

When to seek help

If you or someone you know is in a mental health crisis, contact a local crisis line or go to the nearest emergency department without delay.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.