Do you have periods of time when you feel unusually “up” (happy and outgoing, or irritable), but other periods when you feel “down” (unusually sad or anxious)? During the “up” periods, do you have increased energy or activity and feel a decreased need for sleep, while during the “down” times you have low energy, hopelessness, and sometimes suicidal thoughts? Do these symptoms of fluctuating mood and energy levels cause you distress or affect your daily functioning?

Bipolar disorder is a mental illness that can be chronic (persistent or constantly reoccurring) or episodic (occurring occasionally and at irregular intervals). Sometimes referred to as “manic depressive disorder” or “manic depression”. It causes unusual shifts in mood. May experience changes in energy, thinking, behavior, and sleep. It can be difficult to carry out day-to-day tasks, go to work or school, and maintain friendships and/or relationships.

Manic episodes or unusually elevated moods in which the individual might feel very happy, irritable, or “up”, with a marked increase in activity level.

Depressive episodes, in which they feel sad, indifferent, or hopeless, combined with a very low energy level. Hypomanic episodes, which are like manic episodes, but not severe enough to cause marked impairment in social or occupational functioning or require hospitalization.

Hypomanic episodes may make an individual feel very good and productive; they may not feel like anything is wrong.

Types of Bipolar Disorder

• Bipolar 1 disorder is defined by manic episodes that last at least 7 days (most of the day, nearly every day) or when manic symptoms are so severe that hospital care is needed. Usually, separate depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of mood disturbance with mixed features are also possible. The experience of four or more episodes of mania or depression within a year is termed “rapid cycling”.
• Bipolar 2 disorder is defined by a pattern of depressive and hypomanic episodes, buy the episodes are less severe than the manic episodes than in bipolar 1 disorder. Sometimes misdiagnosed as major depression if episodes of hypomania go unrecognized or unreported.
• Cyclothymic disorder is defined by recurrent hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.

Symptoms of Bipolar

A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that last a week or two, sometimes longer. During an episode, the symptoms last every day for most of the day. Feeling is intense and happen with changes in behavior, energy levels, or activity levels that are noticeable to others. In between episodes, mood usually returns to healthy baseline. May experience delusions (false beliefs) or hallucinations (seeing or hearing things that others do not see or hear)

Symptoms of a Manic Episode	Symptoms of a Depressive Episode
Feeling very up, high, elated, extremely irritable, or touchy.	Feeling very down or sad, or anxious
Feeling jumpy or wired or being more active than usual.	Feeling slowed down or restless.
Racing Thoughts	Trouble concentrating or making decisions.
Decreased need for sleep	Trouble falling asleep, waking up too early, or sleeping too much.
Talking fast about a lot of different things	Talking very slowly, feeling unable to find anything to say, or forgetting a lot of things.
Excessive appetite for food, drinking, sex, or other pleasurable activities	Lack of interest in almost all activities.
Feeling able to do many things at once without getting tired	Unable to do even the simple things.
Feeling unusually important, talented, or powerful	Feeling hopeless or worthless, or thinking about death or suicide
Overly excited, productive and invincible	Avoid friends, family, and participating in their usual activities.
Euphoria	Guilt, emptiness
Racing or jumbled thoughts	Forgetfulness
Impulsiveness, risky	Indecisiveness



Tips to Help Manage Bipolar Disorder

• Keep a consistent sleep schedule. Go to bed and wake up at the same time each day. But sleeping more than usual may be a sign of a depressive episode.
• Eat well and get regular exercise.
• Take medications as prescribed.
• Keep a mood journal. By tracking how you feel day to day, you can notice triggers, monitor how your treatment is working, and spot changes in your eating or sleeping patterns. 
• Minimize stress. Simplify your life when possible. try relaxation activities, like meditation or yoga.