Bipolar Disorder Signs and Symptoms

Characterised by periods of mania and depression, bipolar affective disorder can cause enormous disruption in a person’s life. During manic episodes, a person can feel excesses of energy, behave impulsively, and spend a great deal of time pursuing unrealistic goals. Depressive episodes involve feelings of sadness, low energy, and a loss of ability to feel pleasure. Some people also experience mixed episodes with some symptoms of a manic episode and some symptoms of a depressive episode occurring at the same time. Certain people also have episodes of a less severe form of mania known as hypomania. During hypomanic episodes, people experience symptoms of mania that are not severe enough to qualify as full manic episodes.

Bipolar affective disorder can range in severity, and people who struggle with the most severe form may experience hallucinations or other forms of psychosis. While some people struggle with severe forms of bipolar affective disorder, others can struggle with a range of bipolar-like symptoms, including the following:

  • Cyclothymia: People with cyclothymia experience symptoms of manic episodes and symptoms of depressive episodes, but these symptoms are not severe enough to warrant a full bipolar affective disorder diagnosis.
  • Recurrent manic episodes NOS: Sometimes, people experience repeated manic episodes without depressive episodes. In this situation, a person would be diagnosed with recurrent manic episodes NOS.

When a person is struggling with a substance use disorder in addition to co-occurring bipolar affective disorder, the two disorders can build upon each other and cause immense devastation in a person’s life if he or she does not seek help. If you feel you or a loved one is struggling with bipolar disorder, proper treatment can help you manage the symptoms.


Across the U.K., approximately 1% to 2% of people will struggle with bipolar affective disorder during their lives. A 2002 study by the National Health Service (NHS) found the annual total cost of bipolar disorder to be approximately £2 billion, which accounts for both direct healthcare costs as well as indirect costs such as lost productivity.

Causes and Risk Factors for Bipolar Affective Disorder

Although the exact causes of bipolar affective disorder are still being researched, experts generally agree that the following factors play a role:

Genetic: Evidence suggests that bipolar affective disorder tends to run in families. Approximately 10% to 15% of people with the disorder have family members who also have the disorder.

Environmental: In addition to genetic factors, environmental factors can also affect a person’s chances of developing bipolar affective disorder. For example, people who have been separated, divorced, or widowed are more likely to develop the disorder than are people who are married or who have never been married.

Risk Factors:

  • Family history of bipolar affective disorder
  • Being separated, divorced, or widowed
  • Living in a high-income country
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Signs and Symptoms of Bipolar Affective Disorder

While each individual person’s struggle with substance misuse and co-occurring bipolar affective disorder can look different, the following are some common symptoms that may indicate a person meets criteria for the disorder:

Behavioural symptoms (manic episode):

  • Excessive talkativeness
  • Spending a great deal of time on unrealistically ambitious projects
  • Reduced need for sleep
  • Excessive activity
  • Impulsive or poorly-judged behaviours

Physical symptoms (manic episode):

  • Heightened alertness
  • Change in appetite
  • Weight changes
  • Restlessness
  • Excessive movement

Cognitive symptoms (manic episode):

  • Feelings of extreme creativity
  • Racing thoughts
  • Extreme self-confidence
  • Unrealistically positive expectations regarding the success of one’s efforts

Psychosocial symptoms (manic episode):

  • Excesses of enthusiasm
  • Emotional fluctuations
  • Frustration with others who fail to support individual’s unrealistic plans

Behavioural symptoms (depressive episode):

  • Restlessness
  • Low energy
  • Poor motivation
  • Difficulty sleeping
  • Fatigue

Physical symptoms (depressive episode):

  • Change in weight
  • Tiredness, lethargy, or weakness
  • Feeling as though one’s body is “slow”
  • Changes in appetite

Cognitive symptoms (depressive episode):

  • Slowed thought processes
  • Thoughts of death
  • Loss of interest or pleasure in daily activities
  • Difficulty concentrating and making decisions
  • Memory difficulties

Psychosocial symptoms (depressive episode):

  • Feeling worthless or guilty
  • Depressed mood
  • Loss of interest in relationships

Effects of Bipolar Affective Disorder

When a person is struggling with substance misuse and co-occurring bipolar affective disorder, there is great potential for life-altering negative consequences. Some of these negative consequences may include:

  • Severe impairment in work performance
  • Job loss and financial difficulty
  • Poor performance on cognitive tests
  • Interpersonal strain
  • Increased risk of contracting a sexually-transmitted infection such as HIV or hepatitis C as a result of poor judgment during a manic episode
  • Divorce or separation
  • Social isolation

Co-Occurring Disorders

People struggling with substance misuse and co-occurring bipolar affective disorder are also at risk of other disorders and mental health symptoms, including:

  • Anxiety disorders
  • Attention-deficit hyperactivity disorder (ADHD)
  • Other substance use disorders
  • Suicide attempts
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