Bipolar Disorder: Signs, Support and Safety

Signs of mania or hypomania

• Much less need for sleep without feeling tired
• Unusually high energy, rapid speech, racing thoughts or extreme irritability
• Inflated confidence or beliefs about special power or ability
• Impulsive spending, unsafe travel, risky sex, aggression or other uncharacteristic decisions
• Difficulty functioning, or hallucinations and fixed false beliefs in severe episodes

Hypomania is less severe than mania but is still a clear change from the person’s usual state. Mania can require urgent hospital care.

Depressive episodes

• Persistent low or irritable mood, loss of interest and low energy
• Changes in sleep, appetite, concentration or movement
• Hopelessness, guilt, feeling worthless, or thoughts of death or suicide

Treatment and everyday support

Effective care commonly combines prescribed medicines with psychological and social support. Ongoing treatment may be needed to prevent relapse. Some medicines require blood tests or other monitoring.

• Take medicines only as prescribed and do not stop suddenly
• Protect a regular sleep routine and notice early changes in sleep, energy, speech and spending
• Avoid alcohol and non-prescribed drugs, which can worsen symptoms and treatment safety
• Agree on an early-warning and crisis plan when the person is well
• Include the person respectfully in decisions whenever possible

When help is urgent

Get urgent help for suicidal intent, dangerous or uncontrollable behaviour, several nights with almost no sleep and rapidly escalating activity, severe confusion, hallucinations, or inability to stay safe. Call 112 or go to the nearest hospital emergency department.