All Conditions

Bipolar Disorder.

Cycles of intense emotional highs and lows that disrupt daily life.

Bipolar disorder (formerly known as manic depression) is characterised by periods of intense emotional high and lows. During the phase of an emotional high, called mania, a person with bipolar disorder may feel euphoric, extremely energetic, irritable and prone to making risky financial and sexual decisions. They may feel little need for sleep and may be bothered by all routine tasks. Sometimes a manic phase can cause a break from reality, leading to psychosis and the need for hospitalization. A hypomanic phase is less severe than mania, but causes many of the same problems. On the other hand, when the depressive phase rolls around, there is an energy crash and the person may begin to sleep much more than they usually do. They may withdraw from social obligations, have a hard time concentrating, feel a loss of pleasure in activities that used to make them happy and begin to contemplate and plan suicide. It is possible for a person with this condition to have phases of stability in between these periods.

When to seek help

Left untreated, bipolar disorder can wreak havoc on a person’s health, finances, relationships and all manner of life goals. It is best to seek help at the first signs of a manic or hypomanic episode. While bipolar disorder is a lifelong condition and cannot be fully treated, its symptoms can become comparatively much easier to manage with a combination of psychotropic medication and therapy.

How we can help

Self-assessment scales

These are the same validated scales clinicians use. Your answers stay on your device and take a few minutes.

Common questions

How do I tell bipolar disorder apart from mood swings or having a "moody" personality?
Bipolar mood episodes are distinct, sustained shifts that last days to weeks rather than hours. A manic episode involves at least a week of elevated or irritable mood with reduced need for sleep, racing thoughts, increased activity, and often impulsive decisions. Hypomania has a similar shape but is milder and shorter, lasting four days or more. Depressive episodes meet the full criteria for major depression. Ordinary day-to-day mood variation is not bipolar disorder. Episodic shifts that last for days, change behaviour, and disrupt functioning are what clinicians are looking for [1].
What's the difference between Bipolar I and Bipolar II?
Bipolar I requires at least one full manic episode, often severe enough to need hospitalisation and sometimes accompanied by psychotic features. Bipolar II requires at least one hypomanic episode together with at least one major depressive episode, but no full mania. Bipolar II is frequently misdiagnosed as recurrent depression, because hypomanic periods can feel productive or creative, and people rarely report them as a problem. Getting the type right matters because it changes which medications help and which can make the picture worse.
Can therapy alone treat bipolar disorder?
For most people, no. Bipolar disorder has a strong biological component and usually requires mood-stabilising medication. Lithium remains the gold-standard mood stabiliser, with strong evidence both for reducing relapses and for lowering suicide risk. Valproate, lamotrigine, and certain antipsychotics are also commonly used. Therapy on its own is rarely sufficient, but it adds substantial benefit on top of medication. Psychoeducation, CBT, and interpersonal and social rhythm therapy are all useful, particularly for managing depressive phases, recognising early warning signs, and stabilising sleep and routines.
Can antidepressants treat the depression in bipolar disorder?
Antidepressants can have a role in bipolar depression, but they are not used on their own. An antidepressant given without a mood stabiliser can trigger a manic switch or speed up cycling between episodes. For bipolar depression specifically, the safer first-line options are quetiapine, lurasidone, or the olanzapine and fluoxetine combination, often added to lithium or lamotrigine. When antidepressants are used, they are usually added to an existing mood stabiliser and monitored closely [2]. Treating bipolar depression with an antidepressant alone, without a stabiliser and without medical supervision, is a common path to a bad outcome.

References

  1. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) — American Psychiatric Association, 2022
  2. CANMAT and ISBD 2018 guidelines for the management of patients with bipolar disorder — Yatham et al., Bipolar Disorders, 2018

Written by

Marium Nasir · MS Clinical Psychology (NUST), C-DBT certified

Clinically reviewed

Dr. Zuhaib Ali · MBBS, FCPS (Psych)

Last reviewed 29 April 2026