Bipolar disorder: mania, depression, treatment and where to get help
What bipolar disorder is, the signs of mania and depression, how it is diagnosed and treated, how to prevent relapse, and where to get help in India.
Also known as: Bi-polar Disorder; Bipolar affective disorder; Bipolar affective psychosis; Bipolar spectrum disorder; Depression, bipolar; Manic depression and 2 more
Manic depressive illness; Manic-Depressive Illness
What bipolar disorder is
Bipolar disorder is a long-term mental health condition that causes episodes of extreme changes in mood, energy and activity. People experience periods of depression and periods of mania or hypomania, an unusually high or irritable mood with increased energy. Between episodes, many people feel well for long stretches.
In bipolar I disorder, people have at least one episode of full mania, which can be severe enough to need hospital care and may include psychotic symptoms. In bipolar II disorder, people have episodes of depression and hypomania, a milder form of mania. Depressive episodes are often longer and more frequent than high episodes.
Bipolar disorder is a medical condition, not a character flaw or a lack of willpower. With treatment and support, most people manage it well, work, study and have families.
Symptoms
Mania or hypomania
- Elevated or irritable mood — feeling extremely happy, excited, angry or on edge
- Reduced need for sleep without feeling tired
- Racing thoughts and talking fast, jumping between topics
- Feeling unusually important or powerful
- Risky behaviour — overspending, reckless driving, impulsive decisions or sexual behaviour out of character
- Being easily distracted and taking on many projects at once
- In severe mania, losing touch with reality — hearing voices or holding false beliefs
Depression
- Low mood, sadness or emptiness most of the day
- Loss of interest in activities you used to enjoy
- Low energy, sleeping too much or too little
- Difficulty concentrating, feelings of guilt or worthlessness
- Thoughts of death or suicide
Some people have mixed episodes, with features of mania and depression at the same time, which can be particularly distressing and risky.
Causes and who is at risk
The exact cause is not known. A combination of genes, brain chemistry and life events is involved. Risk is higher with:
- A parent, brother or sister with bipolar disorder
- Stressful life events, which can trigger episodes
- Disrupted sleep, night shifts and long-distance travel
- Use of alcohol, cannabis and other drugs
- Some medicines, such as steroids or antidepressants taken without a mood stabiliser, which can trigger mania in people at risk
- The period after childbirth, a high-risk time for an episode
Bipolar disorder usually begins in the late teens or early adulthood, though it can start later.
How it is diagnosed
Diagnosis is made by a psychiatrist through a clinical assessment: a detailed conversation about current and past mood episodes, sleep, energy, behaviour, family history, alcohol and drug use, and risks. Hearing from family members is often very helpful, because a person in a high may not recognise the change.
There is no blood test or scan for bipolar disorder. Tests, including a thyroid function test, may be done to rule out physical causes and to check that treatment is safe. Keeping a mood chart — a daily record of mood, sleep and events — helps with diagnosis and later with spotting early warning signs. It can take time to diagnose bipolar disorder, because many people first seek help during depression.
Which professional to see
A psychiatrist diagnoses bipolar disorder and leads treatment, including medicines. A clinical psychologist provides talking therapies and helps with relapse prevention. A general physician can be the first point of contact and can share care.
You can find psychiatrists in Bengaluru and clinical psychologists on The Doctor Index. The Mental Healthcare Act, 2017 gives every person in India a right to access mental health care and treatment from services run or funded by the government.
Treatment
Medicines
Mood stabilisers are the core of treatment. Lithium is one of the most effective for preventing both highs and lows and reduces suicide risk; it needs regular blood tests to check levels and kidney and thyroid function. Sodium valproate and lamotrigine are other options. Some antipsychotic medicines, such as quetiapine, olanzapine or aripiprazole, treat mania and some help depression and prevent relapse. Antidepressants are used cautiously and usually only with a mood stabiliser.
Talking therapies and education
Psychoeducation — learning about the condition, triggers and early warning signs — helps people and families prevent relapse. Psychotherapy, including cognitive behavioural therapy, family-focused therapy and interpersonal and social rhythm therapy, supports recovery alongside medicines.
During severe episodes, hospital care may be needed for safety. Electroconvulsive therapy is an option for severe depression or mania that does not respond to other treatment.
Living with bipolar disorder
Regular sleep is one of the most protective things you can do; protect it during exams, festivals and travel. Avoid alcohol and recreational drugs. Keep a mood chart, know your early warning signs — often sleeping less, talking faster or withdrawing — and agree a crisis plan with your psychiatrist and family. Keep follow-up appointments and blood tests. Plan pregnancy with your psychiatrist, because both the condition and some medicines need careful management at that time.
Family members can help by learning about the condition, noticing changes early and supporting treatment without blame.
When it is an emergency
Get help immediately — call 112, go to the nearest emergency department, or call Tele-MANAS on 14416 — if someone:
- Talks about suicide, has a plan, or has harmed themselves
- Has gone days without sleep and is acting dangerously or out of control
- Has lost touch with reality, hearing voices or holding false beliefs
- Is confused, shaky, vomiting or has diarrhoea while taking lithium — this can be lithium toxicity
Questions to ask at your appointment
- What type of bipolar disorder do I have?
- Which medicine do you recommend, and what are the side effects?
- Which blood tests will I need, and how often?
- What are my early warning signs, and what should I do if they appear?
- How can my family help?
- What should I know before planning a pregnancy?
Common questions
Questions people ask
- Is bipolar disorder the same as mood swings?
- No. Everyone has ups and downs. Bipolar disorder involves distinct episodes of mania or hypomania and depression that last days to weeks, change sleep, energy and behaviour, and affect daily life. A psychiatrist can tell the difference.
- Will I need medicines for life?
- Most people with bipolar disorder benefit from long-term treatment to prevent relapse, especially after several episodes. Your psychiatrist will review the need regularly. Never stop on your own, as relapse after stopping is common and can be severe.
- Can people with bipolar disorder marry and have children?
- Yes. Many people with bipolar disorder marry, have children and lead full lives. Planning ahead with your psychiatrist is important, because some medicines need to be changed before pregnancy and the time after childbirth carries a higher risk of an episode.
- What is Tele-MANAS?
- Tele-MANAS is the Government of India's free, round-the-clock mental health helpline, reached by dialling 14416. Callers can choose their language and speak to trained counsellors, who can link them to mental health professionals for further care.
This condition is usually assessed by a psychiatrist. Every profile shows the doctor’s registration and what has been checked.
Psychiatrists in Bangalore
A few psychiatrists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Bipolar Disorder; ask the clinic whether the doctor sees it.
Related conditions
- Anxiety
- Attention Deficit Hyperactivity Disorder
- Depression
- Obsessive-Compulsive Disorder
- Panic Disorder
- Postpartum Depression
- Schizophrenia
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Bipolar Disorder
- World Health Organization — Mental disorders fact sheet
- Press Information Bureau, Government of India — Tele-MANAS launched with 24/7 toll-free helpline 14416
- India Code — The Mental Healthcare Act, 2017
- MedlinePlus, National Library of Medicine — Bipolar Disorder — Public-domain health-topic summary
- MedlinePlus Genetics — Bipolar disorder — Public-domain Genetics summary
Bipolar disorder: mania, depression, treatment and where to get help is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0357.