Bipolar Depression

People with bipolar disorder experience episodes of extreme mood swings from depression to mania.

The mood spectrum looks like this:
Mania <=> Hypomania <=> Normal mood <=> Dysthymia <=> Depression

Symptoms of mania:

  • high self esteem
  • feelings of elation
  • lots of energy
  • racing thoughts
  • psychosis
  • hallucinations
  • agitation
  • irritability
  • reckless behaviour.

At the other end of the scale you may experience dysthymia (low mood) and depression.

One of the best-known British celebrities with bipolar depression is Stephen Fry. While he talks openly about the dark low periods, he maintains that his bipolar has also led to his most creative achievements. He has chosen to speak up about his experiences in order to help improve understanding of mental health conditions:

“Once the understanding is there, we can all stand up and not be ashamed of ourselves, then it makes the rest of the population realise that we are just like them but with something extra.”
– Stephen Fry

The different types of bipolar

There are two main types of bipolar disorder:

  • Bipolar 1: People with bipolar 1 swing between mania and depression, and will often come to the attention of the GP in both the manic and depressive stages of the condition.
  • Bipolar 2: People with bipolar 2 swing between hypomania and depression. The ‘highs’ for those experiencing bipolar 2 tend to be milder than full mania. This can mean that it is harder to diagnose as individuals tend only to visit the GP when feeling severely depressed – as such it can often be misdiagnosed as clinical depression.

There is a milder form of bipolar which is called cyclothymia. People tend to experience mild but sometimes frequent mood shifts. People with cyclothymia tend to go undiagnosed due to the mildness of symptoms.

Treatment of bipolar

If you have bipolar it’s likely you will be referred to a psychiatrist, who will work with you to establish the best treatment. This can include a combination of medication and referral to behavioural therapy. You may also have a community psychiatric nurse (CPN) who will support you in the community.

There are three main types of medication used to treat bipolar:

  • mood stabilizers such as lithium
  • anti-psychotics
  • antidepressants

It is possible to be on more than one type of medication such as a mood stabilizer and an antidepressant. Often antidepressants on their own are ineffective for people with bipolar.


It can help you greatly to learn to recognise your early warning signs before your mood changes. One common early warning sign is a change in sleeping habits. Not sleeping or being active most of the night could be an early indication of a mood shift towards mania. Increased sleeping and withdrawal from everyday activities could be indicative of moving towards depression.

With thanks to Yvonne Fleming, Bipolar Scotland for this content.

Further Information

  1. Bipolar Scotland: the only organisation in Scotland which focuses solely on bipolar disorder
  2. MDF, The Bipolar Organisation: a user led charity covering England and Wales.

Read about other types of depression.

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