Symptoms of bipolar disorder: quick guide

Bipolar disorder is considered one of the most severe and disabling mental disorders, as confirmed by the WHO in its ranking of the most disabling diseases. This article serves as a guide to describe the symptomatology of this still largely underdiagnosed condition.

Bipolar disorder is characterized by an alternation of euphoric and depressive episodes, as described in the DSM-5.

This guide presents the main symptoms to help recognize them quickly.

List of symptoms of bipolar disorder

Symptoms of the (hypo)manic episode

To go further:

• Hypomania — definition and symptoms
• Mania — definition and symptoms

Reduced need for sleep

• Hypomania:
  • Reduction of sleep by a few hours without fatigue.
  • Characterized by: Refusal to sleep OR Inability to sleep.
• Mania:
  • Less than 3 hours of sleep.
  • The body signals a need for sleep that the brain forbids.
  • Sometimes, the body is tired but the brain is not.
  • Personal record → 5 days without sleeping → 1 hour of sleep → still feeling fine.

Increased energy

• Very energetic and multiplication of projects.
  • Experienced in August 2025 → 2 books written in 9 days + 1 blog.
• Often mistaken as simply being extremely productive and creative.
• Psychomotor agitation (mental and physical).
  • I ran at 2 a.m. for over an hour, without preparation, without feeling tired at the end.

Impulsivity

• Alcohol, risky sexual behavior, reckless spending, toxic substances, dangerous situations.
• Mania:
  • Often a counterproductive multiplication of projects.
  • Grandiose, confused ideas, many projects started but rarely finished.
  • Projects often left unfinished:
    • First manic phase → several websites never completed.
    • Chaotic upon rereading.
  • Endangering oneself and others.

Tachypsychia

• Strong acceleration of thought.
• Impression of sometimes thinking about several things at once without rest.
• Example → it often happens that I think about several things in parallel while a piece of music plays in the background of my mind.
• A sense of urgency to
  • start activities
  • or talk more than usual, even interrupting and monopolizing conversations.
• To distinguish from autism:
  • A source of misdiagnosis between autism and bipolar disorder (comorbidities I discuss on the blog).
  • Autistic individuals → difficulties with social codes → may interrupt conversations or infodump without realizing it.
  • In (hypo)manic individuals → a symptom to be treated and uncontrollable (especially in mania).

Logorrhea and graphorrhea

• Logorrhea → Being more talkative than usual, preventing others from speaking.
  • Experience: I spoke non-stop for 20 minutes upon arriving at a friend’s place.
• Graphorrhea → Being unable to stop writing (or painting, drawing, etc.). Example:
  • I wrote two books in nine days.
  • I drew continuously in the hospital for days.

Flight of ideas

• Jumping from one idea to another, often without connection.
• A direct consequence of tachypsychia.
• The person seems to jump from one topic to another.

Distractibility

• Everything attracts attention → a butterfly passing by, background noise, a reflection.
• May lead to misdiagnoses of ADHD (even though both can coexist).

Alteration and loss of insight

• Insight = ability to assess one’s own mental state.
• Hypomania → impaired but still partial.
• Mania → often a complete loss of insight accompanied by impaired judgment.
  • With awareness of the illness → this symptom can lessen.

Self-esteem and grandiosity

• Inflated self-confidence and self-esteem, and grandiose ideas.
• Hypomania vs Mania → intensity of the symptom.
• Feeling invincible, or like a deity.
• Mania → may develop into psychosis.

Specific characteristics of mania

• Hospitalization required → manic episode.
• If psychotic features are present → manic episode.

Psychosis

• Complete loss of insight accompanied by delusions and/or hallucinations.
  • Most common delusions → grandiose, mission-based, mystical, and erotomanic delusions.
  • Hallucinations → often auditory (voices commenting, giving orders, sounds) & visual (shadows, lights).
• I experience psychotic traits almost systematically.
  • I know I am manic
  • but have no ability to question my beliefs → loss of contact with reality.

Disorganization

• Hypomania → I reinforce my routines; more productivity, efficiency.
• Mania → collapse of routines, hygiene, and dispersion in activities (e.g., I go somewhere then turn back, I take the bus without a goal).
• Mania disorganizes → it is my personal chaos.

Sensory alteration

• Mania → senses are often affected:
  • Lights appear vivid, vibrant, saturated.
  • Everything seems more detailed, as if in 4K.
  • My world feels enhanced.
• In autistic individuals, senses are already affected.
  • A person hypersensitive to visual stimuli may feel amazed by the world.
  • Seeking visual stimulation.

Differences between hypomania and mania

• Hypomania → often seen as productive, with overall functioning preserved and moderate intensity.
• Mania → chaotic, extremely intense and highly disabling, inability to function.

Symptoms of the depressive episode

To go further: Bipolar depression — definition and symptoms.

Depressed mood

• Depressed mood → sad or anxious.
• At first → I have repeated crying spells.
• As it intensifies → I feel like I no longer have the energy to cry.

Anhedonia

• Loss of interest OR pleasure.
• In autistic individuals → possible loss of pleasure even in their special interests.
• Concretely → I do nothing anymore, I just wait for the day to pass.
• Not to be confused with autistic burnout (see here).

Weight gain or loss

• I have already lost 8 kg in one month from no longer eating.
• Results from loss of motivation.

Insomnia or hypersomnia

• Often hypersomnia → I sleep 12 to 14 hours per night.
• I stay in bed for the rest of the day.

Psychomotor agitation or retardation

• Agitation:
  • Moves constantly, difficulty staying still.
  • Thinks about too many things (≠ different from tachypsychia).
• Retardation:
  • Thinks and processes more slowly.
  • Functions in slow motion.
• Must be noticeable by others.
• Psychomotor retardation is often seen in bipolar disorder.
• For me → feeling slowed down, I walk more slowly, I respond more slowly.

Fatigue

• With lack of energy.
• Severe fatigue → non-restorative sleep.
• No longer has the energy even for simple tasks (for me → taking a shower, shaving).

Feelings of worthlessness / excessive guilt

• Devalues oneself, loses self-esteem and self-confidence.
• Guilt:
  • Excessive, overwhelming, irrational.
  • Examples:
  • “I am a bad person.”
  • “I am a burden to others.”
  • “I am selfish.”
• These are the kinds of thoughts that weigh on me when I am depressed.

Decreased concentration OR indecisiveness

• Difficulty making decisions, even simple ones.
• Difficulty concentrating (≠ mania).

Dark/suicidal thoughts

• Dark thoughts:
  • “I should not have been born.”
  • “I wish everything would stop.”
• Suicidal thoughts/planning/attempts.

Symptoms of the mixed episode

To go further: Mixed episode — definition and symptoms.

• (Hypo)manic episode with ≥ 3 depressive symptoms.
• High energy + despair → most unstable state.
• In my case:
  • I experience it as the most terrifying episode of bipolar disorder.
  • Suicidal thoughts overwhelm me from morning to night.
  • I have the energy to be afraid of these thoughts.
  • A real trauma.
• Autistic individuals seem more prone to mixed episodes.

Recognizing these states is already a way to regain some control.

Hypomania may seem useful.
Mania is always destructive.
Both come at a cost.

If these words help you understand yourself, you can support the project ☕