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 ☕