You may sleep only 3 hours a night for several days and feel as if you have unlimited energy.
Ideas come in waves, everything seems possible. And then suddenly—you don’t have the strength to get out of bed, and the simplest tasks become impossible.
This is not just a “bad day.” It may be Bipolar Disorder.
Bipolar disorder (BD) is a chronic mental condition in which extreme mood states occur alternately—ranging from mania or hypomania to depression. These are not ordinary emotional fluctuations. They are profound changes in brain functioning that affect thinking, emotions, decision-making, energy levels, and everyday behavior. During an episode, a person may function completely differently than usual—as if they were “a different version of themselves.”
During a manic episode, reality may feel accelerated and intense. There is a surge of energy, a reduced need for sleep, a sense of uniqueness, and strong belief in one’s abilities. A person may start multiple activities at once—new projects, spontaneous decisions, spending money, or engaging in risky behaviors. Speech becomes rapid, thoughts race, and stopping can be difficult. In severe cases, psychotic symptoms such as delusions may appear. Importantly, mania is not always perceived as negative—for some, it feels empowering, which can reduce the perceived need for treatment.
Hypomania is a milder form of mania and is often harder to recognize. A person may feel more productive, creative, and sociable—and precisely for this reason, this state may be overlooked or even seen as a “better version” of oneself. This is one reason why the disorder may remain undiagnosed for a long time.
On the other end lies depression—often deep and debilitating. It is not just sadness, but a state in which a person loses energy, motivation, and the ability to feel pleasure. Simple tasks such as getting out of bed, washing, or replying to a message can feel overwhelming. Feelings of guilt and hopelessness appear, and in severe cases, suicidal thoughts may occur. Depression in bipolar disorder is often more severe than in unipolar depression and can last a long time, significantly impairing daily functioning.
In everyday life, the disorder may look like a cycle of extremes. In one phase, a person acts intensely, full of energy and plans, making quick decisions without much reflection. In another, they withdraw, lose contact with others, and struggle with basic responsibilities. This is not a lack of willpower or a “weak character,” but a real disruption in brain function.
The causes of the disorder are complex. A key role is played by imbalances in neurotransmitters such as dopamine, serotonin, and norepinephrine, which regulate mood and emotions. Brain activity also changes, especially in the limbic system and the prefrontal cortex. Genetic factors are significant—risk is higher in individuals with a family history of similar disorders. However, genetics is not the whole story. Environmental factors such as stress, sleep deprivation, substance use, or major life changes can trigger episodes.
Diagnosing bipolar disorder can be difficult and is often delayed. Many people seek help during a depressive episode, which may lead to a misdiagnosis of unipolar depression. Failure to recognize episodes of mania or hypomania results in delayed appropriate treatment. Accurate diagnosis is crucial for effective therapy.
Treatment is long-term and includes several components. The foundation is pharmacotherapy—primarily mood stabilizers such as lithium and antipsychotic medications. In some cases, antidepressants are also used, but with caution. Psychotherapy and psychoeducation are also important, helping patients better understand the disorder and recognize early warning signs of relapse. Lifestyle factors are crucial as well—regular sleep, a stable daily routine, avoiding alcohol, and reducing stress. Even minor sleep disturbances can trigger episodes of mania or depression.
Untreated bipolar disorder can lead to serious consequences—work problems, financial difficulties, relationship breakdowns, addiction, and an increased risk of suicide. At the same time, it is important to emphasize that with proper treatment, many people with bipolar disorder live stable, fulfilling lives, achieve professional goals, and maintain social relationships.
Patient FAQ
Is it possible that during mania I feel “more like myself” than usual?
Yes, many people describe mania as a state in which they feel more confident, bold, and “authentic.” The problem is that this state distorts reality and can lead to decisions later regretted.
Why does a breakdown often follow a period of “feeling great”?
The body cannot sustain such a high level of activation as in mania for long, so a drop often follows—sometimes very sudden.
Do I need to continue treatment for life?
In many cases, yes, as it is a chronic condition requiring long-term management.
Can I predict an upcoming episode?
Often yes—early warning signs may include changes in sleep, energy levels, or thinking patterns.
Do seasons affect it?
For some people, yes—for example, spring may trigger mania, while autumn and winter may be linked to depression.
Bibliography
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
World Health Organization (WHO). Bipolar disorder
National Institute for Health and Care Excellence (NICE). Bipolar disorder: assessment and management
Grande I, Berk M, Birmaher B, Vieta E. Bipolar disorder. The Lancet, 2016
Goodwin GM, Jamison KR. Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression
National Institute of Mental Health (NIMH). Bipolar Disorder Overview
