What Is Bipolar Disorder? Symptoms, Types, Causes, and Treatment

Bipolar disorder — once known as manic depression — is a mental health condition that causes extreme shifts in mood, energy, and behaviour. It includes episodes of depression and mania (or hypomania). Treatment for bipolar disorder includes psychological therapy, medication, lifestyle changes, and long-term support.

TL;DR

  • Bipolar disorder involves episodes of depression and mania or hypomania, with varying intensity.

  • There are different types of bipolar disorder: Bipolar I, Bipolar II, and Cyclothymia.

  • It's a complex brain condition with genetic, neurological, and environmental causes.

  • Treatment for bipolar disorder typically includes medication (like mood stabilisers) and psychological therapy.

  • Early diagnosis and long-term care can lead to meaningful recovery and stability.

What Is Bipolar Disorder?

Bipolar disorder is a mood disorder marked by alternating episodes of depression and mania. These episodes affect not just mood but also energy, sleep, behaviour, and ability to think clearly.

It is not simply being "moody" — bipolar is a serious psychiatric condition that requires medical and psychological care. While the depression phase may resemble major depression, the manic phase is what distinguishes bipolar disorder.

Bipolar used to be called manic depression, and you might still hear that term used.

The Symptoms of Bipolar Disorder

Depressive Episodes:

  • Feeling hopeless, empty, or sad

  • Lack of energy or motivation

  • Sleep changes (too much or too little)

  • Appetite changes

  • Suicidal thoughts or feelings

  • Trouble concentrating

  • Loss of pleasure or interest in activities


Manic Symptoms (Bipolar Mania):

  • Abnormally elevated mood or irritability

  • Inflated self-esteem or grandiosity

  • Racing thoughts or rapid speech

  • Reduced need for sleep (e.g. 2 hours and still energetic)

  • Impulsivity (e.g. spending sprees, risky sex, quitting jobs)

  • Distractibility

  • Poor judgment or disconnection from reality (in extreme cases)


Hypomania:

Similar to mania but less intense, and without psychotic features. People may feel highly productive, talkative, and energetic — these symptoms can look largely normal and be experienced as positive, which is why hypomania in type 2 bipolar disorder often goes undiagnosed.

Types of Bipolar Disorder

Type 1 Bipolar Disorder:

  • At least one manic episode (lasting 1 week or requiring hospitalisation), with or without depressive episodes.

  • More likely to include psychosis (e.g. delusions, hallucinations) during mania.

Type 2 Bipolar Disorder:

  • At least one major depressive episode and one hypomanic episode, but no full manic episodes.

  • Often misdiagnosed as depression due to subtle hypomania.

Cyclothymic Disorder:

  • Milder, chronic mood swings for 2+ years (hypomanic and depressive symptoms not meeting full diagnostic criteria).


Bipolar Disorder Not Otherwise Specified (NOS):

  • Mood symptoms that don't fit neatly into one of the above types.


What Causes Bipolar Mood Disorder?

Bipolar disorder is multifactorial, meaning several elements contribute to its development:

  • Genetics: Bipolar disorder tends to run in families. If a parent or sibling has it, your risk increases.

  • Brain structure and function: Neuroimaging shows differences in brain areas regulating emotion and decision-making.

  • Neurotransmitter imbalances: Particularly dopamine, serotonin, and norepinephrine.

  • Stressful life events: Trauma, sleep disruption including international travel or prolonged work stress can trigger an episode

  • Substance use: Drugs like cannabis or stimulants can worsen symptoms.

  • Is Bipolar Genetic?

Yes, bipolar disorder has a strong genetic component. However, not everyone with a family history will develop it, and not everyone who develops it has a family history.

Having a relative with bipolar increases your risk, but lifestyle, trauma, and neurological factors also play a role.

How a Person with Bipolar Thinks

During a manic phase, a person with bipolar may:

  • Have racing thoughts

  • Feel invincible or like they're on a special mission

  • Struggle to filter or slow down their thinking

  • Overestimate their abilities

  • Jump quickly between ideas


During a depressive phase, they may:

  • Feel like a burden

  • Have extremely negative self-talk

  • Find decision-making nearly impossible

  • Become stuck in rumination

Bipolar thinking can be intense, polarised, and fast-shifting, depending on the phase.

Bipolar Test: How Do You Know If You Have It?

There's no one-size-fits-all bipolar test, but psychologists and psychiatrists use screening tools and interviews to assess for:

  • Pattern of mood episodes

  • Duration and severity

  • Family history

  • Sleep, energy, thought, and behaviour changes


If you've been treated for depression but suspect your highs might be hypomania, it's worth seeking another clinical assessment.

Treatment for Bipolar Disorder

Bipolar is treatable, but it requires a long-term care plan. Most effective bipolar depression treatment plans include:

Medication:

  • Mood stabilisers: lithium, lamotrigine, valproate

  • Antipsychotics: quetiapine, olanzapine (for mania or depression)

  • Antidepressants: used cautiously, and often with a mood stabiliser to avoid triggering mania


Bipolar Disorder Therapies

Psychological therapy helps with self-awareness, relapse prevention, and emotional regulation. Useful approaches include:

  • Cognitive Behavioural Therapy (CBT): For managing unhelpful thoughts and emotional reactivity

  • Interpersonal and Social Rhythm Therapy (IPSRT): Stabilises sleep and daily routines

  • Psychoeducation: Helps people and families understand warning signs

  • Family-focused therapy: Supports communication and reduces conflict at home

  • ACT and mindfulness-based therapies: Builds psychological flexibility and encourages value driven behaviours


Living with Bipolar: What to Expect

With the right support, many people with bipolar disorder lead full and productive lives.

Treatment is about managing episodes, reducing their frequency/intensity, and learning to identify early warning signs.

Keys to stability:

  • Medication compliance

  • Sleep regulation

  • Avoiding substance triggers

  • Supportive routines and relationships

  • Regular check-ins with your psychologist and GP


Local Support for Bipolar Disorder in Sydney

At Equilibrium Psychology, our experienced team offers compassionate, practical help for bipolar disorder. We provide:

  • Diagnosis and therapy for depression, mania, and comorbid conditions

  • Evidence-based therapies including CBT, ACT, and IPSRT

  • Telehealth appointments across Australia

  • Convenient Sydney CBD location, 3 mins from Wynyard Station


Why Choose Equilibrium Psychology?

Founded by Clinical Psychologist Gemma Cribb almost 20 years ago, our experienced team of over 20 AHPRA registered Clinical Psychologists (and Angel the Therapy Dog!) offer practical help in treating depression, mania and comorbid conditions.

We offer:

  • Warm, non-judgmental, evidence-based care

  • LGBTQIA+ inclusive and neurodiversity affirming

  • Medicare rebates available with a GP referral

  • After-hours and online sessions available

  • No waitlists

  • Located in Sydney CBD, 3 minutes from Wynyard Station

  • Telehealth appointments are also available


Next Steps

If you're wondering whether it's bipolar disorder, depression, or something else, don't guess — get clarity.

You don't have to figure this out on your own.

👉 Enquire about being matched with one of our experienced psychologists online, or

📞 Call our friendly team on (02) 9262 6156 to find the right psychologist for you.


*Last updated: July 2025*

NEED URGENT SUPPORT?

If you're feeling overwhelmed or need immediate help, please contact:

- Beyond Blue: 1300 22 4636

- Lifeline: 13 11 14

- In an emergency, call 000

These services are available 24/7 and can provide immediate support.

Gemille Cribb