Bipolar disorder, formerly known as manic-depressive illness, is a major mental health condition characterised by mood episodes/ extreme shifts in mood, energy, and activity levels.
These changes go beyond the normal ups and downs of life and can deeply affect an individual’s ability to function in daily activities, maintain relationships, and manage work or studies. Understanding this condition is essential for empathy, early intervention, and effective management.
Two phases of bipolar disorder
At its core, bipolar disorder involves two distinct mood states — high phase (mania or hypomania) and low phase (depression). During a high phase, individuals may feel unusually energetic, euphoric, or irritable. They might overgroom themselves and wear very colourful/ ceremonial dresses, engage in excessive shopping or donate excessive money, and make irrational life decisions. They might talk excessively, too fast, be flooded with multiple ideas, be quite distractible, not feel the need to sleep, make impulsive decisions, or feel invincible.
According to Dr Sameer Malhotra, Principal Director and Head, Mental Health and Behavioural Sciences, Max Super Speciality Hospital, Saket, this heightened state can sometimes lead to risky behaviours such as overspending, excessive substance/ alcohol use, reckless driving, sex risk behaviours and aggression/ violent behaviours. At times, the affected individuals may make unnecessary purchases or get into major risky financial transactions or brush with the law. They can have false grandiose beliefs about self and their power/abilities/associations, and may also have auditory and visual hallucinations (i.e. having unusual experiences of hearing and seeing what others can not).
On the other hand, depressive episodes are marked by sustained sadness of mood, fatigue, feelings of worthlessness, helplessness, hopelessness, guilt/ remorse. loss of interest in previously enjoyable activities and disturbed sleep. These alternating states can vary in intensity and duration depending on the type of bipolar disorder — Bipolar I (it has a manic episode), Bipolar II (hypomanic episode), or Cyclothymic disorder (milder form, frequent mood swings).
Impact of bipolar disorder on regular life
The impact of bipolar disorder on daily life and relationships can be profound. At work or school, fluctuating moods may interfere with concentration, decision-making, productivity and attendance. A high phase might initially seem to enhance creativity and energy, but it often leads to disorganisation and poor judgment. Conversely, during depressive episodes, even simple tasks like getting out of bed, eating, or attending meetings can feel impossible. Many individuals struggle to maintain consistent performance, leading to job instability or academic setbacks.
Relationships, too, can become strained. Loved ones may find it difficult to understand sudden changes in mood and behaviour. During mania, individuals may act impulsively or speak harshly, become aggressive, causing friction, while during depression, they might withdraw. Without proper understanding, partners, family members, friends, colleagues and employers may feel confused or hurt, which can lead to isolation and loneliness for the person affected.
Physical health is also influenced by bipolar disorder. Sleep patterns are often disrupted, appetite changes are common, and the stress of managing unpredictable moods, unhealthy lifestyle can predispose to other health issues such as hypertension, diabetes or substance misuse.
Underlying biological changes, including neurochemical changes, need appropriate and timely management.
Diagnosis and treatment
With timely identification, proper diagnosis and treatment, people with bipolar disorder can be effectively managed. Treatment typically includes mood-stabilising medications, psychotherapy, and lifestyle management. Cognitive-behavioural therapy (CBT) helps individuals recognise mood triggers and develop coping strategies. Regular sleep-wake schedule, balanced nutrition, exercise, and avoiding alcohol or drugs play a crucial role in mood regulation. Support from family, peers, and mental health professionals also makes a significant difference.
Living with bipolar disorder requires awareness, acceptance, and ongoing care. With the right treatment plan, self-discipline, and social support, many people are able to manage their condition, pursue careers, nurture relationships, and live meaningfully. Understanding and empathy — both from within and from society — remain key to helping those with bipolar disorder navigate daily life with dignity and hope.
