Bipolar disorder is characterized by extreme changes in mood (poles), from mania to depression. Between these mood swings, a person with bipolar disorder may experience normal moods.

“Manic” describes an increasingly restless, energetic, talkative, reckless, powerful, euphoric period. Lavish spending sprees or impulsive risky sex can occur. Then, at some point, this high-flying mood can spiral into something darker, irritation, confusion, anger, feeling trapped.

“Depression” describes the opposite mood,  sadness, crying, sense of worthlessness, loss of energy, loss of pleasure, sleep problems.

But because the pattern of highs and lows varies for each person, bipolar disorder is a complex disease to diagnose. For some people, mania or depression can last for weeks or months, even for years. For other people, bipolar disorder takes the form of frequent and dramatic mood shifts.

“There’s a whole spectrum of symptoms and mood changes that have been found in bipolar disorder,” says Michael Aronson, MD, a clinical psychiatrist and consultant for WebMD. “It’s not always dramatic mood swings. In fact, some people seem to get along just fine. The manic periods can be very, very productive. They think things are going great.”

The danger comes, he says, when the mania grows much worse. “The change can be very dramatic, with catastrophic results. People can get involved in reckless behavior, spend a lot of money, there may be sexual promiscuity, sexual risks.”

The depressed phases can be equally dangerous: A person may have frequent thoughts of suicide.
If you or someone you know has thoughts of death or suicide, contact a healthcare professional, loved one, friend, or call 911 immediately.

Bipolar disorder is equally difficult for families of those affected. The condition is the most difficult mental illness for families to accept, Aronson tells WebMD. “Families can more easily accept schizophrenia, to understand that it is an illness. But when a person is sometimes very productive, then becomes unreasonable or irrational, it wreaks more havoc on the family. It seems more like bad behavior, like they won’t straighten up.”

If this rings true, either for you or a loved one, the first step in tackling the problem is to see a psychiatrist. Whether it’s bipolar disorder or another mood-related problem, effective treatments are available. What’s most important is that you recognize the problem, and start looking for help.