Mania symptoms make the person feel intensively well, energetic and optimistic to the extent that it affects thinking and judgement. While it may make the person happy or excited, and overflowing with new ideas, they can also become irritable as others may not respond with the same enthusiasm. They are more active, while more easily distracted, and unable or unwilling to sleep. Libido can increase.³

Consequences can include making unrealistic or fanciful plans, moving and talking more quickly, loosing inhibitions or being reckless. This might translate into having casual sex, excessive spending, gambling or drinking, and being over-familiar or critical with others.^2,3

Depression can be major with intense negative mood, extreme unhappiness, a loss of interest, restlessness and agitation, and feelings of no self-confidence or no self-worth. Decision making and concentrating are difficult, with significant sleep disturbance and tiredness. The patient may avoid other people and have suicidal thoughts.³

Psychoses – hallucinations or delusions – can also occur with bipolar. For example, in manic episodes, the patient may believe they have special powers or abilities, while in a depressive phase the person may feel extreme guilt, that they are far worse than anyone else or that they do not exist.^3,5