"What happens to me during a bipolar episode?"  This is a common question that many people first diagnosed with bipolar disorder ask their doctor; however, they may simply get a medical answer instead of one that they can understand.


First, let's clear up a couple common misconceptions.  A bipolar episode will not just sneak up on you without you knowing it – you will have warning signs and symptoms that an episode is approaching; the problem is whether you will recognize them or not.


Another common misconception about bipolar disorder is that the person with it will continually go back and forth between episodes constantly, like a rollercoaster ride.  This is not the truth.  People can go long periods of time between bipolar episodes.


For example, if you have been diagnosed with Bipolar I Disorder, you may only have 8–10 episodes in your entire life. However, these episodes can be so severe that they can inflict serious havoc upon your finances, your relationships, your job, etc.


So what does happen to you during a bipolar episode? In both episodes, the most likely cause is that the chemicals in your brain have become imbalanced.


Let's look at manic and depressed episodes separately:


Manic Episodes

A person doesn’t enter a full-blown manic episode overnight. The symptoms build up over the course of 7–14 days. Because the initial symptoms are mild, you need to watch for them.


Without treatment, the manic episode could last for as long as three months. When the episode ends, you will either enter a depressive episode or will return to your normal mood.


If you’ve just experienced your first manic episode, you shouldn’t wait to get treatment. Without treatment, relapses usually occur within the first six months, so please see your medical or mental health professional as soon as you can.


You may experience the following symptoms during a manic episode:


  • Increased energy, activity, and restlessness
  • Excessively "high," overly good, euphoric mood
  • Extreme irritability
  • Racing thoughts and talking very fast, jumping from one idea to another
  • Distractibility, can't concentrate well
  • Little sleep needed
  • Unrealistic beliefs in one's abilities and powers
  • Poor judgment
  • Spending sprees
  • A lasting period of behavior that is different from usual
  • Increased sexual drive
  • Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
  • Provocative, intrusive, or aggressive behavior
  • Denial that anything is wrong.


A manic episode is diagnosed if elevated mood occurs with 3 or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, 4 additional symptoms must be present.


Depressive Episodes

Many times you might enter a depressive episode immediately after coming out of a manic episode. Other times, you might go from a normal mood to a state of depression.


After a depressive episode, you should go back to a normal mood.


You may experience the following symptoms during a depressive episode:


  • Lasting sad, anxious, or empty mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in activities once enjoyed, including sex
  • Withdrawal from family and friends
  • Decreased energy, a feeling of fatigue or of being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Restlessness or irritability
  • Sleeping too much, or can't sleep
  • Change in appetite and/or unintended weight loss or gain
  • Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
  • Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if 5 or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

Depending on what triggered the episode may decide how much longer the episode will last.  For example, if a stressful situation caused you to have the bipolar episode, removal of the situation can cause your stress levels to drop and your episode may end quicker.  If you had a manic episode due to lack of sleep, just catching up on your sleep may help to end your episode more quickly.  Change in bipolar medications may also help.