Mania and Depression in Bipolar Disorder


If a family member has recently received a diagnosis of bipolar disorder, you’re likely to have questions about what to expect during episodes of mania and depression. This brief overview can help you better understand what typically occurs.

A person with bipolar disorder typically has alternating periods of major depression and mania, interrupted by periods of normal mood that usually last for many months.

Major hallmarks of depression include a persistent low or sad mood, decreased or absent interest in almost all activities, loss of self-confidence, and a feeling of worthlessness. Mania, which can be thought of as the opposite of depression, is usually characterized by an elated or elevated mood, increased activity, an overblown self-image and an exaggerated sense of self-confidence.

During what psychiatrists call an acute episode, the symptoms of either mania or depression become very pronounced. Patients may become extremely agitated or deeply depressed and unresponsive. Seeing a family member go through such an episode can be distressing.

If the individual seems to be at risk for self-harm or harming others, his or her doctor may recommend immediate hospitalization. If the doctor determines that your family member doesn’t require hospitalization while experiencing an acute manic episode, it is important to provide as calm and stable an environment as possible, with a minimum of stimulation. Individuals going through an acute depressive episode may be at high risk of committing suicide.

During an acute episode, it’s very difficult for the patient-and family caregivers-to make rational decisions. Major decisions regarding family, finances, or job-related issues should be put on hold until the episode has passed.

During periods when symptoms are under control, it is important that patients be involved in making decisions about their treatment with their healthcare provider, particularly since such patient participation tends to result in better adherence to the prescribed therapy.