Bipolar disorder

In Falgun, Nabil barely slept. The founder of a fintech startup that everyone in Dhaka was talking about, he pitched four investors in three days, booked a launch party at a rooftop in Gulshan, and talked so fast his co-founder could not follow. He felt brilliant. By the start of the monsoon he could not get out of bed, the party had cost him a year’s savings, and he could not explain to his parents what had happened.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding bipolar disorder

Bipolar disorder is a medical condition in which mood swings far beyond ordinary ups and downs. Most people have depressive episodes, with low mood, loss of interest and exhaustion, and all have periods of mania or hypomania, with euphoria or irritability, great energy, racing thoughts, little need for sleep, and impulsive or risky decisions. Between episodes many people feel well.

How common is bipolar disorder?

In 2023, 36 million people in the world were living with bipolar disorder, WHO estimates, including 3.3 million adolescents. People with bipolar disorder are at increased risk of suicide, which is one reason treatment matters.

Signs and symptoms of bipolar disorder

• Periods of unusual energy, little sleep, racing thoughts or reckless spending
• Periods of deep low mood that follow or precede them
• Family or friends saying you seem “like a different person”
• A family history of bipolar disorder

Treatment for bipolar disorder

WHO lists effective treatments for bipolar disorder: psychoeducation, support for social functioning, and medicines. NICE guidance puts mood stabilisers, lithium first, at the base of long-term treatment. Getting the diagnosis right matters, because some medicines used for ordinary depression can trigger mania in bipolar disorder. Treatment also helps people and families learn their early warning signs, such as a few nights of short sleep, so they can act before an episode takes hold.

What getting better can look like

Stability, for Nabil, looks like a year without an emergency, a pitch deck that still makes sense in the morning, and a sleep routine guarded as closely as his cap table.

Common questions about bipolar disorder

What is the difference between bipolar disorder and normal mood swings?

Everyone has ups and downs. In bipolar disorder mood swings far beyond them, into periods of mania or hypomania, with great energy, racing thoughts, little need for sleep and impulsive decisions, and for most people into depressive episodes too. Between episodes many people feel well, and family often notice the change before the person does.

Can antidepressants make bipolar disorder worse?

They can. Some medicines used for ordinary depression can trigger mania in bipolar disorder, which is why getting the diagnosis right matters and why mood stabilisers are the basis of treatment. Anyone already taking medication should not change it on their own, and can raise the question with their psychiatrist.

When to see a psychiatrist

If you or someone close to you has periods of unusually high energy with little sleep, followed by low mood, a psychiatric assessment is the right next step. Mania can need urgent care.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• World Health Organization, “Mental disorders” fact sheet, September 2026
• NICE guideline CG185, Bipolar disorder: assessment and management (last reviewed 2 September 2025)