Bipolar disorder affects at least 1% of the global population, but the actual prevalence is believed to be higher, with many cases never diagnosed—particularly when depressive symptoms predominate and manic symptoms are milder, making them less noticeable to patients and their families.
It is characterised by episodes of marked changes in mood and energy, often interfering with the individual’s personal, family, social, and professional functioning. Episodes can be mild, moderate, or severe, occurring cyclically, with symptom-free periods in between. Bipolar disorder can begin at any stage of life, but it most commonly emerges in young adulthood. It is a chronic condition that may progress to more severe forms if not properly treated.
Traditionally, two types are distinguished:
- Type I: the more severe form, in which patients experience at least one manic episode lasting a minimum of one week, with or without depressive episodes;
- Type II: characterised mainly by recurrent depressive episodes, with occasional periods of elevated mood or irritability that are not severe enough to be considered full manic episodes.
During mania, mood can be euphoric, with excessive optimism and a sense of wellbeing and fulfilment. Irritability may also predominate, potentially involving aggression and low frustration tolerance. Energy levels are increased, with a tendency to engage in multiple projects simultaneously, not necessarily completing them. Decisions are made impulsively, without adequately considering their consequences.
There is often a reduced need for sleep without feelings of fatigue. Speech tends to be accelerated and may be difficult to interrupt or follow. The patient tends to overestimate their abilities, which may lead them to undertake complex tasks or risky situations, believing they can manage them with ease. This feeling can reach delusional proportions, with the patient believing they have special powers, have been chosen for a mission, or that others have a particular interest in them.
At the opposite pole, during depression, persistent sadness predominates, along with reduced energy and psychomotor slowing, making everyday tasks arduous. Pervasive pessimism is common, with feelings of guilt, loss, worthlessness, and hopelessness about the future, which may not reflect reality.
Effective treatments exist that help control symptoms and improve the quality of life for people with bipolar disorder, including medication, psychotherapy, and other interventions. Psychoeducation is essential to enable individuals to recognise early signs of relapse, allowing for rapid management under the guidance of their treating psychiatrist.
Joana Camacho Aguiar (OM 60762)
30, March 2026
