Bipolar disorder is a condition which results in extreme mood swings, from manic to depressive – it’s sometimes been called ‘manic depression’. While the depressive phase of the disorder can have serious effects, the manic phase can be even more difficult to cope with.

During the manic phase of bipolar disorder, a person may have feelings of invincibility and invulnerability. They believe they can run any risk and come out ahead. Many engage in risk-seeking behavior, such as gambling with high stakes, driving aggressively and at high speed, or spending money they don’t actually have (the ’shopaholic’ is often suffering from bipolar disorder). Some engage in promiscuous sex during their manic phases – even if they are in happy marriages and faithful to their spouses the rest of the time.

Less extreme bipolar disorder mania can involve the person becoming hyperactive – their energy level is extremely high, to the extent that they can’t settle down, rest, or stop fidgeting. Typical symptoms include talking extremely fast, so that friends can’t keep up with them, and getting engrossed in projects that seem extremely important at the time (though they may in fact be subject to a delusion, such as that they can stop global warming, or develop manned space flight in their basement workshop). They may become irritable if anyone interrupts their pet projects, and impatient with anyone who can’t keep up with their hyperactivity or doesn’t want to be involved in their schemes.

During the manic phase of bipolar disorder, normally equable people can become highly volatile. They appear to be feeling deliriously happy, but a small thing – someone contradicting them, a single item out of place on their desk – can set them off into anger and even rage. They may shout at colleagues or lose control with their children.

Insomnia often accompanies the manic stage. Someone during this stage typically may be unable to sleep, and may not feel any fatigue despite not having slept. They may be impatient with partners who want them to come to bed. They may also complain that their thoughts are racing, so that they can’t relax in order to sleep.

A big difficulty with the manic phase of bipolar disorder is that it creates the feeling that the person is somehow special, that they are on the verge of achieving something terribly important. Sometimes, bipolar disorder does in fact accompany great creativity; many great artists and musicians have been diagnosed with the disorder. However, more often these feelings are not justified by reality – they are delusions created by the disorder.

Such feelings make the person believe the manic phase of the disorder is ‘good’. It certainly feels great to them at the time – they are on a real high. Unfortunately this makes it unlikely that they will see the point of seeking the help they need. Even if they have sought help and are on medication, sometimes they will miss their manic highs – this may be a reason for people with bipolar disorder lapsing their medication.

The good news is that once someone suffering from bipolar disorder takes the decision to seek help, they can control the disorder and live a normal life, with the assistance of medication and counseling. Once the person diagnosed, and their family, can recognize the signs of an approaching manic phase, they can easily take action to prevent its extreme manifestations. Medication such as lithium can help moderate the mood swings; lithium is particularly effective in reducing the manic highs. Equally, for the family and perhaps for colleagues, knowing that the difficulties they experience are nothing personal, but the result of an illness, can help them cope with the difficulties posed by bipolar manic behavior more easily.

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• Bipolar Schizophrenia

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