During severe episodes of mania or depression, a person may also exhibit psychotic symptoms like hallucinations and delusions, which need to be distinguished from schizophrenia or delusional disorder. They may also show suicidal tendencies and may indulge in cutting or hurting themselves for pleasure or because they feel unloved. Individuals suffering from this disorder may also have substance abuse disorder (but this cannot be attributed as the cause of the disorder) and suffer problems in relationships.

Diagnostic statistical Manual of Mental disorders or DSM defines four types of bipolar disorder. In Bipolar I Disorder, the person may have severe mania symptoms and depression symptoms alternating for a period of 2 weeks. Bipolar II Disorder may be defined as a pattern of depressive episodes with hypomania episodes.

The disorder generally includes a range of moods which alternate. In some cases, the individual may have severe depression with no mania episode or may have mild depression called dysthymia coupled with hypomania or severe mania. Hypomania episode may involve increased energy but it is not as severe as typical mania. Without proper treatment hypomania can transform into severe mania or depression. During mixed state, the symptoms may include agitation, irritation, trouble in sleeping and changes in appetite.

The individual may feel too tired or slowed down. S/he may have problems in concentrating and remembering. Their decision making process may be slowed. They may change their eating and sleeping habits. Some of them may binge eat, while some would starve. They may feel guilt ridden and unloved which can trigger thoughts about death and suicide.

During the episode, the individual may have a long period of hopeless and irratability. The person may feel a loss of interest in activities s/he once enjoyed, including pleasurable activities like sex or hobbies.

During this episode the individual may talk very fast, jump from one idea to another due to racing thoughts. The person may get easily distracted and take on new projects at an extremely fast pace. Individual may also feel restless, may sleep little and have an unrealistic belief in her/his abilities. Most of the sufferers may behave impulsively and take part in pleasurable and high risk behaviors. They may go on shopping sprees or indulge in implusive sex or impulsive business investments.

During the mania episode, an individual may experience a long period of feeling ‘high’ or overly outgoing. The individual may feel unusually ‘jumpy,’ participate too much in different activities and might appear extremely irritable or agitated.

A person may suffer from the symptoms of mania or depression for most of the time, nearly each day. The symptoms may be so severe that the individual’s social or occupational functioning may deteriorate to large extent. A teenager may start getting unusually low grades at school, an adult might do lesser work at the job. Their social lives may also feel the wrath of this disorder and its associated mood swings.

An individual suffering from mood swings may experience extreme changes in energy, feeling too high during a mania episode and too low during a depressive episode. They may also exhibit changes during sleep and activity periods. It is possible that a person suffering from this disorder may have long lasting episodes of acute depression or mania.

People suffering from this mood disorder tend to have intense emotional states that may appear as unusual and bizarre to people around them. They may have ‘mood episodes,’ wherein they may feel overly happy and joyful during the manic episode and extremely sad and hopeless during the depressive episode. Moreover, these moods are alternating and some may present combined symptoms of both the episodes. This is called the mixed state. These episodes generally alternate over a period of time.