Clinically reviewed by Bülent Ada, BSc.(Psychol.)(Hons.), MAPS · Updated August 2025

Bipolar disorder is one of the most misunderstood conditions in mental health. It is routinely confused with personality, dismissed as “just mood swings”, or used colloquially to describe someone who is simply changeable or unpredictable. None of these captures what bipolar disorder actually is — or what it is actually like to live with.

In Australia, approximately 2–3% of the population will experience bipolar disorder at some point in their lives. The average time between first experiencing symptoms and receiving an accurate diagnosis is around nine years. During that period, people are often misdiagnosed with depression, anxiety, ADHD, or personality disorder — receiving treatments that, without addressing the full picture, may have limited effect.

This article aims to provide a clear, accurate, and compassionate introduction to bipolar disorder — what it involves, who it affects, and how effective support looks in Australia.

What Is Bipolar Disorder?

Bipolar disorder is a mood disorder characterised by significant episodes of elevated or expansive mood (mania or hypomania) alternating with episodes of depression. The pattern, severity, and frequency of these episodes varies considerably between individuals.

Crucially, bipolar disorder is not simply about having a wide emotional range. The mood episodes in bipolar disorder are distinct from ordinary emotional variation — they are sustained, they significantly impair functioning, and they are not always triggered by life events.

Types of Bipolar Disorder

Bipolar I Disorder

Bipolar I is defined by the presence of at least one manic episode — a period of abnormally elevated, expansive, or irritable mood lasting at least seven days (or less if hospitalisation is required), with increased goal-directed activity or energy.

During mania, a person may:

• Feel unusually energised, euphoric, or “on top of the world”
• Require significantly less sleep without feeling tired
• Talk more than usual, with racing or pressured thoughts
• Show impulsive or reckless behaviour (spending sprees, risky sexual behaviour, poor financial decisions)
• Have grandiose beliefs about their abilities, significance, or mission
• Experience psychotic symptoms in severe episodes (delusions, hallucinations)

Manic episodes often cause significant disruption to relationships, finances, work, and health. Some episodes require hospitalisation. Major depressive episodes typically also occur in Bipolar I, though they are not required for the diagnosis.

Bipolar II Disorder

Bipolar II involves hypomanic episodes — similar to mania in quality, but less severe and shorter in duration (at least four days), without the functional impairment or psychotic features of full mania — plus at least one major depressive episode.

Hypomania can feel positive. People often describe increased energy, productivity, creativity, and sociability. This is one reason Bipolar II is underdiagnosed — the hypomanic episodes don’t feel like a problem, only the depression does. When someone presents to a GP or psychologist with depression alone, the hypomanic history may not be disclosed or explored.

This matters because treating Bipolar II depression with antidepressants alone, without mood stabilisation, can trigger hypomanic or mixed episodes.

Cyclothymic Disorder

Cyclothymia involves numerous periods of hypomanic symptoms and depressive symptoms (neither meeting full criteria for a hypomanic or major depressive episode) over at least two years. The cycling is more chronic and persistent, without the clear episode boundaries of Bipolar I or II.

Common Misconceptions

“Bipolar just means having mood swings.” Ordinary mood variation is part of being human. Bipolar disorder involves distinct episodes of altered mood state that last days to weeks, not hour-to-hour emotional shifts.

“Everyone is a bit bipolar.” No. The term has entered colloquial language in a way that trivialises a serious condition and contributes to stigma.

“People with bipolar can’t lead stable, successful lives.” This is false. With appropriate treatment and support, most people with bipolar disorder can live full, meaningful, productive lives. Many prominent Australians and global figures have spoken publicly about living with bipolar disorder.

“Bipolar means you’re dangerous or unpredictable.” Bipolar disorder does not make someone violent or dangerous. People with bipolar disorder are far more likely to be victims of harm than perpetrators.

The Diagnostic Journey in Australia

Because bipolar disorder can look like depression, anxiety, ADHD, or personality disorder — and because the elevated mood phases may not seem like a problem — the diagnostic journey is often long and frustrating.

A thorough assessment by a psychiatrist is typically required for a bipolar diagnosis. This involves:

• A comprehensive psychiatric history, including mood episode history
• Family history (bipolar disorder has a strong genetic component)
• Ruling out medical causes (thyroid conditions, substance use, medications)
• Information from family members where possible and consented

If you are concerned you may have bipolar disorder — particularly if you have been treated for depression without significant improvement, or if you recognise hypomanic experiences in your history — it is worth discussing this specifically with a psychiatrist or your GP.

How Bipolar Disorder Is Treated

Medication

Medication plays a central role in bipolar disorder management. Mood stabilisers (lithium, valproate, lamotrigine) and atypical antipsychotics are commonly prescribed to reduce the frequency and severity of episodes. Finding the right medication combination can take time and requires close monitoring.

Medication decisions are made by a psychiatrist. It is important not to stop medication without medical guidance, even when feeling well.

Psychological therapy

Psychological therapy is an important complement to medication in bipolar disorder management. The most researched approaches include:

Psychoeducation — helping the person (and their family) understand the condition, recognise early warning signs, and develop a relapse prevention plan. Research consistently shows psychoeducation reduces episode frequency and hospitalisation rates.

Cognitive Behavioural Therapy for Bipolar Disorder (CBT-BD) — adapted CBT focusing on mood monitoring, identifying triggers, modifying unhelpful cognitions during episodes, and maintaining structure and routine.

Interpersonal and Social Rhythm Therapy (IPSRT) — focuses on stabilising daily routines and sleep-wake cycles, which research suggests play an important role in mood regulation in bipolar disorder.

Family-focused therapy — involves significant others in understanding the condition and improving communication and problem-solving.

A clinical psychologist can provide evidence-based psychological support as part of a broader treatment team that typically includes a psychiatrist and GP.

Lifestyle factors

Consistent sleep and waking times, regular exercise, reduced alcohol and caffeine, stress management, and maintaining social connections are all evidence-supported factors in mood stability for people with bipolar disorder.

Resources

• Black Dog Institute — blackdoginstitute.org.au (research and resources on bipolar disorder)
• Beyond Blue — 1300 22 4636
• Bipolar Australia — bipolaraustralia.org.au (peer support and resources)
• SANE Australia — sane.org | 1800 187 263 (mental health support line)

Frequently Asked Questions

What is bipolar disorder?

Bipolar disorder is a mood disorder marked by significant episodes of elevated mood (mania or hypomania) alternating with episodes of depression. These episodes are sustained, distinct from ordinary emotional variation, and significantly impair functioning. The pattern, severity and frequency vary between individuals. It is not simply having a wide emotional range or being changeable from hour to hour.

What is the difference between Bipolar I and Bipolar II?

Bipolar I is defined by at least one full manic episode lasting around a week or requiring hospitalisation, often with depressive episodes too. Bipolar II involves hypomanic episodes, which are less severe and shorter, plus at least one major depressive episode. Hypomania can feel productive, which is one reason Bipolar II is frequently underdiagnosed until the depression is treated.

Why is bipolar disorder so often misdiagnosed?

Bipolar disorder can resemble depression, anxiety, ADHD or personality disorder, and the elevated phases may not feel like a problem, so people often present with depression alone. As a result, the average time to an accurate diagnosis is around nine years. If depression has not improved with treatment, or you recognise hypomanic periods, raise this specifically with a psychiatrist or GP.

How is bipolar disorder treated?

Medication, particularly mood stabilisers and sometimes atypical antipsychotics prescribed by a psychiatrist, plays a central role. Psychological therapy complements this, including psychoeducation, CBT adapted for bipolar disorder, Interpersonal and Social Rhythm Therapy, and family-focused therapy. Consistent sleep, routine, reduced alcohol and stress management also support stability. It is important not to stop medication without medical guidance.

Can people with bipolar disorder live normal lives?

Yes. With appropriate treatment and support, most people with bipolar disorder live full, meaningful and productive lives. The belief that they cannot is a misconception that contributes to stigma. Bipolar disorder also does not make someone dangerous; people living with it are far more likely to be harmed than to harm others.

Related reading

• Bipolar disorder support services
• Depression versus sadness
• What a psychological assessment involves

About the author: Bülent Ada is the Principal Psychologist and Founding Director of Mind Health Associates in Parramatta, Sydney. With over 20 years of clinical experience, Bülent works with individuals experiencing mood disorders, depression, anxiety, and trauma. Learn more about Bülent.

This article is for informational purposes only and is not a substitute for professional mental health advice. Bipolar disorder requires specialist assessment and treatment. If you are concerned about your mental health, please speak with your GP or a mental health professional.

Ready to take the next step? Mind Health Associates offers evidence-based psychological support in Parramatta and via telehealth across Australia. Contact us to enquire about appointments.