Sketch of Bipolar Disorder

Look for seasonal changes in mood.

It's common for people with bipolar disorder to experience a shift as the seasons change. In some cases, a manic or depressive episode will last an entire season. In other cases, the change in season prompts the beginning of a cycle that includes both mania and depression.

• Manic episodes are more common in the summertime. Depressive episodes are more common in the fall, winter and spring. This is not a hard and fast rule, however; some people experience depression in the summer and mania in the winter.

Understand that having bipolar disorder doesn't always impair functionality. Some people with bipolar disorder have trouble at work and in school. In other cases, the person may seem to be doing just fine in these areas.

• Those with bipolar II and cyclothymia can often function at work and school. Those with bipolar I tend to have a harder time in these areas.

Be aware of substance abuse issues. Up to 50 percent of people who suffer from bipolar disorder struggle with substance abuse. They use alcohol or other tranquilizers to stop racing thoughts during manic episodes. They may also use drugs to try to achieve a high when they're in a depressive episode.

• Substances like alcohol have their own effects on mood and behavior. They can be difficult to distinguish bipolar disorder.


• People who abuse drugs and alcohol are at greater risk of suicide. This is because substance abuse can increase the severity of both mania and depression.


• Substance abuse may also instigate a cycle of manic depression.

Notice breaks from reality. People with bipolar disorder are often out of touch with reality. This occurs both during periods of extreme mania and periods of severe depression.

• This can manifest as either a dangerously inflated ego or a sense of guilt that is not in proportion to real events. In some cases, psychosis and hallucinations occur.


• Breaks from reality happen most frequently in bipolar I during manic and mixed episodes. They occur less often in bipolar II and almost never in cyclothymia.