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Bipolar disorder involves shifts in mood, energy, and activity that go beyond the everyday ups and downs most of us experience. These shifts can include periods of elevated or irritable mood, sometimes referred to as mania or hypomania, alongside periods of low mood, known as depression. At Central Minds, our psychologists regularly support individuals living with bipolar disorder, and we understand how disorienting it can feel when your mood, thinking, and energy seem to change without warning.
The two most commonly diagnosed forms of Bipolar Disorder are Bipolar I Disorder and Bipolar II Disorder. They share some features, but differ in the type and intensity of the mood episodes involved. Recognising the symptoms is often a meaningful first step towards making sense of what you, or someone you care about, may be experiencing.
Physical Symptoms of Bipolar Disorder
Bipolar disorder is often thought of as a mood condition, but the physical experience of each episode plays an equally significant role. Sleep, energy, and physical activity levels typically shift in line with each mood episode.
Physical Symptoms During Manic or Hypomanic Episodes
- A reduced need for sleep, where you may feel rested after only a few hours and find it difficult to wind down
- Noticeably increased energy, sometimes alongside restlessness or feeling driven to keep busy
- Rapid speech, where words come quickly and others may find it difficult to interject
- Increased physical activity, such as taking on multiple tasks, projects, or social plans at once
- Changes in appetite
- Heightened sensory awareness, where sounds, lights, or colours may feel more vivid than usual
Physical Symptoms During Depressive Episodes
- Persistent tiredness or low energy, even after a full night’s sleep
- Sleep changes, including sleeping much more than usual or having difficulty falling and staying asleep
- Slowed movement and speech, where everyday activities can take a lot of effort
- Changes in appetite or weight
- Aches, pains, or general physical discomfort without an obvious medical cause
- Reduced interest in activities you previously enjoyed
If you are noticing physical symptoms that feel new or unfamiliar, it can be worth speaking with a medical doctor first to rule out other health conditions that may produce similar symptoms.
Psychological and Emotional Symptoms of Bipolar Disorder
Bipolar disorder is often most recognisable through the emotional and cognitive shifts that accompany each mood episode.
Emotional Symptoms During Manic or Hypomanic Episodes
- An unusually elevated, expansive, or euphoric mood that may feel exhilarating in the moment
- Increased irritability or impatience, particularly when things do not go according to plan
- Inflated self-confidence, sometimes including beliefs about your abilities that others find difficult to relate to
- Racing thoughts, where ideas come faster than you can keep up with
- Difficulty concentrating, often because attention shifts quickly from one thing to the next
- Impulsive decisions around spending, work, or relationships that may feel out of character
- A sense of being unstoppable or that everything is going particularly well
Emotional Symptoms During Depressive Episodes
- Persistent low mood, sadness, or emotional flatness
- A loss of interest or pleasure in activities you usually enjoy
- Feelings of worthlessness or guilt that may feel disproportionate to the situation
- Difficulty concentrating, remembering things, or making decisions
- A sense of hopelessness about the future
- Withdrawal from social contact, work, or daily routines
It is also common to experience anxiety or stress alongside bipolar mood episodes. A psychologist can help you understand which symptoms relate to bipolar disorder and which may be linked to something else.
How Long Do Bipolar Episodes Last?
The length of each episode varies from person to person, and from one episode to the next. There is no definitive duration or frequency of bipolar cycles, however commonly we find that.
- Manic episodes typically last at least one week
- Hypomanic episodes typically last at least four days and are less intense than manic episodes
- Depressive episodes often last two weeks or more, and sometimes considerably longer
- Between episodes, many people experience periods of more stable mood, although some continue to notice subtle shifts
A psychologist can help you map your own pattern over time, which is often an important part of psychotherapy for bipolar disorder.
Common Signs of Bipolar Disorder
The signs below may help you identify whether what you are experiencing is consistent with bipolar disorder, rather than another condition.
| Sign | What It May Look Like |
| Distinct mood episodes | Periods of elevated or low mood that feel noticeably different from how you usually feel |
| Changes in sleep and energy | Sleeping much less or much more than usual |
| Periods of high activity followed by low | Bursts of productivity, creativity, or sociability followed by extended periods of low mood and withdrawal |
| Impact on daily life | Difficulty maintaining relationships, work, or routines because of mood episodes |
Mood swings and bipolar disorder are sometimes confused. The key difference is that episodes of bipolar mood tend to last for days or weeks at a time, rather than shifting from hour to hour, and they typically involve broader changes in energy, sleep, and behaviour. A psychologist can help you understand what is happening in your specific case.
How Symptoms of Bipolar Disorder Can Change Over Time
Bipolar disorder does not always present the same way throughout a person’s life.
- Symptoms often first appear in late adolescence or early adulthood, although they can begin at other times
- The frequency, length, and intensity of episodes can vary across the years
- Some people experience long periods of stable mood between episodes, while others notice more frequent shifts
- Triggers such as significant life changes, sleep disruption, or sustained stress can sometimes precede an episode
- Co-occurring experiences, such as anxiety or depression outside of bipolar episodes, are common, and professional support can help make sense of how each condition relates to the others.
How Bipolar I and Bipolar II Differ
Bipolar I and Bipolar II are related but distinct. The table below outlines the main differences.
| Feature | Bipolar I | Bipolar II |
| Hypomanic episodes | May occur | Present, lasting at least four days |
| Depressive episodes | Often present, though not required for diagnosis | Present, often more frequent and longer than the high-mood episodes |
| Intensity of high-mood episodes | More noticeable, with greater impact on daily functioning | Less intense, sometimes mistaken for periods of high productivity |
| Recognition | Often recognised earlier because manic episodes are more visible | Recognition sometimes comes later, especially when hypomania is misinterpreted as part of a person’s personality |
Both types can be supported through psychological therapy, often alongside input from a psychiatrist where medication is helpful. You can read more about the difference between a psychologist and a psychiatrist on our FAQ page.
You May Benefit From Support If…
It’s common to feel uncertain about whether you need professional support. Here are a few signs that might help you decide.
- You have noticed periods of elevated mood, energy, or activity that feel distinctly different from how you typically feel
- You have experienced periods of low mood, low energy, or loss of interest that lasts two weeks or longer
- Your mood shifts are affecting your relationships, work, or daily routines
- You have made decisions during high-mood periods that you later found difficult to understand
- Friends, family, or colleagues have shared observations about changes in your mood or behaviour
- You suspect you may have bipolar disorder but have not had the opportunity to speak with a professional
- You have an existing diagnosis and would like additional support alongside your current care
Our Psychologists Who Work With Bipolar Disorder
Dr. Sharmeen Shroff
Clinical Psychologist
With over 14 years of experience, Dr Shroff has worked in community mental health centres, private psychology clinics, medical clinics and both outpatient and inpatient units in hospitals in Hong Kong, the United Kingdom and the USA. She is one of the few clinical psychologists in Hong Kong that have been intensively trained to practice psychotherapy from a psychodynamic depth perspective.
Dr. Kaili Chen
Clinical Psychologist
Dr. Chen has worked in the field of psychology since 2010 in several non-profit organizations and community mental health centers. Before settling in Hong Kong, she has lived in Singapore, Thailand, Malaysia, China, and the United States, and understands firsthand the stresses expats face living abroad and the intricacies of multicultural lifestyles.
Dr. Christine Mok-Lammé
Clinical Psychologist
Dr. Mok-Lammé is a US trained clinical psychologist licensed in the States of Colorado and Massachusetts. She has worked in the field of psychology in various settings since 2012. She has a wealth of experience working with adults who face difficulties due to complex traumas, challenging family dynamics, and relationship problems.
Michael Beckham
Clinical Counsellor
Michael Beckham is a US-trained and licensed psychotherapist with 20 years of experience specialising in anxiety, couples counselling, intimacy, relationship dynamics, self-esteem, problem-solving, sexual exploration, and existential issues. Michael assists his clients to have more clarity on themselves, more clarity on the world, and more clarity on themselves in the world.
Dr. Melissa Chan
Clinical Psychologist
Dr. Chan is a UK trained Clinical Psychologist, who has worked in the field of mental health taking up clinical and research roles in the community and academic settings for ten years. She is experienced in treating people with symptoms of depression and anxiety disorders (e.g. social anxiety, bipolar tendencies etc). She also works with people who are struggling with low self-esteem, stress, grief and bereavement, adjustment difficulties.
Dr. Karen Wai Liem
Clinical Psychologist, Counselling Psychologist, and Aviation Psychologist
Dr. Liem is a Clinical Psychologist, Counselling Psychologist, and Aviation Psychologist based in Hong Kong. She provides psychotherapy for adolescents adults facing psychological or relational challenges. With over 15 years of clinical experience in Hong Kong and overseas, she has worked in diverse settings.
Dr Elaine Ching
Clinical Psychologist
Dr. Ching is a UK trained Clinical Psychologist, offering support to adults with difficulties around anxiety, low mood, stress and burnout, self-esteem, childhood or event specific trauma, interpersonal relationships, and life adjustments (e.g. relocation, grief, chronic physical health, third culture kids). She also has experience with individuals with individuals with emotional
dysregulation and high sensitivity (HSP).
Dr. Edward C. K. Lam
Clinical Psychologist
Edward is a U.S.-trained and licensed Clinical Psychologist in the state of Massachusetts, now bringing his expertise to Hong Kong. With extensive experience across various settings, Edward has helped clients become stronger, more independent, and resilient in the face of challenges. He creates a supportive and non-judgmental environment where clients can explore their struggles and engage more fully in life.
Dr Steven Livingstone
Clinical Psychologist & Systemic Family Therapist
Dr Steven Livingstone is a UK-trained Consultant Clinical Psychologist and qualified Family Therapist with over 20 years’ experience working in the National Health Service and academia. Steven’s clinical work is rooted in systemic and relational approaches, helping individuals, couples, and families make sense of distress in the context of their relationships and life experiences. He draws on evidence-based models including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Open Dialogue, integrating these with compassion-focused and mindfulness-informed principles.
FAQs About The Symptoms Of Bipolar Disorder
Is bipolar disorder the same as having mood swings?
No. Everyday mood swings are common and tend to be brief, often linked to a specific situation. Episodes of Bipolar Disorder typically last for days or weeks at a time and involve broader changes in sleep, energy, thinking, and behaviour. A psychologist can help you understand whether what you are experiencing fits the pattern of bipolar disorder, or relates to something else, such as mood swings linked to stress or other factors.
Can bipolar disorder be diagnosed by a psychologist?
A clinical psychologist can carry out a thorough assessment of your symptoms, history, and patterns, which can be a helpful step towards understanding what you are experiencing. Where a clinical diagnosis or medication is being considered, a psychiatrist is typically involved as well. Many people benefit from working with both. You can read more on our bipolar disorder expertise page.
What is the difference between Bipolar I and Bipolar II?
The main difference lies in the type of high-mood episode involved. Bipolar I includes manic episodes, which are more intense and longer-lasting. Bipolar II includes hypomanic episodes, which share some features with mania but are less intense and shorter. Both types typically include depressive episodes. A clinical assessment is the most reliable way to clarify which fits your experience.
Do I need a referral to speak with a psychologist at Central Minds?
No referral is needed to contact us directly. However, if you are planning to use insurance, we recommend checking with your provider beforehand, as some insurers do require a referral letter. You can find more information on our insurance and fees FAQ.
How is bipolar disorder treated?
Bipolar disorder responds well to a combined approach. Psychological therapies, including Cognitive Behavioural Therapy (CBT), psychodynamic therapy, and family-focused approaches, can help people understand their patterns, recognise early warning signs, and develop practical strategies for managing mood episodes. Medication, prescribed by a psychiatrist, is often part of care as well. Our psychologists work alongside each person to develop an approach that fits their needs. You can contact us to discuss what might be appropriate for your situation.
Can symptoms of bipolar disorder appear later in life?
While bipolar disorder most commonly first appears in late adolescence or early adulthood, symptoms can sometimes emerge later. Significant life events, sustained stress, or sleep disruption can sometimes coincide with the appearance of symptoms. A psychologist can help you make sense of what you are noticing, whenever it begins.
