What Is Manic Depression?

Medically reviewed by Elizabeth Erban, LMFT, IMH-E
Updated March 21, 2023by BetterHelp Editorial Team

Content Warning: This article briefly mentions suicide. If you are thinking about suicide, considering harming yourself or others, feeling that any other person may be in any danger, or if you have any medical emergency, you must immediately call the emergency service number (1-800-273-8255 in the US and 0800-689-5652 in the UK) and notify the relevant authorities. Seek immediate in-person assistance.

Manic depression, an older term for bipolar disorder, is a common but serious mental illness that is characterized by large swings in emotions. Low moods and energy levels are typical for many during the depressive swings of bipolar disorder, whereas markedly high moods and energy levels are common during manic episodes. Manic depression is treatable, and many find that their emotional swings are stabilized through a combination of medications and therapy. 

Therapy Can Improve Your Mood Stability And Overall Wellbeing

People diagnosed with bipolar disorder may experience intense emotional shifts that can dramatically alter how they feel, think, and act. Shifting episodes occurring four or more times per year are classified as rapid cycling, though some people with manic depression can experience daily oscillations in mood. Experiencing rapid cycling does not mean the pattern is permanent or lifelong, and adjustments in treatment plans may be able to effectively reduce the occurrence of rapid cycling. 

Depressive Episodes

Sadness is a common emotion for most people, but people experiencing depressive episodes describe periods of negative thoughts that extend beyond general sadness. A five-year study found that it takes individuals in a depressive cycle 11 weeks, on average, from the time of initial symptoms of depression to return to a state without diagnosable depression. Many people experiencing a depressive episode experience some of the following symptoms:  

  • Difficulty focusing
  • Low energy and/or motivation
  • Trouble sleeping or oversleeping
  • Little interest in activities that were once enjoyable
  • Feeling lonely, worthless or both
  • Change in eating habits
  • Feeling extended periods of sadness or unhappiness
  • Isolating behavior from friends and loved ones
  • Thoughts of suicide

Manic Episodes

During depressive episodes, many people with bipolar disorder may experience symptoms of major depressive disorder. During manic episodes, however, symptoms are different.  

Symptoms of manic episodes might include:

  • Impulsive decision-making
  • Racing thoughts or speaking quickly
  • Experiencing high levels of energy
  • Delusions of grandeur
  • Engaging in risky behaviors
  • Feeling extremely confident, excited, or irritable
  • Needing less sleep
  • Experiencing paranoia and/or hallucinations

Though heightened energy levels may sound like a positive emotional change to some, many people experience irritability, anger, and a lack of control that can be challenging to manage.  


Psychosis is a term that describes hallucinations and grandiose delusions. Studies suggest that half of individuals diagnosed with bipolar disorder may experience some degree of psychosis within their lifetime. Individuals experiencing psychosis may be misdiagnosed as schizophrenic, and this may be particularly common amongst Black and Hispanic individuals. A medical doctor should evaluate you in person, taking a careful history to make an accurate diagnosis. 

Assessment standards for bipolar disorder in adults and children has improved significantly within the past decade. During assessment, a medical doctor (such as a psychiatrist), will evaluate mood fluctuations and determine if you meet the criteria for any type of bipolar disorder. These include Bipolar I (manic depressive), or Bipolar II (major depression and less severe hypomanic cycles). A doctor may diagnose you with another type of bipolar disorder or a related disorder. In children, it can be more challenging to diagnose bipolar disorder because it’s more common for them to experience episodes with symptoms of both mania and depression, called “mixed episodes.”

How Do Mood Swings Work?

Though many people living with diagnosed bipolar disorder experience symptoms that enable early detection of a bipolar episode, mood swings can be unpredictable. They may occur gradually, or they can occur abruptly, and they can last for hours, weeks, or months at a time. As described by Dr. David A. Merrill for Forbes Health, reoccurrence of mood swings is “the expectation, not the exception” because the disorder is characterized by these mood oscillations. A therapist can help you work to recognize overstimulation and things that may make the occurrence of episodes more likely, and you can keep a mood journal to document how your emotions change over time. 


Though there is not always a trigger for a manic or depressive episode, there can be. Changing jobs, living situations, or adjusting (or halting) medication can all be triggers. Other things, such as drug or alcohol use, traumatic experiences, changes in relationship status, lack of quality sleep, or anything else that causes heightened stress or excitement can initiate an episode. You can familiarize yourself with some of the common warning signs of a potential manic or hypomanic episode to help yourself possibly better mitigate and manage them.  

Therapy Can Improve Your Mood Stability And Overall Wellbeing


Bipolar disorder is a long-term, cyclical disorder, so long-term treatment is recommended for most people. A mixture of psychotherapy and medications, such as mood stabilizers, are typically recommended. 

Medication requires careful management from a physician who is experienced in treating bipolar disorder. For example, some people may find it difficult to adhere to their medication treatment plan during phases of mood swings. In these cases, there are medication approaches that can be helpful in reducing rates of “breakthrough symptoms.” Additionally, antidepressant use is not recommended for patients with diagnosed bipolar disorder, so if you have previously been diagnosed with depression and prescribed antidepressants, your care provider may seek to change your medications or you can discuss doing so with them. 

Therapy can be a helpful strategy for people with bipolar disorder to improve wellbeing and life satisfaction. You may find therapy modalities such as interpersonal and social rhythm therapy (IPSRT) and FFT may be helpful.

An online therapist can help you learn about your disorder and develop the tools to recognize and navigate your symptoms. Cognitive behavioral therapy (CBT) is effective in reducing the severity of mania and rate of relapsing for people with bipolar disorder. A 2017 study of online CBT, which is offered from sites like BetterHelp, found that it is effective in managing symptoms of bipolar disorder. Additionally, online therapy can be less costly for some, and you may find it easier to stick with therapy sessions because it’s often more convenient.


Bipolar disorder, formerly called manic depression, is very common. Symptoms are characterized by significant mood swings, and an in-person physician can provide a diagnosis and treatment plan to help you manage your disorder. Online therapy can be an effective part of your strategy to manage your symptoms and recognize early signs of a manic or depressive episode. 

You Don’t Have To Face Depression Alone. Our Experienced Counselors Can Help.

The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
You don't have to face depression aloneGet Started