Everyone's mood fluctuates during a typical day. "It's normal to have mood swings," says Alan Manevitz, MD, clinical psychiatrist at Lenox Hill Hospital in New York City.  For an individual with bipolar disorder, however, mood swings can be so intense and extreme that they have a negative impact on daily functioning.

"Depression is somewhat familiar to people," says Michael McKee, Ph.D., clinical psychologist at the Cleveland Clinic. "You feel down and sad, have difficulty concentrating, or have problems sleeping too much or too little, or eating too much or not eating."

Depression can bring on feelings of worthlessness, hopelessness, and difficulty concentrating.

Bipolar disorder, however, has both a depressive and a manic state that can trigger such behaviors as feelings of grandiosity, a decreased need for sleep, and accelerated speech that is loud and emphatic, Manevitz says.

If you're not sure if certain which behaviors are day-to-day-routine, and which point to something more serious, here are some warning flags.

Depressive Symptoms

1. Feelings of worthlessness and hopelessness.

2. Not being able to handle the chores of everyday life, like getting out of bed and taking a shower.

3. Feelings that life is not worth living.

Manic or Hypomanic Symptoms

1. Racing thoughts. "If your thoughts are going at high speed, and you almost feel like you are high, this is not normal," says Elizabeth Sublette, MD,  Ph.D., assistant professor of clinical psychiatry at Columbia University Medical Center in New York City. "When your thoughts are going at high speed and have sort of a roller coaster quality, this is a problem."

2. Decreased need for sleep. "This is really the biggest red flag," Sublette adds. "The person feels very hyper, talkative, and full of energy, despite not having slept."

3. Intense feelings of creativity and excitement. "This feels almost like an intensification of the state that anyone would feel during a creative period," Sublette says. "But in a manic state, it is excessive. You feel as if you really are a brilliant playwright, poet, or politician." Often, she says, a person in this state will become uncharacteristically over-involved with creative projects that don't really go anywhere.

4. Irritability and anger. These negative emotions may alternate with an elevated, euphoric mood, Sublette says.

5. Extreme distractibility. Everyone gets distracted, but if your thought processes are jumping around  and it's hard to think straight, this could be a red flag, says McKee.
"It's hard to think straight or get things done," he says.

Both depression and mania should be taken very, very seriously, Sublette says. If you start feeling this way, or you see a close friend or relative in this situation, call your doctor or therapist, Sublette says.

"Or if it is really extreme, go to the emergency room of your hospital or to that hospital's psych ward," she advises.

One of the problems with treating bipolar disorder, McKee says, is that the individual doesn't think he has a problem. "The person can feel like he is on top of the world, and that he has special powers," McKee says.

If you or someone you know has bipolar disorder, get a reality check, McKee says. "Ask a close friend or someone you can confide in if they think you are getting too high or too low," he says. "It is important to be in touch with someone who can help you."

Elizabeth Sublette, MD,  Ph.D. reviewed this article.