What are the early signs of bipolar disorder in adults?

Short answer: early signs often show up as distinct periods of unusually high energy, activity or irritability (mania/hypomania) alternating with periods of low mood, low energy and loss of interest (depression). Many early signs are subtle and can be mistaken for stress, personality traits, substance effects, ADHD or ordinary mood swings — a clinical evaluation is required for diagnosis.

Common early warning signs

Manic or hypomanic signs (elevated/activated mood)
- Noticeably increased energy, activity or restlessness
- Decreased need for sleep (feels rested after 3–4 hours)
- Unusually talkative, rapid speech or pressured speech
- Racing thoughts; jumping quickly between topics
- Increased goal-directed activity (work, social, sexual) or agitation
- Excessive involvement in risky activities (spending sprees, impulsive sex, risky investing)
- Overconfidence, grandiose ideas, or unusually optimistic plans
- Distractibility and poor judgment
- Increased irritability or aggression (especially in mixed states)

Depressive signs
- Persistent low mood, sadness or emptiness
- Loss of interest or pleasure in usual activities
- Fatigue, low energy or slowed thinking
- Sleep changes (insomnia or oversleeping)
- Appetite or weight changes
- Difficulty concentrating or making decisions
- Feelings of worthlessness or excessive guilt
- Recurrent thoughts of death or suicide

Mixed features and other clues
- Experiencing symptoms of mania and depression at the same time (e.g., racing thoughts while feeling hopeless and suicidal)
- Rapid changes in mood over hours to days rather than weeks
- Early onset in late teens or early adulthood (common), family history of bipolar disorder
- Repeated depressive episodes that respond poorly to standard antidepressants (antidepressants can sometimes trigger mania)
- Co-occurring anxiety, substance use, or sleep problems

Timing and diagnostic notes
- Mania (DSM-5): distinct period of abnormally elevated or irritable mood + increased activity/energy lasting at least 1 week (or any duration if hospitalization required).
- Hypomania: similar but shorter and less severe, lasting at least 4 days and not causing major functional impairment.
- Major depressive episodes: symptoms lasting at least 2 weeks.
- Only a trained clinician can make an official diagnosis.

What to do next
- If you are feeling suicidal or are a danger to yourself or others, seek emergency help immediately (call your local emergency number or crisis line).
- Make an appointment with a primary care provider or a mental health specialist (psychiatrist or psychologist) for assessment.
- Track mood, sleep, activity, and risky behaviors — a mood diary can help clinicians see patterns.
- Bring family history and any past episodes or hospitalizations to the appointment.
- Screening tools (e.g., Mood Disorder Questionnaire) exist but are only the start of an evaluation.

Treatment overview (why early recognition matters)
- Effective treatments (mood stabilizers like lithium, some antipsychotics, psychotherapy, sleep and routine stabilization) reduce symptoms and lower relapse and suicide risk.
- Early recognition and treatment improve functioning and quality of life.

If you want, I can:
- Suggest questions to bring to a clinician
- Describe what a psychiatric assessment looks like
- Provide a simple mood-tracking template

Would you like any of those?