Bipolar illnesses comprise of depressive episodes, as well as, distinct manic episodes. And briefly in a manic episode it can be thought short hand as the opposite of depression. When somebodies depressed they think nothings going to work out with them and everything is doomed to failure. Where as, in the height of a manic episode these individuals think they can't possibly fail and they tend to discount any negative consequences. And while it can be good to have this level of confidence when it departs from reality it leaves these individuals to take risks that lead to bad outcomes and bad consequences. Other details of manic episodes are a flight of ideas, or in other words, individuals have a rapid sequence of ideas that are crashing into one another. And this can manifest into what we call pressured speech where these individuals will speak very rapidly, want to keep talking, and at the extreme can be almost impossible to interupt. Usually these episodes end up with individuals getting into some kind of trouble that leads them into treatment, but if somehow they manage to avoid getting arrested or ending up in the emergency room these episodes will be self limited and will eventually burn themselves out, but it's the decreased need for sleep that often causes these illnesses to get worse because when you have sleep deprivation it can lead to psychotic symptoms that can be associated with manic episodes. And often these psychotic symptoms are the things that get these patients into trouble. And it's very important to keep in mind that bipolar disorder does not refer simply to having mood swings as people often think. If a person is moody it doesn't mean that they have bipolar disorder. Bipolar disorder consists of having specific episodes of mania which can be diagnosed by a psychiatrist. Generally speaking people who have bipolar disorder do need medications to manage their symptoms. So, it's very important that individuals are evaluated and stay in treatment with a psychiatrist.