Not just mood swings: Early signs of bipolar disorder people often miss, says doctor

Bipolar disorder is commonly associated with dramatic mood swings — from extreme highs to deep lows. However, mental health experts say the early signs are often far more subtle, making the condition difficult to identify in its initial stages.

According to Dr Srinivas Rajkumar T, Consultant Psychiatrist at Mind & Memory Clinic, Apollo Clinic, early symptoms of bipolar disorder can easily be mistaken for stress, personality traits or even a phase of increased productivity.

“People often assume bipolar disorder means obvious emotional extremes. In reality, the early indicators can be mild and easy to overlook,” he explains.

However, experts stress that it is not a single symptom but a pattern over time that should be monitored — particularly changes in sleep, energy levels and behaviour.

Dr Rajkumar points out a crucial distinction: unlike insomnia, where a person feels tired despite not sleeping enough, individuals in the early stages of bipolar disorder may sleep very little yet feel unusually energetic.

This pattern — reduced sleep without fatigue — is often overlooked but can be a key indicator of a hypomanic phase.

While this may initially seem like improved efficiency, it can also be accompanied by distractibility — difficulty focusing on a single task or completing what has been started.

Contrary to popular belief, this phase does not always involve happiness. Instead, some individuals may experience irritability or heightened emotional responses rather than a consistently elevated mood.

Dr Rajkumar explains that individuals may develop an inflated sense of confidence during this phase, often failing to recognise the risks associated with their actions. As a result, the behaviour may continue unchecked for some time.

Typically, stress leads to fatigue, reduced productivity and disrupted sleep. In contrast, early bipolar episodes — particularly hypomanic phases — are marked by decreased need for sleep combined with increased productivity and activity.

“These differences are subtle but important,” the doctor notes.

This delay in recognition can lead to missed opportunities for early intervention.

Early intervention can help prevent the progression to more severe episodes and enable better management of the condition through therapy, medication and lifestyle adjustments.

“If someone notices frequent changes in sleep, energy or behaviour, it is important to seek professional help,” Dr Rajkumar advises.

Recognising these signs early, rather than dismissing them as temporary phases or stress, can make a meaningful difference in diagnosis and treatment.