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Keeping tabs on your symptoms of mania and depression can help stop a bipolar episode before it starts. A good way to track those mood swings is in a mood diary.

Subtle changes in your personality might not seem like a big deal to you, but they can be an important warning sign when it comes to predicting an episode of bipolar disorder.

Do you find that you’re more excitable, more carefree with your money, more likely to start staying up late or binging on junk food before an episode of mania? Before a bout of depression, do you start sleeping too much or staying home instead of going out with friends? Whatever the warning signs of a bipolar episode are for you, tracking your mood swings in a diary can help you pinpoint when an episode is likely to occur.

“A mood diary is incredibly helpful, and I always encourage people with bipolar disorder to use one,” says Adele C. Viguera, MD, a psychiatrist and the director of women’s mental health at the Cleveland Clinic in Ohio. “It’s hard when you’re with your doctor to remember what it was like over the last month.”

Dr. Viguera says that a mood diary can help both you and your doctor manage bipolar disorder. “On a day-to-day basis, you’re in tune with how you’re doing, and you can take better care of yourself,” she says.

How a Mood Diary Can Help

Since taking care of yourself is top priority, every little thing that you can do helps. Keeping a bipolar mood diary can actually help you maintain healthy habits and ward off a bipolar episode. “When having another episode is constantly in your awareness, you’re less likely to do things that are self-destructive,” Viguera says.

A mood diary can also help you make better choices, Viguera says. You can identify bipolar episodes earlier, which allows for earlier treatment. You can use the diary as a way to talk to your doctor, so the two of you can figure out what’s going on and what you can do about it, she says.

Tracking Mood Swings

Viguera suggests that keeping a calendar to note how you’re feeling on a particular day is a good start. She says to devise a simple rating system of your symptoms for a particular day. For example, a “1” can denote a good day, while a “5” may indicate a bad day. As those ratings accumulate, it can show patterns of your symptoms that may help determine what’s causing them.

“There are some calendars that are devised just for people with bipolar disorder, where you can chart if you’re on the upside or the downside,” she says. “Then, your doctor will have a pattern of how you’ve been doing and can look at the course of your symptoms over time.” Online mood trackers are also available.

Bipolar Symptoms: What to Write Down

To get started keeping your diary of bipolar symptoms and mood swings, Viguera offers these ideas to help you figure out what to track and record:

• Your sleep patterns, whether too much or not enough
• Your anxiety levels
• Your mood
• Changes in your diet, including different foods and how much you eat
• Changes in menstruation for women
• Relationships and changes or problems in them
• Stressors like a move, a new job, or a new baby

Any of these changes can indicate an alteration in your mental health, and major stressors may be behind them. Tracking these symptoms can make it easier for you and your doctor to piece together the clues that may suggest when a bipolar episode is on the horizon.

Some people with bipolar disorder who experience episodes of mania can also have psychotic symptoms like delusions and paranoia.

People with bipolar disorder may have many different symptoms, including depression, joy, hypersexuality, and even psychotic symptoms like delusions or paranoia. These are all symptoms of one condition — not separate conditions that a person has to deal with.

Bipolar disorder makes the mind swing between different thoughts and emotions, so it’s difficult to know what to expect. But if medication and therapy can manage bipolar disorder, psychotic symptoms stay under control, too.

Psychotic symptoms occur most often during manic episodes, says Adele C. Viguera, MD, a psychiatrist and the associate director of the perinatal and reproductive psychiatry program at the Cleveland Clinic in Ohio. But people can also experience psychotic symptoms during episodes of depression.

Typically, “patients are hospitalized if they have psychotic symptoms,” says Dr. Viguera. They may have “grandiose delusions — think they’re Christ or they have powers. Or, that they have a special connection with the universe and they can feel people’s pain.”

“You see that typically in mania,” says Viguera, but “people can be so depressed that they can be psychotically depressed. It happens [more] frequently with mania [than with] depression.” People may seem like they are out of touch with reality — and are in danger of hurting themselves.

Treating Psychotic Symptoms

Viguera says people experiencing psychosis immediately receive antipsychotic medications and a mood stabilizer. “Generally it’s for the acute period of time — once they’re better from that acute episode, we’ll generally take them off of that,” says Viguera, although some of those medications may also be used as a maintenance treatment.

Examples of antipsychotics include olanzapine (Zyprexa) — usually given along with an antidepressant medication — quetiapine (Seroquel), and risperidone (Risperdal). Mood stabilizers include lithium and the anticonvulsant divalproex sodium (Depakote).

The antipsychotics and mood stabilizers will stop the psychosis and keep it from coming back, Viguera says. Therapy, besides the medications, is effective in managing psychotic symptoms and bipolar disorder.

People with bipolar disorder are “not chronically psychotic,” Viguera says. Regular follow-ups with a doctor are important for managing psychotic symptoms and bipolar disorder itself, so that any recurring episodes can be spotted and stopped quickly.

Psychosis: How Family and Caregivers Can Help

Bipolar disorder is a disease that requires a long-term commitment to wellness, compliance to treatment, and monitoring. You don’t take a pill and it just goes away. While symptoms can be well-managed, it’s important to keep an eye on them to see if bipolar disorder symptoms start popping up again.

“It’s a kind of illness that needs constant vigilance and a good working relationship with your doctor,” says Viguera. “Patients with bipolar disorder definitely benefit from close follow-up, even if they’re well.”

And caregivers, friends, and family members can be a huge help in keeping a loved one with bipolar disorder on track. Reminding your loved one about taking his medications, making sure appointments (including counseling sessions) are kept, and encouraging healthy habits are all important tasks for caregivers and friends.

Bipolar disorder isn’t something that can or should be managed alone. The individual with bipolar disorder needs help to stay on track, and to spot symptoms that he might not be able to notice. Family can be a huge help in monitoring symptoms, and letting the doctor know of any changes or suspicious signs of an impending episode. The earlier signs are caught, the better the opportunity to prevent an episode and keep symptoms under control.

Hypersexuality, or increased sex drive, is a common manic symptom of people with bipolar disorder.

Bipolar disorder is a mood disorder that can be characterized by drastic mood swings — between feeling elated, energetic, and risky to feeling sad and disinterested. These drastic swings are called episodes of mania and depression, and they are the classic signs of bipolar disorder. Not everyone has these drastic swings; some people with bipolar disorder swing back and forth between depressive and somewhat elated states.

But when someone with bipolar disorder is having a manic episode, risky, reckless sexual behaviors and significantly increased sex drive are quite common. Hypersexual behavior is often a warning sign of a manic episode, but keeping bipolar disorder managed with medication and therapy can stop hypersexuality.

Some people with bipolar disorder may show a greater interest in sex and sexually risky behaviors than is otherwise normal for them.

Related: Bipolar Disorder and Gender

Bipolar Disorder: What Hypersexuality Means

“In general it’s a symptom of hypomania or mania — it goes with that particular mood episode,” says Adele C. Viguera, MD, a psychiatrist and associate director of the perinatal and reproductive psychiatry program at the Cleveland Clinic in Ohio.

Mania is one of the two main episodes that someone with bipolar disorder may experience; hypomania is just a milder form of mania. “Hypersexuality can be one of the characteristic symptoms for that,” says Dr. Viguera. Other symptoms include:

• Spending an excessive amount of money
• Not sleeping
• Having trouble concentrating
• Speaking quickly and in a scattered manner

Bipolar Disorder: Focus on Sex

There isn’t a clear-cut definition or criteria for being hypersexual, but for a person with bipolar disorder, it means being more focused on sex and risky sexual behaviors than they normally are. What’s significant is that there is a change or difference from normal behaviors.

People with bipolar disorder experiencing hypersexuality may:

• Have multiple sex partners
• Think about sex constantly
• Have one-night stands
• Be more interested in pornography
• Notice a difference in their sexual behaviors
• Engage in other reckless behaviors like driving too fast or gambling

Bipolar Disorder: Managing Hypersexuality

Hypersexuality with bipolar disorder isn’t a separate condition or problem that needs its own treatment — it’s a symptom of bipolar disorder. Once the bipolar disorder is successfully treated and mood swings and symptoms are under control, those hypersexual feelings will dissipate.

“You treat the disease, not the symptom,” says Viguera. Once the disease is under control, people with bipolar disorder often react differently to sex and their past behaviors.

“You often see a lot of regret for the past behavior because they put themselves in very bad situations,” says Viguera. “When they’re well, they reflect back on that and there can be a lot of regret and remorse. It’s just another clue that shows you that that was not their normal state.”

Related: Making Good Choices With Bipolar Disorder

Bipolar Disorder Treatments

Bipolar disorder is usually treated with:

• Mood-stabilizing medications
• Antipsychotic medications
• Antidepressants
• Cognitive-behavioral therapy
• Other forms of therapy and counseling that may include family members
• Electroconvulsive therapy (ECT); also called “shock therapy” because small electrical waves are used

The right combination of these various therapies can reduce or eliminate bipolar mood changes between mania and depression, and symptoms of hypersexuality will no longer be a problem.

But those symptoms of hypersexuality may be a big red flag for some people with bipolar disorder that they are slipping into a manic episode. When they start to notice themselves thinking more about sex or engaging in promiscuous behavior, it’s time to notify the doctor that symptoms are starting.

Learn about the differences between these two easily confused disorders.

Bipolar disorder and borderline personality disorder (BPD) are both mental illnesses that involve extreme mood swings. Since many BPD and bipolar symptoms overlap, these conditions are often mistaken for each other. But bipolar disorder and BPD are different illnesses, each with their own symptoms and treatments.

How BPD Differs From Bipolar Disorder

Both bipolar disorder and BPD can interfere with relationships, work or school, and the ability to lead a productive life.

In bipolar disorder, which is also called manic depression, a person experiences severe mood swings, resulting in the dramatic emotional highs of mania and the profound lows of severe depression. In BPD, on the other hand, people have both unstable moods and problems with self-image that specifically affect their ability to form healthy relationships. People with personality disorders such as BPD are often not aware that their behavior is abnormal, but their disordered personality makes it difficult for them to deal with other people.

“BPD is based around interpersonal relationships and self-image, versus bipolar disorder, which is manic highs and lows,” says Julie Walther Scheibel, MEd, a therapist based in St. Louis, Mo.

Like bipolar disorder, BPD does lead to mood swings. Unlike bipolar disorder, in which a manic or depressive episode typically lasts for at least a week, a BPD-associated mood swing usually runs its course in a few hours or up to a day.

Although more people are familiar with bipolar disorder, BPD is actually more common. It affects 2 percent of the adult population. Young women are at highest risk of developing BPD.

Symptoms of BPD include:

• Episodes of anger, depression, and anxiety
• Aggressive behavior
• Self-harm
• Drug or alcohol abuse
• Binge eating or spending
• Frequent changes in life goals
• Poor self-esteem
• Feelings of emptiness
• Fear of being alone
• Intense, but unstable relationships
• Suicide threats or suicide attempts
• Impulsiveness
• Manipulative behavior

Bipolar disorder symptoms, on the other hand, include episodic, dramatic shifts from an overly elated mood to severe depression. During manic periods, people with bipolar disorder experience excessive energy, insomnia, irritability, racing thoughts, and difficulty concentrating. While depressed episodes lead to intense sadness, inability to enjoy activities, and suicidal thoughts.

Like those with BPD, people with bipolar disorder often engage in impulsive behavior, but they don’t tend to view their relationships in the same damaging ways as people with BPD. In BPD, people often manipulate others due to distrust and a profound fear of rejection.

Since BPD often occurs along with other psychiatric illnesses, it is not unusual for a person to have both BPD and bipolar disorder.

Treatment for Bipolar Disorder vs. BPD

Treatment for bipolar disorder involves the long-term use of mood stabilizing medications. Bipolar treatment may also involve psychotherapy, which can educate a person with bipolar disorder on how to recognize an impending manic or depressive period so it can be dealt with before it becomes a full-blown episode.

Whereas the mainstay of bipolar disorder treatment is medication, treatment for BPD typically centers around psychotherapy, either group or individual therapy. Anti-depressant medications may also be prescribed, depending on the individual’s specific symptoms.

Both bipolar disorder and BPD are serious mental illnesses that should be managed by a mental health professional.