Bipolar I and II Disorders are characterized by extreme mood swings, from highs (Hypomania or Mania) to lows (Depression). Bipolar Disorder sufferers experience extreme mood swings, energy levels, and activity. In a hypomanic state, symptoms often include high energy, extroversion, impulsive behaviors and productivity. In full-blown mania, symptoms include delusions and/or hallucinations, requiring immediate intervention. Then, mood shifts to a depressive state of sadness, lethargy, detachment, loss of pleasure and possible suicidal ideation or attempts.

In pregnant and postpartum women, bipolar depression can look just like a very severe depression, or might be experienced as anxiety. It is very important that mood history is reviewed to assess whether the mother has had times of a persistently elevated mood, decreased need for sleep, and periods of over-average productivity. There is a high risk of increased severity if one is treated only for depression but has the potential to move into a manic or hypomanic part of their cycle.