Bipolar Affective Disorder is characterised by alternating between periods of depressed mood and periods of elevated mood. This is not to be confused with “moodiness”, anger (in the absence of other symptoms), or rapidly changing mood. Each period must last at least four days and usually longer. The elevated periods can include irritable mood, an increase in goal-directed behaviour, increased energy, increased self-esteem, decreased need for sleep, being more talkative, being easily distracted, or an increase in spending / sexual activity / impulsive decisions or behaviour. The depressed periods can include all of the symptoms mentioned under the “Depression” link on the previous page. Alternating between these two extreme mood states can be highly distressing and interfere with people’s ability to maintain a stable lifestyle. Sometimes, people report that the periods of depression are made worse by feelings of regret about things they may have done during the elevated periods.