Bipolar disorder, a mental health condition affecting about 2-3% of adults worldwide, involves extreme mood swings between manic (or hypomanic) highs and depressive lows. No single "first" symptom applies universally, as onset varies by individual and type (Bipolar I, II, or cyclothymia). However, the earliest red flag often emerges in late adolescence or early adulthood (ages 15-25) and is typically a prolonged period of elevated mood, irritability, or increased energy lasting at least several days a hallmark of (hypo)mania.

This isn't everyday excitement. Watch for sudden surges in goal-directed activity, like starting multiple projects without follow-through, reduced need for sleep (feeling rested after 3-4 hours), rapid speech, racing thoughts, or risky behaviors (e.g., impulsive spending, reckless driving, or hypersexuality). In Bipolar II, this might appear as milder hypomania, often mistaken for productivity or a "good streak." Family history of mood disorders raises risk, as genetics play a 60-80% role per twin studies.

Depression can precede mania in some cases, but the manic shift is what distinguishes bipolar from unipolar depression. Early signs are subtle: a teen who was previously even-tempered suddenly becomes grandiose ("I can conquer the world!") or irritable over minor issues. Without intervention, episodes intensify, leading to hospitalization in severe cases (e.g., Bipolar I requires full mania).

Why does this matter? Untreated bipolar has a 15-20% suicide risk 10-15 times higher than the general population (NIMH data). Early detection via mood tracking apps or journals can prompt professional screening (e.g., DSM-5 criteria). Consult a psychiatrist if symptoms disrupt work, relationships, or safety. Medications like mood stabilizers (lithium) plus therapy (CBT) achieve remission in 60-70% of cases when started early.

Bipolar isn't a character flaw it's brain chemistry involving dopamine dysregulation. Stigma delays help; normalize seeking support. If you notice these flags in yourself or a loved one, act fast: the "first" red flag is your cue to investigate, not ignore.