Bipolar disorder involves significant changes in mood, energy, sleep, and activity. During mania or hypomania, a man may feel unusually confident, need less sleep, or experience racing thoughts. However, those changes can also lead to impulsive spending, risky decisions, and conflict that affects relationships and work.

Depressive episodes can bring a different struggle: low energy, loss of interest, difficulty concentrating, and feelings of hopelessness. As a result, maintaining responsibilities and staying connected to others may become difficult. These episodes vary, and they do not always follow a predictable cycle.

For some men, alcohol or drugs become a way to manage distress or changes in energy. Unfortunately, substance use can worsen symptoms and complicate diagnosis. Because depression may be the first reason someone seeks help, earlier periods of unusually elevated mood can go unrecognized. A thorough assessment considers both mood history and substance use, helping guide care toward greater stability.