They may withdraw and stop seeing friends, avoid social activities, and cease simple tasks such as shopping and showering. They are overwhelmed by a deep sadness, lose their appetite, subsequently lose weight, cannot concentrate and may experience associated feelings of guilt or hopelessness. Some attempt suicide because life becomes meaningless or they feel too guilty to go on. People with bipolar disorder who experience depression lose touch with reality. They may hear imaginary voices.
Endogenous depression tends to occur in mid-life and is more common in women.
Normal moods Most people who have episodes of mania and depression experience normal moods in between. They are able to live normal lives, manage household and business commitments and hold down a job. Of course everyone experiences mood swings from time to time. It is only when these moods become extreme and lead to a failure to cope with life that medical attention is necessary. Both men and women have an equal chance of developing the disorder, although it is most common in people in their twenties.