Bipolar disorder is associated with suicidal behaviour and two thirds of those who die by suicide have a depressive illness (which includes bipolar disorder) at the time they die. Furthermore, having a problem with alcohol or drug abuse may increase the risk of suicidal behaviour. It is also important to realise that euphoria can change quite quickly into dysphoria and the two states may in fact alternate over a very short period of time. Hence individuals who are experiencing mania or mixed mania may still be at risk of suicide. Nevertheless, the majority of people with bipolar disorder never commit suicide. This means that, despite the increased risk associated with bipolar disorder, most people either do not experience the life stresses or other risk factors that contribute to high suicide risk, or they get the help they need. Just because someone thinks about wanting to die does not mean they will definitely try to harm themselves. Threats of suicide or specific plans should, however, always be taken seriously.