Bipolar disorder is a mental health condition that causes extreme shifts in a person's mood and energy level. A person with bipolar disorder may experience periods with an extremely elevated or irritable mood (called manic episodes, or mania) as well as episodes of depression.
These shifts are more severe than the normal changes in mood that affect everyone. They can involve impaired thinking and behavior, and can affect your ability to function day to day.
Common Questions & Answers
Signs and Symptoms of Bipolar Disorder
There are different types of bipolar disorder, differing in symptoms and severity. A hallmark of every type is discrete mood episodes that are interspersed with periods of normal, level mood and function. Your doctor will diagnose your condition on the basis of the length, frequency, and pattern of episodes of your mania and depression.
When a person doesn’t meet the criteria for any of the other types of bipolar disorder but still experiences periods of a significant, abnormal elevation in mood, they may be diagnosed with "other specified and unspecified bipolar and related disorders."
You may feel easily distracted, as though your thoughts are racing, and be excessively talkative. You may also need less sleep. And along with an inflated sense of self-confidence, you might engage in pleasurable but reckless, risky behaviors with negative consequences.
Manic episodes involve a distinct and observable change in mood and functioning, and are severe enough to result in problems in your daily activities or to require hospitalization to prevent harm to yourself or others. A manic episode may also trigger a break from reality (psychosis), including hallucinations or delusions.
Symptoms of a major depressive episode include a loss of interest in regular activities you normally derive pleasure in or purpose from, significant changes in weight or appetite, changes in sleep, restlessness or fatigue, feelings of emptiness and worthlessness, trouble concentrating, and thoughts of suicide. Five or more of these sustained and disruptive symptoms every day over a two-week period, with at least one of the symptoms being depressed mood, is considered a major depressive episode.
Causes and Risk Factors of Bipolar Disorder
Researchers aren't sure what exactly causes bipolar disorder, but there appears to be an association between the condition and genetics, brain structure, and brain function.
Studies using brain-imaging tools, such as?functional magnetic resonance imaging (fMRI)?and positron emission tomography (PET), have attempted to reveal how the brains of people with bipolar disorder differ from the brains of healthy people or those with other mental disorders.
People with a history of other mental health disorders — including?anxiety,?attention deficit hyperactivity disorder, and?post-traumatic stress disorder?— appear to be at an increased risk of developing bipolar disorder, though these links are still being studied.
A number of symptoms or situations that result from bipolar disorder can also be triggers for the disorder. Changes in sleep patterns, blowout arguments with coworkers or loved ones, high stress or traumatic events, alcohol abuse, certain medication interactions, shifts in season, and the hormonal changes of pregnancy can all put you at a greater risk of a manic or depressive episode.
How Is Bipolar Disorder Diagnosed?
It’s important to seek emergency medical help if you’re afraid you might hurt yourself or attempt suicide. In some instances, hospitalization may be necessary. But in many cases, outpatient treatment of bipolar disorder is successful.
When to See a Doctor
Diagnosis typically involves these components:
- A physical exam
- A psychiatric evaluation
There is no single bipolar disorder test, but?blood tests?and neuroimaging may be used to rule out other conditions.?Bipolar symptoms?can resemble those of other disorders, which can make it challenging to properly diagnose the condition.
In children and teens,?symptoms of bipolar disorder?may be especially hard to distinguish from normal mood changes and behaviors. Children and teens in a manic episode may be irritable and short-tempered, have trouble sleeping and staying focused, and engage in risky behaviors. Those experiencing a depressive episode may complain of stomachaches and headaches, experience changes in eating habits, have little energy and interest in activities they usually enjoy, have thoughts about death and suicide.
Treatment and Medication Options for Bipolar Disorder
Treatment can involve a combination of?mood-balancing medication, psychotherapy, brain stimulation therapies, and certain lifestyle changes and complementary health approaches.
Mood stabilizers,?antipsychotics,?antidepressants, and antianxiety drugs are the types of medication prescribed for bipolar disorder, sometimes in combination with one another.?These drugs can have a variety of side effects, and finding the right drug therapy can be challenging and take some time. It’s important, though, not to stop taking your medication without talking to your doctor, even if you’re feeling better.
Common medications for bipolar disorder are:
Additional?and Complementary Therapies
In conjunction with medication, some form of psychotherapy or counseling will likely be recommended by your doctor. A common option is cognitive behavioral therapy, in which a?psychiatrist?or psychologist will help you identify episode triggers and work to develop behavioral strategies for managing your condition.
Making certain?lifestyle changes may also be necessary, such as quitting drugs and alcohol,?avoiding certain foods, or making sure you’re exercising regularly. Seeking out educational resources and a community of support can help you understand how to live with the condition and cope with symptoms.
Duration of Bipolar Disorder
While symptoms can intensify and subside, bipolar disorder is a lifelong condition that typically doesn’t go away on its own. But with treatment, it can be managed.
Liife With Bipolar Disorder
Adherence — taking your medication, keeping your appointments with your doctor or therapist — is key. Sticking to routines can be helpful, too, especially when it comes to recognizing changes in mood. And setting a?sleep schedule?is important, particularly when it comes to sleep and wake cycles.
The Relationship Between Bipolar Disorder and Sex Drive
During manic episodes, people with bipolar disorder may engage in certain impulsive behaviors. For some people, this kind of behavior can involve a preoccupation with sex and a heightened?sex drive, leading to unprotected sex or risky sexual situations with potentially damaging consequences, both physical and emotional. Hypersexuality, or an increased interest in sex, is known to be a symptom of bipolar disorder, though the research on the subject is limited.
Complications of Bipolar Disorder
Research and Statistics: Who Has Bipolar Disorder?
Gender Differences in Bipolar Disorder
What Is the Difference Between Bipolar Disorder and Manic Depression?
It's also been argued that the older term carries a stigma in popular culture and that both "manic" and "depression" are now used to describe everyday feelings and emotions. As a result, bipolar disorder is now the preferred term and the one that healthcare professionals use in diagnosis.
Resources for Managing Bipolar Depression
Living with bipolar disorder comes with a variety of challenges for both you and your loved ones. Fortunately, there are a number of good sources of accurate information on the condition, as well as organizations that provide emotional support and suggestions for seeking financial assistance if needed.
Resources We Love
This national advocacy and education organization is a one-stop shop where you can find comprehensive?information on bipolar disorder, tips on treatment and support, and links to relevant discussion groups.
Looking for the most clinical information on the condition? The American Psychiatric Association provides a succinct breakdown of the different types of bipolar disorder.
Whether you're decoding the symptoms, looking for the right treatment (psychotherapy included), or dealing with the prognosis, Harvard University experts help you understand when it’s time to call a professional and get help.
Resources for Family and Friends
The mission of the Depression and Bipolar Support Alliance is to educate, support, and help people living with a mood disorder and the people closest to them. This community-like website offers in-person and online support groups, as well as videos, programs, and a “Wellness Toolbox” for family and friends.
Bipolar Disorder Advocates
The Bipolar Barbie is a brutally honest Australian woman sharing her journey in the form of heartfelt?Instagram?captions and inspirational?YouTube?videos that intend to break the stereotypes and stigma surrounding the condition. From the struggles of being in a relationship, to dealing with anxiety at work, to how having pets greatly improved her symptoms, she tells it all.
This young mom of three says she’s #unashamed of having bipolar disorder. You can follow her journey on?Instagram?and learn how to love and understand someone dealing with the constant (and unexpected) ups and downs of the condition. Her blog is easy to read and full of insights.
TED Talks on Bipolar Disorder
Laura Bain turned her struggle with bipolar II into an inspirational talk that will leave you with goose bumps and greater appreciation for women with this condition.
A caring teacher “comes out” of the manic depression closet she had been hiding in to describe her ups and downs, her “manic trips,” and how she hopes her personal story will resonate with others dealing with bipolar disorder.
A former particle physicist gives a humorous narrative on?lithium?—?one of the most common?treatments for bipolar disorder?—?and why you don’t think about it until you can’t live without it. Or can you?
Keeping track of mood swings when you're suffering from bipolar disorder can be an anxiety trigger in itself. This data storage system can make the task more bearable for those living with the condition. Best thing about this app? You can send monthly reports directly to your doctor with one click.
Clinical Trials Study Finder
Want to get involved? In addition to detailed symptom and treatment information about bipolar disorder, this branch of the National Institute of Health provides information on clinical trials and how to become part of a study.
Editorial Sources and Fact-Checking
- Bipolar Disorder.?National Institute of Mental Health. January 2020.
- What Are Bipolar Disorders??American Psychiatric Association. January 2021.
- Kerner B. Genetics of Bipolar Disorder. The Application of Clinical Genetics. February 12, 2014.
- Bipolar Disorder.?National Alliance on Mental Illness. August 2017.
- Stahl EA, Breen G, Forstner AJ, et al. Genome-Wide Association Study Identifies 30 Loci Associated With Bipolar Disorder. Nature Genetics. May 1, 2019.
- Orrù?G,?Carta?MG. Genetic Variants Involved in Bipolar Disorder, a Rough Road Ahead.?Clinical Practice and Epidemiology in Mental Health.?2018.
- Clark L,?Sahakian?BJ. Cognitive Neuroscience and Brain Imaging in Bipolar Disorder.?Dialogues in Clinical Neuroscience.?June 2008.
- Maller?JJ,?Thaveenthiran?P, Thomson RH, et al. Volumetric, Cortical Thickness and White Matter Integrity Alterations in Bipolar Disorder Type I and II.?Journal of Affective Disorders.?December 1, 2014.
- Bipolar Disorder: Symptoms & Causes.?Mayo Clinic. February 16, 2021.
- Bipolar Disorder in Children and Teens.?National Institute of Mental Health. 2020.
- ECT,?TMS, and Other Brain Stimulation Therapies.?National Alliance on Mental Illness.
- Diflorio?A, Jones I. Is Sex Important? Gender Differences in Bipolar Disorder.?International Review of Psychiatry. November 2010.
- Mason BL, Sherwood Brown E, Croarkin PE. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria. Behavioral Sciences. July 15, 2016.