What is bipolar disorder?

Bipolar disorder is a mental health condition that involves dramatic shifts in mood, energy, and behavior. Although there’s still a stigma associated with bipolar disorder, the condition is relatively common in the U.S. In fact, more than 4% of U.S. adults will experience bipolar disorder at some point in their lives. 

If you or someone in your life is showing signs of bipolar disorder, learning how to recognize the symptoms can help ensure they seek treatment and receive a timely and accurate diagnosis. With access to the right treatment and professional support, it’s possible to stabilize your mood, cope with your symptoms, and improve your ability to function in daily life.

Signs and symptoms of bipolar disorder

While it’s normal to experience different moods, people with bipolar disorder are prone to unpredictable mood swings — ranging from manic or hypomanic highs to depressive lows. 

How to spot a manic episode

Manic episodes are periods of intense euphoria, energy, and irritability. These episodes also sometimes include psychosis, like hearing or seeing things that aren’t there. Other signs that someone with bipolar disorder might be experiencing a manic episode include:

• Feeling intensely happy or elated
• Not sleeping but staying energized
• Engaging in risky or impulsive behaviors, like speeding or overspending
• Talking so quickly that other people notice
• Thinking they’re invincible
• Experiencing racing thoughts that are hard to control
• Having trouble focusing and being easily distracted
• Becoming fixated on a certain topic or activity 
• Pacing, fidgeting, or other repetitive behaviors

How to spot a hypomanic episode

Hypomanic episodes cause many of the same symptoms as manic episodes, like an increase in energy, speech, and risky or repetitive behaviors. 

However, symptoms tend to be less intense, last for shorter periods of time, and don’t include symptoms of psychosis. While manic episodes last for a week or longer, hypomanic episodes only need to last for four days.

How to spot a depressive episode

Many people with bipolar disorder also experience periods of low mood known as depressive episodes. Signs that someone with bipolar disorder might be experiencing a depressive episode include:

• Having low energy and fatigue
• Feeling worthless, guilty, or ashamed
• Struggling with focus and concentration
• Having trouble falling or staying asleep
• Unintentional changes in appetite or weight
• Having thoughts of suicide* or harming themselves

*The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. If you’re experiencing a life-threatening emergency or you need immediate help, please call 911.

Four types of bipolar disorder

Bipolar disorder refers to a series of related conditions that all involve changes in mood. Each type of bipolar disorder causes depressive, manic, or hypomanic episodes, but the length and severity of the episodes vary.

1. Bipolar I disorder

The most common and severe form of bipolar disorder, bipolar I causes both depressive and manic episodes. To be diagnosed with bipolar I, a person’s manic episodes must last at least seven days or be severe enough to require hospitalization. Depression isn’t required for an official diagnosis, but it’s common for people to experience depressive episodes that last for at least two weeks.

2. Bipolar II disorder

Bipolar II involves episodes of depression and hypomania. It’s less severe than bipolar I and doesn’t typically require hospitalization. To be diagnosed with bipolar II, depressive episodes must last at least two weeks and hypomanic episodes must last at least four days.

3. Cyclothymic disorder

Cyclothymic disorder is a milder form of bipolar disorder that causes frequent mood swings. To be diagnosed with cyclothymic disorder, a person must experience symptoms of hypomania and mild depression for at least two years, with brief periods of “normal mood” that last for less than eight consecutive weeks. 

4. Bipolar disorder unspecified 

When a person experiences periods of clinically significant mood swings but doesn’t meet the criteria for bipolar I, II, or cyclothymia, they may be diagnosed with bipolar disorder unspecified.

What causes bipolar disorder?

Most people with bipolar disorder first experience symptoms around age 25, though it’s possible to be diagnosed during adolescence. The exact cause of bipolar disorder is unknown, but potential influences include:

• Genetics: Having a family member with bipolar disorder is a leading risk factor for developing the condition yourself. It can even skip generations.
• Brain chemistry: There may be subtle differences in the brain structures of people with and without bipolar disorder. 
• Substance use: Bipolar disorder, especially bipolar I, has been linked to excessive and unhealthy use of drugs and alcohol. In fact, more than half of people with bipolar I also have alcohol use disorder.

Long-term effects of bipolar disorder

Research has found that up to 40% of people with bipolar disorder are misdiagnosed, often with depression, attention-deficit hyperactivity disorder (ADHD), or borderline personality disorder (BPD). When bipolar disorder is misdiagnosed or left untreated, manic and depressive episodes can become more common and severe.

Bipolar disorder has the potential to negatively impact a person’s mental and physical health, career, relationships, and overall quality of life. Unmanaged bipolar disorder can affect your ability to maintain healthy relationships and lead to a higher risk of unemployment. The condition is linked to cardiovascular issues, diabetes, eating disorders, and substance use. It’s also associated with an increased risk of premature mortality and suicide. Thankfully, with treatment, these risks decrease and symptom management is possible. 

How is bipolar disorder treated?

Bipolar disorder is a lifelong condition. Although there’s no cure, there are ways to effectively manage symptoms. For many people with bipolar disorder, treatment involves a combination of talk therapy, medication management, and lifestyle changes.

• Talk therapy: Cognitive behavioral therapy (CBT) and family-focused therapy (FFT) are both considered effective therapeutic techniques for bipolar disorder. CBT, in particular, has been shown to improve depressive symptoms, decrease mania severity, and lead to fewer relapses. 
• Medication: Your provider may recommend medications, and there are several options to consider. This should be an ongoing conversation with your provider to monitor the medication’s effectiveness and any potential side effects. 
• Lifestyle changes: Getting enough sleep, prioritizing physical activity, and engaging in relaxation exercises — like yoga and meditation — can all help you manage your bipolar symptoms. 

Find care with Rula

If you think you may have bipolar disorder, it’s important to seek professional help as soon as possible. When it comes to managing conditions like bipolar disorder, an official diagnosis is the first step toward learning to cope with your symptoms and live a more balanced life. 

Rula makes it easier to find a mental health provider who’s in network with your insurance, is accepting new clients, and has experience treating your condition. And if medication is part of your treatment plan, we can even connect you with a psychiatric provider.

Find care with Rula