Bipolar Disorder

Bipolar disorder is a mental health condition that affects approximately 5.7 million American adults.
The symptoms can significantly interfere with a patient’s everyday life.

Although bipolar disorder is not curable, it is treatable and manageable with appropriate medical care.

Bipolar Disorder
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What Is Bipolar Disorder?

This mental illness was formerly known as manic depression. It’s characterized by extreme shifts in mood or mental status. A person with bipolar disorder will experience three main types of mood shifts: mania, hypomania, and depression.

  • Mania: The individual experiences an emotional “high” that is characterized by high levels of energy and euphoria.


  • Hypomania: Hypomania is similar to mania. However, the individual doesn’t feel as uncontrollably euphoric.


  • Depression: People with bipolar depression experience a severe lack of energy and motivation. They feel a deep hopelessness and sadness, and they may begin to entertain suicidal thoughts.

People with bipolar disorder usually begin to notice the symptoms by about age 25. However, it may also be diagnosed in teens or in older adults. Rarely, bipolar disorder may affect children.


When an individual begins to exhibit possible signs of bipolar disorder, it’s important to seek medical care soon. Without treatment, bipolar disorder can worsen. It can also interfere with a person’s ability to take care of their daily responsibilities, and it can cause a decline in quality of life. Sometimes, an individual being treated for bipolar disorder may begin to feel much better and may be tempted to stop treatment. Unfortunately, this will lead to a relapse in symptoms. Once a patient is diagnosed with this mental illness, it’s important to continue with the course of treatment.

Signs and Symptoms of Bipolar Disorder

There are different types of bipolar disorder, but all of them are characterized by extremes in mood. The manic episode causes an extreme elevation in mood. It’s typically accompanied by hyperactivity and impulsivity. Other symptoms include:

  • Reduced need for sleep

  • High self-esteem

  • Rapid rate of speech

  • Pursuit of risky activities (such as driving recklessly or taking drugs)

  • Significant distractibility

  • Intense interest in goal-oriented activities

  • Impaired judgment

Hypomania is similar to mania, but it doesn’t involve such an extreme shift in mood. However, people experiencing a hypomanic episode may be described as flamboyant, excitable, talkative, restless, and intensely focused on one activity. Hypomania may lead to certain behaviors, such as spending recklessly, behaving inappropriately, or being hypersexual.


An episode of bipolar depression can be extremely debilitating. A patient may have trouble finding a reason to get out of bed in the morning. Other signs include the following:

  • Lack of interest in regular activities

  • Sleep disturbances/changes in sleep patterns

  • Uncontrollable crying

  • Weight fluctuations

  • Slowed movements

  • Indecisiveness

The symptoms and episodes a person experiences influence which type of bipolar disorder they are diagnosed with. These types are as follows:

  • Bipolar I: Diagnosed if manic episodes last at least seven days or are severe enough to require hospitalization.


  • Bipolar II: No mania is involved. It’s diagnosed if the individual has recurrent episodes of hypomania and major depression.


  • Cyclothymic disorder: Cyclical mood swings that aren’t severe enough to be classified as manic or depressive episodes.


  • Bipolar disorder due to another medical or substance abuse disorder: Diagnosed when a person doesn’t quite meet the criteria for one of the other three disorders.

Causes of Bipolar Disorder

It’s still not known exactly what causes bipolar disorder. It’s likely that many factors contribute to its development. Genetics is a possible culprit, as people with a family history of bipolar disorder are more likely to develop it. However, it’s also quite possible to be born into a family with a history of the disorder, and to never develop it yourself. Studies have determined that even among identical twins, one individual may have bipolar disorder, while the other does not.


It’s also thought that severe stress may act as a trigger. For example, a death in the family, a divorce, or major financial problems may trigger the development of an episode of mania or depression.


Furthermore, researchers have been studying brain scans of individuals with bipolar disorder. They have found that the activation of certain brain structures, as well as the average size of the brain display subtle differences when comparing the brain of a person with bipolar disorder to the brain of someone without it. However, at this time, brain scans cannot be used to diagnose bipolar disorder.

Diagnosis of Bipolar Disorder

When bipolar disorder is suspected, it’s customary to perform a physical exam and perhaps request some lab tests. While a physical exam and lab tests cannot diagnose bipolar disorder, they may be useful in figuring out if something else could be causing the symptoms, such as hyperthyroidism.


Primarily, a diagnosis of bipolar disorder relies on a psychiatric assessment. A physician may perform a preliminary interview to determine the patient’s main symptoms, and then refer the patient to a psychiatrist if appropriate. A psychiatrist can perform a comprehensive assessment, which may include asking the patient to keep a daily record of moods, sleep patterns, and similar issues.


Mental healthcare providers use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose bipolar disorder. The DSM-5 sets the following criteria for diagnosing manic, hypomanic, and depressive episodes.

  • Mania must be present for most of the day, every day, for at least seven days.


  • Hypomania must be present for most of the day, almost every day, for at least four days.


  • A major depressive episode is characterized by five or more given symptoms within two weeks. These symptoms include depressed mood, loss of interest in activities, and loss of energy.

Treatment of Bipolar Disorder

Bipolar disorder may be managed by a team of specialists, including a psychiatrist, psychologist, and social worker. The following are widely accepted treatments for bipolar disorder.

  • Medications: These may include mood stabilizers, antipsychotics, antidepressant-antipsychotics, and benzodiazepines.


  • Psychotherapy: Recommended techniques include cognitive behavioral therapy, psychoeducation, interpersonal therapy, and social rhythm therapy.


  • Substance abuse treatment: Some people with bipolar disorder have a co-existing disorder of substance abuse, which can make it even more difficult to manage bipolar symptoms.


  • Hospitalization: Hospitalization may be required if the patient has become psychotic (detached from reality) or suicidal, or is otherwise behaving dangerously.

In addition, patients can use lifestyle modifications to help manage their mood. These include creating healthy routines for eating, sleeping, and exercising. Psychologists may recommend keeping a daily mood chart. In addition, patients can benefit from surrounding themselves with caring loved ones who understand how to watch out for red flags that indicate a need for medical intervention.

When Should I Call a Doctor?

It’s not uncommon for people with bipolar disorder to be unaware of how their behaviors and mood swings affect their loved ones. As a result, some individuals may delay seeking a doctor’s care. In fact, it’s more common for these individuals to seek help only when they experience severe depression. This may sometimes lead to an incorrect diagnosis of a depressive disorder, rather than bipolar disorder.


An individual who has been experiencing mood swings, manic thoughts or behavior, or depressive symptoms is urged to seek medical help as soon as possible. It’s important to tell the doctor about all of the symptoms experienced during the past months and years to help prevent a misdiagnosis.


In addition, there may be times when emergency medical attention is required. Individuals who are experiencing suicidal thoughts, thoughts of self-harm, or actions of self-harm should call 911 right away. Friends and relatives of people with bipolar disorder should be prepared to take this step when suicidal thoughts or actions are exhibited.

This page offers general health information to facilitate discussion with your telehealth provider. You must not rely on the information on our website as an alternative to medical advice from your doctor, therapist or other professional healthcare provider.

If this is a medical emergency, please call 911. For mental health emergencies, call 988.

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