Bipolar disorder is a mental health condition marked by large shifts in mood from mania to depression. Although bipolar disorder can be challenging to manage, many effective treatments and strategies are available.
Bipolar disorder isn’t a rare condition. In fact, the National Institute of Mental Health says that
The condition used to be known as manic depression and bipolar disease.
Key symptoms of bipolar disorder include:
- episodes of mania, or extremely elevated mood
- episodes of depression, or low mood
These episodes may last from a few days to several weeks or longer.
If you’re living with bipolar disorder, the following treatment options can help you learn to manage mood episodes, which can improve not only your symptoms but also your overall quality of life.
There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia.
Bipolar I is defined by the appearance of at least one manic episode. You may experience hypomanic episodes, which are less severe than manic episodes, or major depressive periods before and after the manic episode. A person can also go through a long period of stable mood before experiencing either mania or depression.
This type of bipolar disorder affects people of all sexes equally.
Are sex and gender the same thing?
People often use the terms sex and gender interchangeably, but they have different meanings:
- “Sex” refers to the physical characteristics that differentiate male, female, and intersex bodies.
- “Gender” refers to a person’s identity and how they feel inside. Examples include man, woman, nonbinary, agender, bigender, genderfluid, pangender, and trans. A person’s gender identity may differ from the sex they were assigned at birth.
People with bipolar II experience one major depressive episode that lasts at least 2 weeks. They also have at least 1 hypomanic episode that lasts about 4 days. According to a
People with cyclothymia experience some symptoms of hypomania and depression, but not enough to characterize an episode of hypomania or depression.
These episodes also involve symptoms that are shorter and less severe than the episodes associated with bipolar I or bipolar II disorder. Most people with this condition experience no mood symptoms for
Your doctor can explain more about what kind of bipolar disorder you have when discussing your diagnosis.
Some people experience distinct mood symptoms that resemble but don’t align with these three types. If that’s the case for you, you might get a diagnosis of:
- other specified bipolar and related disorders
- unspecified bipolar and related disorders
To receive a diagnosis of bipolar disorder, you must experience at least one period of mania or hypomania.
These both involve feelings of excitement, impulsivity, and high energy, but hypomania is considered less severe than mania. Mania symptoms can affect your day-to-day life at work or home. Hypomania symptoms typically don’t cause as much disruption, but they can still be distressing.
Some people living with bipolar disorder also experience major depressive episodes or “down” moods.
These three main symptoms — mania, hypomania, and depression — are the main features of bipolar disorder. Different types of bipolar disorder involve different combinations of these symptoms.
Bipolar I symptoms
According to the
- at least one episode of mania that lasts at least 1 week
- symptoms that affect daily function
- symptoms that don’t relate to another medical or mental health condition or substance use
You could also experience symptoms of psychosis or both mania and depression (known as mixed features). These symptoms can have more impact on your life. If you have them, it’s worth reaching out for professional support as soon as possible.
While you don’t need to experience episodes of hypomania or depression to receive a bipolar I diagnosis, many people with bipolar I do report these symptoms.
Bipolar II symptoms
A diagnosis of bipolar II requires:
- at least one episode of hypomania that lasts
4 days or longerand involves 3 or more symptoms of hypomania
- hypomania-related changes in mood and usual function that others can notice, though these may not necessarily affect your daily life
- at least one episode of major depression that lasts
2 weeks or longer
- at least one episode of major depression involving five or more key depression symptoms that have a significant impact on your day-to-day life
- symptoms that don’t relate to another medical or mental health condition or substance use
Bipolar II can also involve symptoms of psychosis, but only during an episode of depression. You could also experience mixed mood episodes, which means you’ll have symptoms of depression and hypomania simultaneously.
With bipolar II, though, you won’t experience mania. If you have a manic episode, you’ll receive a diagnosis of bipolar I.
A diagnosis of cyclothymia requires:
- periods of hypomanic symptoms and periods of depression symptoms, off and on, over
2 years or longer( 1 yearfor children and adolescents)
- symptoms that never meet the full criteria for an episode of hypomania or depression
- symptoms that are present for at least half of the 2 years and never absent for longer than 2 months at a time
- symptoms that don’t relate to another medical or mental health condition or substance use
- symptoms that cause significant distress and affect daily life
Fluctuating mood symptoms characterize cyclothymia. These symptoms may be less severe than those of bipolar I or II. Still, they tend to last longer, so you’ll generally have less time when you experience no symptoms.
Hypomania may not have a big impact on your daily life. Depression, on the other hand, often leads to more serious distress and affects day-to-day function, even if your symptoms don’t qualify for a major depressive episode.
If you do experience enough symptoms to meet the criteria for a hypomanic or depressive episode, your diagnosis will likely change to another type of bipolar disorder or major depression, depending on your symptoms.
An episode of mania often involves an emotional high. You might feel excited, impulsive, euphoric, and full of energy. You might also feel jumpy or notice your thoughts seem to race. Some people also experience hallucinations and other symptoms of psychosis.
Manic episodes can involve behavior that’s more impulsive than usual, often because you feel invincible or untouchable. Commonly cited examples of this kind of behavior include:
- having sex without using a barrier method
- misusing alcohol and drugs
- going on spending sprees
But impulsiveness can also show up in plenty of other ways. Maybe you:
- quit your job abruptly
- take off on a road trip by yourself without telling anyone
- make a big investment on a whim
- drive much faster than usual, well above the speed limit
- participate in extreme sports you wouldn’t ordinarily consider
While there are many reasons why a person might engage in these behaviors, the key to mania is that these are not things you would choose to engage in periods of stable mood.
Hypomania, generally associated with bipolar II disorder, involves many of the same symptoms, though they’re less severe. Unlike mania, hypomania often
With hypomania, you might feel very productive and energized, but you may not notice other changes in your mood. People who don’t know you well may not, either. Those closest to you, however, will usually pick up on your shifting mood and energy levels.
A “down” change in mood can leave you feeling lethargic, unmotivated, and sad.
Bipolar-related episodes of major depression will involve at least five of these symptoms:
- a lasting low mood marked by deep sadness, hopelessness, or feelings of emptiness
- loss of energy
- a sense of feeling slower than usual or persistent restlessness
- lack of interest in activities you once enjoyed
- periods of too little or too much sleep
- a sense of guilt or worthlessness
- trouble concentrating, focusing, and making decisions
- thoughts of death, dying, or suicide
- changes in appetite or weight
Not everyone with bipolar disorder
It’s also worth noting that sometimes, but not always, the euphoria of mania can feel enjoyable. Once you get treatment for mania, the symptom-free mood you experience might feel more like a “down” shift, or a period of depression, than a more typical mood state.
While bipolar disorder can cause a depressed mood, bipolar disorder and depression have one major difference. With bipolar disorder, you might have “up” and “down” mood states. With depression, though, your mood and emotions
Most research suggests that males and females receive bipolar disorder diagnoses
Females with bipolar disorder tend to receive diagnoses later in life, often in their 20s or 30s. Sometimes, they might first notice symptoms during pregnancy or after childbirth. They’re also more likely to be diagnosed with bipolar II than bipolar I.
Additionally, females living with bipolar disorder tend to experience:
- milder episodes of mania
- more depressive episodes than manic episodes
- rapid cycling, or
four or more episodesof mania and depression in 1 year
- more co-occurring conditions
Females with bipolar disorder may also experience relapse more often, partly due to hormone changes related to menstruation, pregnancy, and menopause. In terms of bipolar disorder, relapse means having a mood episode after not having one for some time.
Males with bipolar disorder, on the other hand, may:
- get a diagnosis earlier in life
- experience less frequent but more severe episodes, especially manic episodes
- be more likely to also have a substance use disorder
- show more aggression during episodes of mania
While the symptoms of bipolar disorder can vary somewhat from person to person and can depend on the type, there are clear criteria for diagnosis.
Research also suggests 50-75% of people living with bipolar disorder will experience some symptoms of psychosis, but this is stable across all racial and ethnic groups.
Both these factors suggest that bias may play a role in this frequent misdiagnosis.
Diagnosing bipolar disorder in children is controversial, largely because children don’t always display the same bipolar disorder symptoms as adults. Their moods and behaviors may also not follow the standards doctors use to diagnose the disorder in adults.
Many bipolar disorder symptoms that occur in children also overlap with symptoms of other conditions that commonly occur in children, such as attention deficit hyperactivity disorder (ADHD).
However, in the last few decades, doctors and mental health professionals have come to recognize the condition in children. A diagnosis can help children get treatment, but reaching a diagnosis may take many weeks or months. It may be worth seeking care from a professional who specializes in treating children with mental health conditions.
Like adults, children with bipolar disorder experience extreme mood shifts. They
All children experience mood changes, but bipolar disorder causes distinct and noticeable mood symptoms. Mood changes are also usually more extreme than a child’s typical change in mood.
Manic symptoms in children
Symptoms of mania in children can include:
- acting very silly and feeling overly happy
- talking fast and rapidly changing subjects
- having trouble focusing or concentrating
- engaging in behaviors that can have harmful effects
- having a very short temper that leads quickly to outbursts of anger
- having trouble sleeping and not feeling tired after sleep loss
Depressive symptoms in children
With bipolar disorder, symptoms of depressive episodes in children can include:
- moping around, acting very sad, or crying frequently
- sleeping too much or too little
- having little energy for usual activities or showing no signs of interest in anything
- complaining about not feeling well, including having frequent headaches or stomachaches
- feelings of worthlessness or guilt
- eating too little or too much
- thoughts of death or suicide
Other possible diagnoses
Some of the behavior issues you notice in your child could suggest other mental health conditions, such as ADHD or depression. It’s also possible for children to have bipolar disorder with another condition.
Your child’s doctor can offer more guidance and support with noting and tracking your child’s behaviors, which can help them find the right diagnosis.
The correct diagnosis can play a major role in finding the most effective treatment for your child. Treatment, of course, can make a big difference in your child’s symptoms, not to mention their quality of life.
Symptoms in teens
Shifting hormones, plus the life changes that naturally happen with puberty, can make teens seem extremely emotional from time to time.
Yet drastic or rapidly fluctuating changes in mood may suggest a more serious condition, such as bipolar disorder, rather than typical teenage development.
A bipolar disorder diagnosis is most common during the late teen and early adult years.
Common symptoms of mania in teenagers include:
- being very happy
- “acting out” or misbehaving
- taking part in behaviors that may have a harmful effect, like substance use
- thinking about sex more than usual
- becoming overly sexual or sexually active
- having trouble sleeping, without signs of fatigue or being tired
- having a very short temper
- having trouble staying focused or getting distracted easily
Common symptoms of a depressive episode include:
- sleeping too much or too little
- eating too much or too little
- feeling very sad and showing little excitability
- withdrawing from activities and friends
- thinking or talking about death and suicide
Remember that many of these signs, like experimenting with substances and thinking about sex, aren’t uncommon teenage behaviors. But if they seem part of a larger pattern of shifting moods or start to affect their day-to-day life, they could be a sign of bipolar disorder or another condition.
Several treatments can help you manage bipolar disorder symptoms. These
Recommended medications may include:
- mood stabilizers, such as lithium (Lithobid)
- antipsychotics, such as olanzapine (Zyprexa)
- antidepressant-antipsychotics, such as fluoxetine-olanzapine (Symbyax)
- benzodiazepines, a type of anti-anxiety medication used for short-term treatment
Recommended therapy approaches may include:
Cognitive behavioral therapy
Cognitive behavioral therapy is a type of talk therapy that helps you identify and address unhelpful thoughts and change unwanted behavior patterns.
Therapy offers a safe space to discuss ways to manage your symptoms. Your therapist can also offer support with:
- understanding thought patterns
- reframing distressing emotions
- learning and practicing more helpful coping strategies
Get tips on finding the right therapist.
Psychoeducation is a therapeutic approach centered around helping you learn about a condition and its treatment. This knowledge can go a long way toward helping you and the supportive people in your life recognize early mood symptoms and manage them more effectively.
Interpersonal and social rhythm therapy
Interpersonal and social rhythm therapy focuses on regulating daily habits, such as sleeping, eating, and exercising. Balancing these everyday basics could lead to fewer mood episodes and less severe symptoms.
Online therapy options
Interested in online therapy? Our review of the best teletherapy options can help you find the right fit.
Other approaches that can help ease symptoms include:
Natural remedies for bipolar disorder
Some natural remedies might also help with bipolar disorder symptoms.
You’ll always want to check with your doctor or psychiatrist before trying these remedies, though. In some cases, they could interfere with any medications you’re taking.
The following herbs and supplements may help stabilize your mood and reduce symptoms of bipolar disorder when combined with medication and therapy:
- Omega-3: Some
2016 researchsuggests that taking an omega-3 supplement may help with symptoms of bipolar I. However, a 2021 study found weak support for using the supplement to treat depression symptoms in bipolar disorder.
- Rhodiola rosea: A
2013 reviewsuggests this plant may help with moderate depression, so it could help treat depression associated with bipolar disorder, but this, too, has not been substantiated with newer research.
- S-adenosylmethionine (SAMe): SAMe is an amino acid supplement that may
help easesymptoms of major depression and other mood disorders. However, it can induce mania and may interact with other medications.
You should consult with a doctor before trying SAMe or any other herbal or natural remedies to help you manage your bipolar symptoms.
Some studies suggest that lifestyle measures can help
- eating a balanced diet
- getting at least 150 minutes of exercise a week
- managing your weight
- getting weekly counseling or therapy
That said, the improvements reported by many of these studies were
Bipolar disorder is a fairly common mental health condition, but experts have yet to determine why some people develop the condition.
Some potential causes of bipolar disorder include:
If your parent or sibling has bipolar disorder, you’re more likely to develop the condition. The risk of developing bipolar disorder is
Keep in mind, though, that most people who have a history of bipolar disorder in their family history don’t develop it.
Learn more about the hereditary aspect of bipolar disorder.
Your brain structure may affect your risk of developing bipolar disorder. Irregularities in brain chemistry, or the structure or functions of your brain, may increase this risk.
It’s not just what’s in your body that can affect your chances of developing bipolar disorder. Outside factors can also play a part. These might include:
- extreme stress
- traumatic experiences
- physical illness
Once you begin to experience mood episodes, you can take steps to help reduce the severity of those episodes and lower your chances of experiencing additional mood episodes. But you can’t always prevent mood episodes entirely or keep the condition from developing in the first place.
Future research may reveal more about the specific causes of bipolar disorder and give researchers more insight into potential ways of preventing the condition.
Some people living with bipolar disorder also have other mental health conditions. A
Other conditions that might occur alongside bipolar disorder include:
- substance use disorders
- eating disorders
- specific phobia
Symptoms of these conditions might show up more severely depending on your mood state. Anxiety, for example, tends to happen more commonly with depression, while substance use might be more likely with mania.
If you have bipolar disorder, you may also have a higher chance of developing certain medical conditions, including:
If you’ve noticed symptoms of bipolar disorder, a good first step involves reaching out to a doctor or therapist as soon as possible.
Similarly, if a friend or loved one has symptoms, consider encouraging them to connect with a therapist as soon as possible. It never hurts to remind them that they have your understanding and support.
Here’s how you can support a loved one living with bipolar disorder.
Always take suicidal thoughts and behavior seriously
It’s not uncommon to have thoughts of suicide during an episode of depression or a mixed features mood episode.
Remember that you’re not alone, and help is available 24/7, 365 days a year. To get confidential support, reach out to the Suicide and Crisis Lifeline at 988 or text “HOME” to 741741.
If you think someone is at immediate risk of hurting themselves or someone else:
- Stay with them if you can. If not, call for help and support.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
Learn more about helping someone during a crisis and get more crisis resources.
Living with bipolar disorder
Treatment can help you manage mood episodes and cope with the symptoms they cause.
Creating a care team can help you get the most out of treatment. Your team might involve:
- your primary doctor
- a psychiatrist who manages your medications
- a therapist or counselor who provides talk therapy
- other professionals or specialists, such as a sleep specialist, acupuncturist, or massage therapist
- a bipolar disorder support group or community of other people also living with bipolar disorder
You may need to try a few treatments before you find one that leads to improvement. Some medications work well for some people but not others. In a similar vein, some people find CBT very helpful, while others may see little improvement.
It’s always best to be open with your care team about what works and what doesn’t. If something doesn’t help or makes you feel even worse, don’t hold back from letting them know. Your mental health matters and your care team should always support you in finding the most helpful approach.
A little self-compassion can go a long way, too. Remember that bipolar disorder, like any other mental health condition, didn’t happen by choice. It’s not caused by anything you did or didn’t do.
It’s OK (and pretty common) to feel frustrated when treatment doesn’t seem to work. Try to have patience and treat yourself kindly as you explore new approaches.
Bipolar disorder and relationships
Bipolar disorder can affect your relationships. But these effects might appear most clearly in your closest relationships, like those with family members and romantic partners.
When it comes to managing a relationship while living with bipolar disorder, honesty can always help. Being open about your condition can help your partner better understand your symptoms and how they can offer support.
You might consider starting with a few basic details, including:
- how long you’ve had the condition
- how episodes of depression usually affect you
- how episodes of mania usually affect you
- your treatment approach, including therapy, medication, and coping strategies
- anything they can do to help
Want more tips on maintaining a healthy relationship when you or a partner has bipolar disorder? Our guide can help.
Bipolar disorder is a lifelong condition, but that doesn’t mean it has to completely disrupt your life. While living with bipolar disorder certainly creates some challenges, sticking with your treatment plan, practicing regular self-care, and leaning on your support system can boost your overall well-being and keep symptoms to a minimum.
Educating yourself and your loved ones about the condition can also have a lot of benefits. Get started with these resources:
- Depression and Bipolar Support Alliance
- Help with Bipolar Disorder
- International Bipolar Foundation