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Bipolar Disorder

What is bipolar disorder?

Bipolar disorder is a mental illness that affects mood, energy, activity levels, and concentration, making it difficult to carry out day-to-day activities. There are three types of bipolar disorder:

  • Bipolar I disorder: This type involves at least one manic episode that lasts for at least 7 days or requires hospitalization. A manic episode is a period of extremely high, elated, irritable, or energetic mood that may also involve psychosis (a break from reality). Usually, depressive episodes also occur, lasting for at least 2 weeks.

  • Bipolar II disorder: This type involves at least one major depressive episode and at least one hypomanic episode. A hypomanic episode is a period of elevated, upbeat, or irritable mood that is less severe than a manic episode and does not cause significant impairment or require hospitalization.

  • Cyclothymic disorder: This type involves many periods of hypomanic and depressive symptoms that last for at least 2 years in adults or 1 year in children and adolescents. The symptoms are not intense enough or do not last long enough to qualify as full-blown episodes.

It affects approximately 2.8% of the U.S. adult population each year. Typically, bipolar disorder is diagnosed in late teens or early 20s, but it can affect both men and women equally.

What causes bipolar disorder?

It is unclear how bipolar disorder develops, but it is likely influenced by a combination of genetic, biological, environmental, and psychological factors.

  • Family history

  • Brain structure and function

  • Hormones and neurotransmitters

  • Stress and trauma

  • Substance use

What are the symptoms of bipolar disorder?

There are several symptoms of bipolar disorder, ranging from mild to severe, that can affect different aspects of a person's life. The main symptoms are:

Manic symptoms

Manic symptoms include:

  • Extremely irritable or touchy, or feeling high, high, or elated

  • Having a jumpy or wired feeling, being more active than usual

  • Sleeping less often

  • Fast-talking or racing thoughts

  • Being easily distracted or having difficulty focusing

  • Being more confident or self-assured

  • Being more sociable or outgoing than usual

  • Having unrealistic or grandiose expectations

  • Risk taking or impulsive behavior (such as spending sprees, gambling, sexual indiscretions, reckless driving, etc.).

  • Delusions (believing things that are not true) or hallucinations (seeing or hearing things that are not there)

Depressive symptoms

Depressive symptoms include:

  • Feeling very down or sad, or anxious

  • Feeling slowed down or restless

  • Having trouble falling asleep, waking up too early, or sleeping too much

  • Losing interest or pleasure in activities that used to be enjoyable

  • Feeling hopeless, worthless, guilty, or empty

  • Having low energy or fatigue

  • Having difficulty concentrating, remembering things, or making decisions

  • Having changes in appetite or weight

  • Having thoughts of death or suicide

Mixed features

Mixed features refer to having both manic and depressive symptoms at the same time. For example:

  • Feeling sad and hopeless while also feeling restless and energetic

  • Feeling euphoric and confident while also feeling irritable and angry

  • Having racing thoughts while also feeling tired and sluggish

Rapid cycling

Bipolar disorder can be harder to treat if you experience four or more episodes of mania, hypomania, depression, or mixed features during one year. Bipolar disorder may also increase your risk of suicide if you experience rapid cycling.

How is bipolar disorder diagnosed?

In addition to being difficult to diagnose, bipolar disorder symptoms can overlap with other mental disorders (such as depression, anxiety, schizophrenia, etc.) or can be mistaken for normal mood swings. There is no single test that confirms bipolar disorder. To diagnose bipolar disorder, a doctor or mental health professional will:

  • Find out about the person's medical history, family history, symptoms, and behaviors

  • Order some blood tests to rule out other possible causes of the symptoms

  • Assess the person's mood, thoughts, feelings, and functioning by conducting a psychological evaluation

  • Diagnose mental disorders using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a handbook used by mental health professionals

How is bipolar disorder treated?

Bipolar disorder is treated based on several factors, including:

  • The type and severity of the episodes

  • The frequency and duration of the episodes

  • The presence of any co-occurring conditions (such as anxiety, substance use, or physical illness)

  • The person’s preferences and goals

The main goals of treatment are to:

  • Stabilize the mood and prevent or reduce the intensity of future episodes

  • Improve the person’s functioning and quality of life

  • Reduce the risk of complications or harm (such as suicide, self-harm, or legal problems)

The treatment options for bipolar disorder include:


The most common types of medication for bipolar disorder are: The most common types of medication for bipolar disorder are:

  • Lithium, valproate, carbamazepine, and lamotrigine are among the mood stabilizers.

  • Drugs that reduce psychosis, agitation, or manic symptoms include olanzapine, quetiapine, risperidone, aripiprazole, and lurasidone.

  • In addition to treating depressive symptoms, antidepressants can also trigger or worsen manic symptoms in some people. For this reason, they are often prescribed together with mood stabilizers or antipsychotics. Among these are fluoxetine, sertraline, bupropion, and venlafaxine.


In psychotherapy, you talk to a trained mental health professional about your feelings, thoughts, and behaviors.

Psychotherapy can be effective for bipolar disorder in different ways. Some examples include:

  • In cognitive-behavioral therapy (CBT), you are taught how to identify, challenge, and replace negative or irrational thoughts that may contribute to your mood swings.

  • In interpersonal and social rhythm therapy (IPSRT), you improve your interpersonal relationships and maintain a regular routine to stabilize your mood.

  • The family-focused therapy (FFT) focuses on improving communication, support, and problem-solving skills among family members, as well as educating them about bipolar disorder.

  • In psychoeducation, you learn about bipolar disorder and its treatment options, as well as how to recognize the signs and symptoms of an episode.

Combined with medication, psychotherapy can be done individually or in a group setting.

How can bipolar disorder be prevented?

In spite of the fact that bipolar disorder is a complex disease with many causes and triggers, there are some steps you can take to reduce the risk or delay the onset of symptoms:

  • When you notice any signs of mood disturbance or impairment in your functioning, seek professional help as soon as possible

  • Taking your medication as prescribed by your doctor and following your treatment plan

  • Keeping regular appointments with your doctor or therapist and reporting any changes in your condition or medication side effects

  • Avoiding substances that may worsen your symptoms, such as alcohol, drugs, and caffeine

  • Joining a support group or online community to learn more about bipolar disorder and its management

  • Establishing a wellness plan that includes strategies for dealing with stress, managing your mood, and preventing relapses

  • Feeling overwhelmed, suicidal, or in crisis? Ask your family, friends, or other trusted people for help


In addition to affecting different aspects of a person's life, bipolar disorder can lead to serious complications if left untreated. It causes unusual changes in mood, energy, activity levels, and concentration. According to the DSM-5 criteria, a doctor or mental health professional can diagnose bipolar disorder based on the medical history, physical examination, psychological evaluation, and psychological evaluation. Medications, psychotherapy, other treatments, or a combination of these options can be used to treat bipolar disorder. Getting professional help early, following the treatment plan, avoiding triggers, learning about the condition, developing a wellness plan, and seeking social support can prevent or delay bipolar disorder.

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