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.
It is unclear how bipolar disorder develops, but it is likely influenced by a combination of genetic, biological, environmental, and psychological factors.
Brain structure and function
Hormones and neurotransmitters
Stress and trauma
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 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 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 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
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.
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
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.
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.