Table of ContentsView AllTable of ContentsWhat Is Bipolar Disorder?TypesSymptomsCausesDiagnosisTreatmentLiving With Bipolar DisorderNext in Bipolar Disorder GuideBipolar Disorder Symptoms and Traits
Table of ContentsView All
View All
Table of Contents
What Is Bipolar Disorder?
Types
Symptoms
Causes
Diagnosis
Treatment
Living With Bipolar Disorder
Next in Bipolar Disorder Guide
This article describes thesymptoms, causes, and treatments for bipolar disorder and discusses how to cope if you’re diagnosed with this mental health condition.
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Manic Episodes
A manic episode is a phase of a week or more during which you have an elevated mood and energy most of the time for most days. In this phase, you may feel abnormally happy, agitated, restless, and don’t need much sleep.
In rare and severe cases, people experiencehallucinationsand delusions during manic episodes. In addition, some people experiencehypomanicepisodes—less severe manic episodes lasting four or more days.
2:22Everything You Should Know About Bipolar Disorder
2:22
Everything You Should Know About Bipolar Disorder
Major Depressive Episodes
A majordepressiveepisode is a period of two or more weeks of depressive symptoms, such as sadness, hopelessness, lethargy (lack of energy), and apathy. These episodes can become severe, leading to suicidal thoughts. As with manic episodes, severe depressive episodes can lead to hallucinations or delusions.
What Are the Types of Bipolar Disorder?
Healthcare providers break down bipolar disorder into fourprimary types: bipolar 1, bipolar 2,cyclothymicdisorder, and unspecified bipolar disorder.
Bipolar 1 Disorder
With bipolar 1 disorder, manic episodes last a week or become so severe that you require hospitalization. In most cases, bipolar 1 also causes depressive episodes. Some people have “mixed” episodes that feature both manic and depressive symptoms at the same time. Neutral periods—neither manic nor depressive—are also common with this type.
Bipolar 2 Disorder
Bipolar 2 disorder occurs when you experience one depressive episode and at least one hypomanic episode (milder manic episodes that last four or more days). In between these are symptom-free periods. Those with bipolar 2 disorder often have other mental health conditions, such as anxiety or depression.
Cyclothymic Disorder (Cyclothymia)
Cyclothymic disorder is a milder type of bipolar disorder that causes regular mood swings. Ranging between those of mild depression and hypomania, the symptoms aren’t severe enough to be considered clinically depressive or hypomanic episodes.
Unspecified Bipolar Disorder
Unspecified bipolar disorder is when you have extreme mood fluctuations, but the symptoms aren’t as bad as those of bipolar 1 or 2. Still, with this type, the symptoms are significant enough to affect daily functioning, relationships, and work or school.
Bipolar Disorder Symptoms
Dramatic and intense changes in your mood, emotions, behaviors, and activity level are the primary signs of bipolar disorder. These shifts tend to be noticeable to others and impact your relationships, performance at work or school, or daily functioning.
The symptoms you experience depend on whether you’re having a manic or depressive episode.
Manic Episode Symptoms
During manic episodes, emotion and activity levels are elevated. Manic episode symptoms include the following:
Major Depressive Episode Symptoms
In contrast to manic episodes, during a depressive episode, you feel “low” in terms of energy, mood, and emotion. Symptoms of this type include combinations of the following:
When to Call 911If you have bipolar disorder, go to an emergency room (ER) if you experience:Suicidal thoughtsThoughts about hurting yourself or othersHallucinations or delusionsLithium toxicity symptoms: nausea, vomiting, dizziness, changes in vision, and slurred speech
When to Call 911
If you have bipolar disorder, go to an emergency room (ER) if you experience:Suicidal thoughtsThoughts about hurting yourself or othersHallucinations or delusionsLithium toxicity symptoms: nausea, vomiting, dizziness, changes in vision, and slurred speech
If you have bipolar disorder, go to an emergency room (ER) if you experience:
What Causes Bipolar Disorder?
Researchers don’t know what exactly causes bipolar disorder. The consensus is that genetic factors, brain chemistry and structure, and environmental factors all play a role in this condition.
Genetic Factors
Though more work is needed, researchers have linked genetics with an increased risk of developing bipolar disorder. This condition is heritable, making family history a risk factor; people with a parent or sibling with the condition are more likely to have it.
Brain Chemistry and Structure
Usingimagingtechniques, researchers have found differences between the brains of those with and without bipolar disorder. Some research shows that people with bipolar disorder have smaller subcortical structures (associated with mood and cognition) and a thinner cortex (the outer layer of the brain).
In addition, researchers have linked imbalances in certainneurotransmitters(brain chemicals), particularly dopamine and serotonin, to bipolar disorder.
Environmental Factors
Stressful or traumatic life events and certain behaviors can also raise your risk of developing bipolar disorder. Examples of traumatic events found to trigger attacks include childbirth, losing a job or a loved one, divorce, misusing or overusing drugs or alcohol, or traumatic head injuries.
How Is Bipolar Disorder Diagnosed?
To diagnose bipolar disorder, a healthcare provider will ask about your medical history, current medications, symptoms, and your family’s mental health history. You’ll also undergo a physical exam and, in some cases, blood tests to rule out other potential causes of bipolar disorder symptoms, such as hypothyroidism, stroke, and substance use disorder.
A healthcare provider or a mental health specialist, like a psychiatrist orpsychologist, will perform a mental health evaluation. They will diagnose bipolar disorder and identify the type based on criteria from theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-5).
Diagnosing Bipolar 1 Disorder
In bipolar 1 disorder, manic episodes last at least one week or are severe enough to require hospitalization. A healthcare provider will look for at least three (or four if you experience irritability) of the following to diagnose you with bipolar 1 disorder:
Diagnosing Bipolar 2 Disorder
A diagnosis ofbipolar 2 disorderis made based on four criteria:
“Hypomania” is defined as at least four days of manic symptoms that aren’t as severe or numerous as with a full manic episode. Major depressive episodes are defined as having daily or nearly daily symptoms for at least two weeks. According to the DSM-5, these are diagnosed when you display five of the following criteria:
Diagnostic Criteria for Cyclothymic Disorder
In the DSM-5, among the criteria for cyclothymic disorder are the following:
Bipolar Disorder Treatment
Treating bipolar disorder typically involves adopting multiple strategies, including medications, counseling, and lifestyle changes.
Medications
Antidepressants, mood stabilizers, and atypical antipsychotics are medication types that healthcare providers consider. A healthcare provider may prescribeselective serotonin reuptake inhibitors(SSRIs), a class of antidepressants, for depression associated with bipolar disorder. However, these can cause what is known as cycling—rapid mood shifts—so healthcare providers prescribe them with caution.
Mood-stabilizing drugs, such asLithobid(lithium) and Depacon (valproate), are indicated alongside SSRIs and help ease or shorten the length of mood episodes.A provider may also prescribe medications to address insomnia (sleep problems) and anxiety, which often accompany bipolar disorder.
Medication Side EffectsThe side effects of medications depend on the type you’re taking. For bipolar disorder, the most common of these are unintended weight gain, sedation, restlessness, and changes in metabolism.
Medication Side Effects
The side effects of medications depend on the type you’re taking. For bipolar disorder, the most common of these are unintended weight gain, sedation, restlessness, and changes in metabolism.
Psychotherapy and Counseling
Psychotherapy and counseling involve talk therapy with a psychiatrist, therapist, or trained counselor. This work aims to identify and change problematic behaviors, thoughts, or emotions that set off episodes. Another alternative iscognitive behavioral therapy(CBT), which focuses on changing thought patterns.
Lifestyle Changes
Alongside medical treatments or therapy, lifestyle changes can help you manage bipolar disorder, including:
Living with bipolar disorder means finding asupport system, developing coping mechanisms, and managing the shifts in your mood and behaviors. Strategies that can help include:
Why Does Bipolar Disorder Get Worse With Age?
Summary
Bipolar disorder causes dramatic and lasting mood and behavior shifts. People with the condition go through high-energy manic episodes and often also experience depressive episodes. Because of its effects on behavior, bipolar disorder can significantly impact your professional, academic, and/or personal life. If you suspect you or someone you care for has this condition, talk to a healthcare provider for an accurate diagnosis and treatment.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What are bipolar disorders?MedlinePlus.Bipolar disorder.National Institute of Mental Health.Bipolar disorder: definition.National Institute of Mental Health.Bipolar disorder: overview.National Alliance on Mental Illness (NAMI).Bipolar disorder.MedlinePlus.Lithium toxicity.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 26;8(9):251-269. doi:10.1177/2045125318769235.Abé C, Liberg B, Klahn AL, Petrovic P, Landén M. Mania-related effects on structural brain changes in bipolar disorder – a narrative review of the evidence.Mol Psychiatry. 2023;28(7):2674-2682. doi:10.1038/s41380-023-02073-4Lee JG, Woo YS, Park SW, Seog DH, Seo MK, Bahk WM.Neuromolecular etiology of bipolar disorder: possible therapeutic targets of mood stabilizers.Clin Psychopharmacol Neurosci. 2022;20(2):228-239. doi:10.9758/cpn.2022.20.2.228Substance Abuse and Mental Health Services Administration.DSM-5 changes: implications for child serious emotional disturbance. Substance Abuse and Mental Health Services Administration; 2016. Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison.Perugi G, Hantouche E, Vannucchi G.Diagnosis and treatment of cyclothymia: the “primacy” of temperament.Curr Neuropharmacol. 2017;15(3):372-379. doi:10.2174/1570159X14666160616120157Marzani G, Neff AP.Bipolar disorders: evaluation and treatment.Am Fam Physician.2021;103(4):227-239Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: A systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006Additional ReadingAmerican Psychiatric Association.What are bipolar disorders?
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What are bipolar disorders?MedlinePlus.Bipolar disorder.National Institute of Mental Health.Bipolar disorder: definition.National Institute of Mental Health.Bipolar disorder: overview.National Alliance on Mental Illness (NAMI).Bipolar disorder.MedlinePlus.Lithium toxicity.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 26;8(9):251-269. doi:10.1177/2045125318769235.Abé C, Liberg B, Klahn AL, Petrovic P, Landén M. Mania-related effects on structural brain changes in bipolar disorder – a narrative review of the evidence.Mol Psychiatry. 2023;28(7):2674-2682. doi:10.1038/s41380-023-02073-4Lee JG, Woo YS, Park SW, Seog DH, Seo MK, Bahk WM.Neuromolecular etiology of bipolar disorder: possible therapeutic targets of mood stabilizers.Clin Psychopharmacol Neurosci. 2022;20(2):228-239. doi:10.9758/cpn.2022.20.2.228Substance Abuse and Mental Health Services Administration.DSM-5 changes: implications for child serious emotional disturbance. Substance Abuse and Mental Health Services Administration; 2016. Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison.Perugi G, Hantouche E, Vannucchi G.Diagnosis and treatment of cyclothymia: the “primacy” of temperament.Curr Neuropharmacol. 2017;15(3):372-379. doi:10.2174/1570159X14666160616120157Marzani G, Neff AP.Bipolar disorders: evaluation and treatment.Am Fam Physician.2021;103(4):227-239Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: A systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006Additional ReadingAmerican Psychiatric Association.What are bipolar disorders?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Psychiatric Association.What are bipolar disorders?MedlinePlus.Bipolar disorder.National Institute of Mental Health.Bipolar disorder: definition.National Institute of Mental Health.Bipolar disorder: overview.National Alliance on Mental Illness (NAMI).Bipolar disorder.MedlinePlus.Lithium toxicity.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 26;8(9):251-269. doi:10.1177/2045125318769235.Abé C, Liberg B, Klahn AL, Petrovic P, Landén M. Mania-related effects on structural brain changes in bipolar disorder – a narrative review of the evidence.Mol Psychiatry. 2023;28(7):2674-2682. doi:10.1038/s41380-023-02073-4Lee JG, Woo YS, Park SW, Seog DH, Seo MK, Bahk WM.Neuromolecular etiology of bipolar disorder: possible therapeutic targets of mood stabilizers.Clin Psychopharmacol Neurosci. 2022;20(2):228-239. doi:10.9758/cpn.2022.20.2.228Substance Abuse and Mental Health Services Administration.DSM-5 changes: implications for child serious emotional disturbance. Substance Abuse and Mental Health Services Administration; 2016. Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison.Perugi G, Hantouche E, Vannucchi G.Diagnosis and treatment of cyclothymia: the “primacy” of temperament.Curr Neuropharmacol. 2017;15(3):372-379. doi:10.2174/1570159X14666160616120157Marzani G, Neff AP.Bipolar disorders: evaluation and treatment.Am Fam Physician.2021;103(4):227-239Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: A systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006
American Psychiatric Association.What are bipolar disorders?
MedlinePlus.Bipolar disorder.
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National Institute of Mental Health.Bipolar disorder: overview.
National Alliance on Mental Illness (NAMI).Bipolar disorder.
MedlinePlus.Lithium toxicity.
Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018 26;8(9):251-269. doi:10.1177/2045125318769235.
Abé C, Liberg B, Klahn AL, Petrovic P, Landén M. Mania-related effects on structural brain changes in bipolar disorder – a narrative review of the evidence.Mol Psychiatry. 2023;28(7):2674-2682. doi:10.1038/s41380-023-02073-4
Lee JG, Woo YS, Park SW, Seog DH, Seo MK, Bahk WM.Neuromolecular etiology of bipolar disorder: possible therapeutic targets of mood stabilizers.Clin Psychopharmacol Neurosci. 2022;20(2):228-239. doi:10.9758/cpn.2022.20.2.228
Substance Abuse and Mental Health Services Administration.DSM-5 changes: implications for child serious emotional disturbance. Substance Abuse and Mental Health Services Administration; 2016. Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison.
Perugi G, Hantouche E, Vannucchi G.Diagnosis and treatment of cyclothymia: the “primacy” of temperament.Curr Neuropharmacol. 2017;15(3):372-379. doi:10.2174/1570159X14666160616120157
Marzani G, Neff AP.Bipolar disorders: evaluation and treatment.Am Fam Physician.2021;103(4):227-239
Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: A systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006
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