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Bipolar disorder is a serious mental illness that causes unusual shifts in mood, ranging from extreme highs (mania or “manic” episodes) to lows (depression or “depressive” episode).
A person who has bipolar disorder also experiences changes in their energy, thinking, behavior, and sleep. During bipolar mood episodes, it is difficult to carry out day-to-day tasks, go to work or school, and maintain relationships.
What Causes Bipolar Disorder?
Bipolar disorder affects millions of adults in the U.S. Most people are diagnosed with bipolar disorder in their teens or twenties, however, it can occur at any age and although the symptoms can persist, many find ways to manage their symptoms successfully. People are at a higher risk if they have a family history of bipolar disorder, experienced a traumatic event, and/or misused drugs or alcohol. Differences in brain structure and function may also play a role. If you think you may have it, tell your health care provider.
Signs and Symptoms of Bipolar Disorder
When a person has a manic episode, they feel overly excited, productive, and even invincible. On the other hand, when a person has a depressive episode, they feel extremely sad, hopeless, and tired. They may avoid friends, family, and participating in their usual activities. A severe manic or depressive episode may trigger psychotic symptoms, such as delusions (false beliefs) or hallucinations (seeing or hearing things that others do not see or hear). These drastic behavior changes usually cause concern among friends and family. Everyone’s experience with bipolar disorder is different, and the signs and symptoms vary:
A "manic" episode may include
A "manic" episode may include:
- Intense feelings of euphoria, excitement, or happiness
- Appearing abnormally jumpy or wired
- Having excessive energy
- Insomnia or restlessness (a decreased need for sleep)
- Speaking fast or being unusually talkative
- Having racing or jumbled thoughts
- Inflated self-esteem
- Doing impulsive, uncharacteristic, or risky things like having unsafe sex or spending a lot of money
- Increased agitation and irritability
A "depressive" episode may include
A "depressive" episode may include:
- Feeling down, sad, worried, worthless, anxious, guilty, empty, or hopeless
- Lack of interest, or no interest, in activities
- Feeling tired, low energy
- Difficulty concentrating
- Changes in sleep, either sleeping too much or too little
- Changes in appetite, either eating too much or too little
- Thoughts of death and/or suicide
Types & Treatment Bipolar Disorder
Types of Bipolar Disorder
Each type of bipolar disorder includes periods between manic or depressive episodes when symptoms lessen, or people feel stable. The major difference between the types of disorder is how extreme the mood states are and how long they last.
- Bipolar I Disorder: having a history of at least one manic episode, but sometimes also having depressed or hypomanic episodes as well.
- Bipolar II Disorder: mood states that vary from an even mood to high to low, but the highs are less extreme and are called hypomanic states. The depressive episodes may be just as severe as those in Major Depressive Disorder and/or Bipolar I Disorder.
- Cyclothymic Disorder: more chronic mood instability (both highs and lows) that are not as long, severe, or frequent as those experienced in bipolar I or II disorder.
Treatment for Bipolar Disorder
Bipolar disorder is a lifelong condition that doesn’t go away on its own. While it can feel overwhelming and isolating at first, an early, accurate diagnosis is the first step toward getting better. Proper treatment, along with support and self-care, helps people with bipolar disorder live healthy, fulfilling lives.
If you think you may have bipolar disorder, tell your health care provider. A medical checkup can rule out other illnesses that might cause your mood changes.
Bipolar disorder is treatable with a combination of medication and therapy.
- Medications. Mood stabilizers, antipsychotics, and antidepressants can help manage mood swings and other symptoms. It is important to understand the benefits and risks of medications. People may need to try different medications before determining which works best for them. They should never stop taking a medication without their doctor’s guidance.
- “Talk therapy” (psychotherapy). Therapy helps people accept their disorder, recognize the warning signs of a manic or depressive episode, develop coping skills for handling stress, and stick with a medication schedule. Therapy also improves communication and relationships among families.
- Long-term, continuous treatment. While there may be times between episodes where a person feels fine, a long-term, continuous treatment plan can reduce the severity and frequency of mood swings.
These healthy lifestyle habits, along with professional treatment, can help manage the symptoms of bipolar disorder:
- Keep a consistent sleeping schedule. Go to sleep and wake up at the same time each day. Being sleep deprived can put people at risk for manic or depressive episodes. Sleeping more than usual may be a sign of a depressive episode. Limit caffeine, which can disrupt sleep.
- Eat well and get regular exercise. A healthy diet will give your body proper nutrition, and exercise may help improve your mood.
- Always take your medicine as prescribed. You should do this even when your mood is stable.
- Check with your doctor before taking over-the-counter supplements or any medications prescribed by another doctor.
- Keep a mood journal. By tracking how you feel day-to-day, you can notice triggers, monitor how your treatment is working, and spot changes in your eating or sleeping patterns. This written information can be especially helpful to your doctor if your medication needs to be adjusted.
- Keep your primary care physician updated. They are an important part of the long-term management of bipolar disorder, even if you also see a psychiatrist.
- Avoid using alcohol and other drugs.
- Minimize stress. Simplify your life when possible. Try relaxation activities, like meditation or yoga.
- Maintain a support network, of family and friends there to help during a crisis. Educate your loved ones about bipolar disorder so they can best support you. Ask them to help you recognize the warning signs of manic or depressive episodes.
- If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org.
- To learn how to get support for mental health, drug, and alcohol issues, visit FindSupport.gov.
- To locate treatment facilities or providers, visit FindTreatment.gov or call SAMHSA’s National Helpline at 800-662-HELP (4357).
- SAMHSA's 2021 National Survey on Drug Use and Health
- Mental Illness and Substance Use in Young Adults
- Co-Occurring Disorders: Diagnoses and Integrated Treatments
- Helping Families: Resources for Mental and Substance Use Disorders
- Preventing Suicide
- National Institute of Mental Health: Bipolar Disorder
- The Diagnosis and Treatment of Bipolar Disorder: Decision-Making in Primary Care | The Primary Care Companion for CNS Disorders
- Mayo Clinic: Bipolar Disorder
- Interdepartmental Serious Mental Illness Coordinating Committee
- SMI Adviser | American Psychological Association (APA) and SAMHSA
- Technology Transfer Centers (TTC) Program