Everything You Need to Know About Bipolar Disorder

Bipolar disorder, formerly manic depression, causes extreme mood shifts ranging from mania to depression. Learn symptoms, diagnosis, treatment, and more.

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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 are available.

Bipolar disorder isn’t a rare condition. In fact, the National Institute of Mental Health says that 2.8% Opens in a new window of U.S. adults — or about 5 million people — have a bipolar disorder diagnosis.

The condition used to be known as manic depression and bipolar disease.

Types of bipolar disorder

There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia. Your healthcare professional 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. This may be diagnosed as “other specified bipolar and related disorders” or “unspecified bipolar and related disorders.”

Bipolar I

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.

You may also go through a long period of stable mood before experiencing either mania or depression.

Bipolar II

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 2017 review Opens in a new window, this type of bipolar disorder may be more common in people assigned female at birth.

Cyclothymia

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 1 to 2 months Opens in a new window at a time.

Bipolar disorder 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 Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), a diagnosis of bipolar I disorder requires:

  • 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 both mania and depression (known as mixed features). These symptoms can have more impact on your life.

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 longer and 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.

Cyclothymia symptoms

A diagnosis of cyclothymia requires:

  • periods of hypomanic symptoms and periods of depression symptoms, off and on, over 2 years or longer Opens in a new window (1 year Opens in a new window for 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.

Understanding bipolar-related episodes of mania and hypomania

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 partner sex without a condom or other 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 involves many of the same symptoms, though they’re less severe.

Unlike mania, hypomania often doesn’t lead to consequences at work, school, or in your relationships. Episodes of hypomania don’t involve psychosis. They typically won’t last as long as episodes of mania or require inpatient care.

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.

Understanding bipolar-related episodes of major depression

A “down” change in mood can leave you feeling lethargic, unmotivated, and sad.

Bipolar-related episodes of major depression 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 experiences major depressive episodes, though many people do.

Depending on your type of bipolar disorder, you might experience only a few symptoms of depression but not the full five needed to diagnose a major episode.

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 might remain “down” until you get treatment.

How bipolar disorder affects people of different sexes

Most research suggests that bipolar disorder is diagnosed at roughly the same Opens in a new window rate across male and female populations.

People assigned female at birth tend to receive Opens in a new window 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. People assigned female at birth living with bipolar disorder tend to experience Opens in a new window:

  • milder episodes of mania
  • more depressive episodes than manic episodes
  • rapid cycling, or four or more episodes of mania and depression in 1 year
  • more co-occurring conditions

People assigned female at birth 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.

People assigned male at birth 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

How bipolar disorder affects historically marginalized groups

Research Opens in a new window shows that people from historically marginalized groups, particularly those of African ancestry, are frequently misdiagnosed with other conditions like schizophrenia, especially if they exhibit symptoms of psychosis.

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 that 50% to 75% Opens in a new window 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.

How bipolar disorder affects children and teens

Diagnosing bipolar disorder in children is controversial, largely because children don’t always display the same symptoms as adults.

Many bipolar disorder symptoms that occur in children also overlap with symptoms of other common conditions, 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 can appear Opens in a new window very happy and show signs of excitable behavior or seem very tearful, low, and irritable.

All children experience mood changes, but bipolar disorder causes distinct and noticeable mood symptoms. Bipolar-related mood changes are usually more extreme than a child’s typical change in mood.

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.

Diagnosis is most common during the late teen and early adult years.

Remember that many of these potential 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.

Bipolar disorder treatment and management

Several treatments can help you manage bipolar disorder symptoms. These include medications, counseling, and lifestyle measures. Some natural remedies can also have benefits.

Medications

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

Psychotherapy

Cognitive behavioral therapy is a type of talk therapy that helps you identify and address unhelpful thoughts and change unwanted patterns of behavior.

Therapy offers a safer space to discuss ways to manage your symptoms. A therapist can also offer support with:

  • understanding thought patterns
  • reframing distressing emotions
  • learning and practicing more helpful coping strategies

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 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.

Natural remedies

Some natural remedies might also help with symptom management.

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:

You should consult with a doctor before trying SAMe or any other herbal or natural remedies to help you manage your bipolar symptoms.

Lifestyle changes

Some studies suggest that lifestyle measures can help reduce the severity Opens in a new window of your symptoms. These can include the following:

  • 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 not significant Opens in a new window, indicating that lifestyle interventions alone may not be enough to manage the condition. They may work better when combined with other treatments.

Potential causes and risk factors for bipolar disorder

Bipolar disorder is a fairly common mental health condition, but experts have yet to determine why some people develop it

Some potential causes include:

Genetics

If a biological parent or sibling has bipolar disorder, you’re more likely to develop the condition. The risk of developing bipolar disorder is 10% to 25% Opens in a new window if one of your parents has the condition.

Keep in mind, though, that most people who have a history of bipolar disorder in their family history don’t develop it.

Your brain

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.

Environmental factors

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

Some people living with bipolar disorder also have other mental health conditions. A 2019 research review Opens in a new window suggests that anxiety disorders are among the most common.

Other conditions that might occur alongside bipolar disorder include:

  • substance use disorders
  • eating disorders
  • specific phobias
  • ADHD

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 disorders might be more likely with mania.

If you have bipolar disorder, you may also have a higher chance of developing certain medical conditions, including:

  • migraine
  • heart disease
  • diabetes
  • thyroid disorders

Ways to cope and find support when living with bipolar disorder

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 you understand and support them.

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.

The bottom line

Bipolar disorder is a lifelong condition, but that doesn’t mean it has to completely disrupt your life.

Living with bipolar disorder can create some challenges, but sticking with your treatment plan, practicing regular self-care, and leaning on your support system can boost 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:

This article originally appeared on Healthline. © 2025 Healthline Media LLC. All rights reserved. Our website services, content, and products are for informational purposes only. Healthline Media does not provide medical advice, diagnosis, or treatment.
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Last updated: March 17, 2025

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By: Healthline

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