Bipolar disorder is a mental illness marked by extreme mood swings from high (mania) to low (depression) and low to high. The mood swings may even become mixed, so you might feel elated and depressed at the same time.
Bipolar is not a rare diagnosis. More than 5 million people in the United States are living with some form of bipolar disorder. Symptoms tend to appear in a person’s late teens or early adult years, but they can occur in children as well. Women are more likely to receive bipolar diagnoses than men, though the reason for this remains unclear.
Bipolar disorder can be hard to diagnose, but there are warning signs you can look for.
Bipolar disorder may include the following warning signs.
7 signs of mania
- feeling overly happy or “high” for long periods of time
- having a decreased need for sleep
- talking very fast, often with racing thoughts
- feeling extremely restless or impulsive
- becoming easily distracted
- having overconfidence in your abilities
- engaging in risky behavior, such as having impulsive sex, gambling with life savings, or going on big spending sprees
7 signs of depression
- feeling sad or hopeless for long periods of time
- withdrawing from friends and family or losing interest in activities that you once enjoyed
- having a significant change in appetite
- feeling severe fatigue or lack of energy
- speaking slowly
- having problems with memory, concentration, and decision-making
- thinking about or attempting suicide, or having a preoccupation with death
Although there are four common types of bipolar disorder, there are two types that are most often diagnosed.
This classic form of bipolar disorder used to be called “manic depression.” In bipolar I, manic phases are clear. The person’s behavior and moods are extreme, and their behavior quickly escalates until they’re out of control. The person may end up in the emergency room if left untreated.
To have bipolar I, a person must have manic episodes. In order for an event to be considered a manic episode, it must:
- include moods or behaviors that are unlike the person’s usual behavior
- be present most of the day, nearly every day during the episode
- last at least one week, or be so extreme that the person needs immediate hospital care
Bipolar II is four times more common than bipolar I. It includes symptoms that are much less severe. These symptoms are called hypomanic symptoms. Bipolar II is harder for people to see in themselves, and it’s often up to friends or loved ones to encourage someone with this type to get help. Hypomania often becomes worse without treatment, and the person can become severely manic or depressed.
Rarer types of bipolar
There are two other types of the disorder that are less common than bipolar I and II. Cyclothymic disorder involves mood swings and shifts similar to bipolar I and II, but the shifts are often less dramatic in nature. A person with cyclothymic disorder can often function normally without medication, though it may be hard. Over time, a person’s mood swings may develop into a diagnosis of bipolar I or II.
Bipolar disorder not otherwise specified is a general category for a person who only has some bipolar symptoms. These symptoms are not enough to make a diagnosis of one of the other three types.
Bipolar disorder can be difficult to diagnose. Unless you have severe mania, the symptoms can be hard to spot. People who have hypomania may feel more energized than usual, more confident and full of ideas, and able to get by on less sleep. These are things that hardly anyone complains about. You’re more likely to seek help if you’re depressed, but your doctor may not observe the manic side then.
When doctors do suspect bipolar disorder, they may use a few different approaches to make the diagnosis:
- a physical exam to rule out any other medical conditions that could cause your symptoms, such as thyroid disease
- a mental health evaluation, which may include a questionnaire and interviews with family members
- a mood-charting diary to keep track of your sleep patterns and daily moods
- the Diagnostic and Statistical Manual of Mental Disorders, which can be used to compare your symptoms with the official description
If you’re worried that you might have bipolar disorder, the best thing to do is educate yourself about mood disorders and their symptoms. Then share your list of symptoms with your doctor.
It can be harder to address if you’re concerned about a friend or loved one having bipolar disorder. Ask for help from other friends or family members. People with bipolar disorder often deny any problems, especially during manic episodes. Think of bipolar disorder as you would any other serious disease, and get professional help right away.
People with bipolar disorder may have other psychological diagnoses, including obsessive-compulsive disorder, eating disorders, and substance abuse. The desire to medicate their bipolar with drugs or alcohol can put them at risk for substance abuse. Men are more likely to deal with substance abuse alongside their bipolar. Women most often experience thyroid disease, obesity, and migraines with bipolar.
Approximately 1 in 5 people with a bipolar diagnosis also have borderline personality disorder. There are some similarities between the two disorders, but there are also many differences in the symptoms and causes. More research is needed to understand the relationship between them.
Once you have a diagnosis, your doctor will decide on a treatment program that works best for you. Bipolar treatment may include:
A licensed psychiatrist usually manages your treatment. You may also have a social worker, psychologist, or psychiatric nurse practitioner involved in your care.
Common prescriptions for people with bipolar include mood-stabilizing drugs. Mood stabilizers, such as those containing lithium and valproic acid (Depakene), will help with manic episodes. If mood stabilizers are not enough to improve a person’s quality of life, a doctor may next prescribe antidepressant-antipsychotic drug combinations such as fluoxetine-olanzapine (Symbyax).
Treatment for bipolar must be ongoing. When people stop taking medication or meeting with their doctor, they will likely have manic and depressive episodes again. However, with the proper treatment, bipolar disorder can be controlled and a person can lead a healthy and productive life.
You asked, we answered
- How do bipolar symptoms in children and teens differ from bipolar symptoms in adults?
Diagnosing bipolar disorder in children and adolescents is harder than diagnosing it in adults. We know that about 30 percent of children who are diagnosed with major depressive disorder will ultimately be diagnosed with bipolar disorder. Forty percent of adolescents diagnosed with major depressive disorder will also ultimately receive a bipolar diagnosis. Therefore, the need for accurate diagnosis is essential. Pediatric patients generally show disruptive behaviors that may lead to the mistaken belief that the child has attention deficit hyperactivity disorder (ADHD). They may then be treated with medications for that condition. Adolescents may also be thought to have ADHD and depression. This is unfortunate, because stimulant medications could cause further mood disruptions.- Healthline Medical Team
- Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.