What is Bipolar Disorder like? Everybody has mood swings from time to time, but these swings in mood are usually caused by environmental or emotional stimuli. Bipolar disorder (BPD), formerly known as “manic depression” is a chronic mental health condition characterised by extreme changes in mood that can last for days or weeks at a time.
A person with bipolar disorder cycles between periods of feeling very “high” or euphoric (mania) and extremely low periods (depression), often without an identifiable triggering event.
The exact cycle of mood changes varies from person to person. In some people changes in mood can last weeks or months, and in others the mood swings are shorter and more intense.
What is Bipolar Disorder like?
Symptoms of bipolar disorder usually first appear before the age of 20, with most people having their first manic or depressive event between the ages of 15 and 19. As depression is often the first symptom experienced by people with bipolar disorder (only about 25% of people experience mania as their first symptom of the condition), many people are initially misdiagnosed.
Types of Bipolar Disorder
There are three recognised types of bipolar disorder, each characterised by the intensity and duration of mood changes.
Type I Bipolar Disorder
People living with Bipolar I Disorder experience extreme manic (high) periods that are long lasting and can interfere with normal function, as well as depressive periods and possibly psychosis.
Type II Bipolar Disorder
People with Bipolar II Disorder typically experience less severe manic episodes (known as hypomania) that generally only last a short while (hours or days). Depressive episodes also occur but most people with Bipolar II experience periods of stability and normal mood between manic and depressive episodes.
This form of Bipolar Disorder is not as severe as others with the mood swings generally being shorter and less severe. This still would leave someone with the thoughts like what is bipolar disorder really.
Symptoms of Bipolar Disorder
People living with bipolar disorder experience symptoms of mania and depression at different stages of their cycle. No two manic or depressive incidents are the same but they share common symptoms.
There are three main symptoms that can occur with bipolar disorder: mania, hypomania, and depression.
While experiencing mania, a person with bipolar disorder may feel an emotional high. They can feel excited, impulsive, euphoric, and full of energy. During manic episodes, they may also engage in behavior such as:
- spending sprees
- unprotected sex
- drug use
Hypomania is generally associated with bipolar II disorder. It’s similar to mania, but it’s not as severe. Unlike mania, hypomania may not result in any trouble at work, school, or in social relationships. However, people with hypomania still notice changes in their mood.
Common symptoms of a manic episode include:
- feeling extremely euphoric (‘high’) or energetic
- Increased goal-directed behaviour or fixation on a task
- Sleeplessness, or going without sleep to achieve goals
- Speaking and reacting quickly with no forethought or care for consequences
- reckless behaviour, such as participating in unsafe sexual activity, overspending or making other rash decisions with long-lasting consequences
- Heightened aggression and irritability
- Unrealistic plans or other forms of irrational thinking
During an episode of depression you may experience:
- deep sadness
- loss of energy
- lack of interest in activities they once enjoyed
- periods of too little or too much sleep
- suicidal thoughts
- Social withdrawal
- Prolonged feelings of sadness or hopelessness
- A lack of appetite or interest in eating
- Weight loss
- Feeling of guilt or anxiety without obvious cause
- Difficulties with concentration
People with BPD experiencing a manic episode may also experience psychotic episodes, with symptoms including:
- Confused thinking – frequently changing or skipping between topics, making up words, speaking in garbled or muddled sentences, speaking with odd cadence (very fast or slow) or using the wrong words to describe things.
- Delusions – false beliefs or sensations not experienced by anyone else, such as a person believing they have special abilities or knowledge or are controlled by an outside force or agent.
- Hallucinations – seeing, smelling, hearing or tasting things that are not there. Many hallucinations involve hearing voices that nobody else can hear.
Mania or hypomania, depression and people with psychosis can all lead to marked changes in personality and behaviour.
What is Bipolar Disorder and What Causes Bipolar Disorder?
As with most mental health conditions, the exact cause for bipolar depression is unknown. Genetics are known to be a major contributing factor to the development of BPD, with research indicating that around 80% of cases have a genetic link. This genetic link is hereditary, with people with a direct relative (sibling or parent) having a four to six times higher chance of developing BPD than those without.
One popular theory for the genetic cause of bipolar disorder is that people with the condition may have a genetic predisposition that makes it easy for neurotransmitters like serotonin and norepinephrine to be thrown out of balance causing the changes in mood.
Environmental factors, illness and stress have also been linked to the development of bipolar disorder. Stress is not known to cause BPD but can be a contributing factor or trigger for the onset of the condition. Many people with bipolar disorder find that learning to manage stress can help then reduce the frequency or relapse.
Each person living with bipolar disorder has individual triggers that can cause a relapse of manic or depressive symptoms, but some of the more common triggers include:
- Use of both legal and illegal drugs, including alcohol and cannabis
- Stress in the home or office
- Negative, impactful life events like the loss of a job, the death of a loved one or illness
- Sleeping too little when manic
- Sleeping too much when depressed
- Metabolic stress from changing normal patterns (irregular eating, sleeping and physical activity)
- Stopping the use of prescribed medication (often during a manic episode)
- Disrupting normal rhythms – radically changing routine, sleep/wake cycles, travelling overseas and the like
Treatment for Bipolar Disorder
Bipolar disorder is a lifelong condition that cannot be cured, but through a mixture of lifestyle changes, medication and therapy, the intensity and duration of manic and depressive episodes can be reduced or controlled.
Depending on the type and severity of bipolar disorder a person experiences, they may be prescribed a number of different medications for mood stabilisation, to help control depressive episodes (antidepressants) or to control any symptoms of psychosis that may occur (antipsychotic medications).
Depending on the frequency and severity of symptoms, medications may be prescribed for long term use or for short term help.
Psychotherapeutic techniques can help a person with BPD better manage their symptoms as well as alter or avoid triggers for relapse.
Cognitive Behavioural Therapy (CBT) and psycho-education can help people living with bipolar disorder to regain control of their lives through a combination of challenging negative thinking and behaviour as well as helping people better understand their mental health condition, ensure that medications are taken to schedule and learn how to self manage symptoms and potential triggers for relapse.
Each person living with bipolar disorder may have specific lifestyle factors that contribute to recurrences of manic or depressive episodes that can be identified with the help of a medical professional, but outside of these specific changes there are still a number of things you can do to aid in control of symptoms, including:
- Keep a routine for both eating and sleeping, and try to maintain this routine no matter the current mood
- Learn to recognise the onset of mood changes
- Document your moods to help better identify triggering events or activities
- Ask a friend or family member to aid in your treatment and management of the condition
- Surround yourself with supportive people or contact a support network
- Avoid drugs, both legal and illegal, including alcohol, cannabis, caffeine and nicotine
If you need help dealing with mental health issues there are a number of quality resources online offering ideas and suggestions, including Beyond Blue , Lifeline , The Black Dog Institute and Reach Out .
You may approach your GP for a Mental Health Care Plan , that involves a referral to a mental health professional for a number of bulk-billable appointments.
Always remember that bipolar disorder is a mental illness marked by extreme shifts in mood. Symptoms can include an extremely elevated mood called mania. They can also include episodes of depression. Bipolar disorder is also known as bipolar disease or manic depression.
People with bipolar disorder may have trouble managing everyday life tasks at school or work, or maintaining relationships. There’s no cure, but there are many treatment options available that can help to manage the symptoms.
Bipolar disorder facts
Bipolar disorder isn’t a rare brain disorder. In fact, 2.8 percent of U.S. adults — or about 5 million people — have been diagnosed with it. The average age when people with bipolar disorder begin to show symptoms is 25 years old.
Depression caused by bipolar disorder lasts at least two weeks. A high (manic) episode can last for several days or weeks. Some people will experience episodes of changes in mood several times a year, while others may experience them only rarely.
Bipolar disorder symptoms in women
Men and women are diagnosed with bipolar disorder in equal numbers. However, the main symptoms of the disorder may be different between the two genders. In many cases, a woman with bipolar disorder may:
- be diagnosed later in life, in her 20s or 30s
- have milder episodes of mania
- experience more depressive episodes than manic episodes
- have four or more episodes of mania and depression in a year, which is called rapid cycling
- experience other conditions at the same time, including thyroid disease, obesity, anxiety disorders, and migraines
- have a higher lifetime risk of alcohol use disorder
Women with bipolar disorder may also relapse more often. This is believed to be caused by hormonal changes related to menstruation, pregnancy, or menopause. If you’re a woman and think you may have bipolar disorder, it’s important for you to get the facts.
Bipolar disorder symptoms in men
Men and women both experience common symptoms of bipolar disorder. However, men may experience symptoms differently than women. Men with bipolar disorder may:
- be diagnosed earlier in life
- experience more severe episodes, especially manic episodes
- have substance abuse issues
- act out during manic episodes
Men with bipolar disorder are less likely than women to seek medical care on their own. They’re also more likely to die by suicide.
Types of bipolar disorder
There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia.
Bipolar I is defined by the appearance of at least one manic episode. You may experience hypomanic or major depressive episodes before and after the manic episode. This type of bipolar disorder affects men and women equally.
People with this type of bipolar disorder experience one major depressive episode that lasts at least two weeks. They also have at least one hypomanic episode that lasts about four days. This type of bipolar disorder is thought to be more common in women.
People with cyclothymia have episodes of hypomania and depression. These symptoms are shorter and less severe than the mania and depression caused by bipolar I or bipolar II disorder. Most people with this condition only experience a month or two at a time where their moods are stable.
When discussing your diagnosis, your doctor will be able to tell you what kind of bipolar disorder you have.
Bipolar disorder in children
Diagnosing bipolar disorder in children is controversial. This is largely because children don’t always display the same bipolar disorder symptoms as adults. Their moods and behaviors may also not follow the standards doctors use to diagnose the disorder in adults.
Many bipolar disorder symptoms that occur in children also overlap with symptoms from a range of other disorders that can occur in children, 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. Your child may need to seek special care from a professional trained to treat children with mental health issues.
Like adults, children with bipolar disorder experience episodes of elevated mood. They can appear very happy and show signs of excitable behavior. These periods are then followed by depression. While all children experience mood changes, changes caused by bipolar disorder are very pronounced. They’re also usually more extreme than a child’s typical change in mood.
Manic symptoms in children
Symptoms of a child’s manic episode caused by bipolar disorder can include:
- acting very silly and feeling overly happy
- talking fast and rapidly changing subjects
- having trouble focusing or concentrating
- doing risky things or experimenting with risky behaviors
- having a very short temper that leads quickly to outbursts of anger
- having trouble sleeping and not feeling tired after sleep loss
Depressive symptoms in children
Symptoms of a child’s depressive episode caused by bipolar disorder can include:
- moping around or acting very sad
- sleeping too much or too little
- having little energy for normal activities or showing no signs of interest in anything
- complaining about not feeling well, including having frequent headaches or stomachaches
- experiencing feelings of worthlessness or guilt
- eating too little or too much
- thinking about death and possibly suicide
Other possible diagnoses
Some of the behavior issues you may witness in your child could be the result of another condition. ADHD and other behavior disorders can occur in children with bipolar disorder. Work with your child’s doctor to document your child’s unusual behaviors, which will help lead to a diagnosis.
Finding the correct diagnosis can help your child’s doctor determine treatments that can help your child live a healthy life.
Angst-filled behavior is nothing new to the average parent of a teenager. The shifts in hormones, plus the life changes that come with puberty, can make even the most well-behaved teen seem a little upset or overly emotional from time to time. However, some teenage changes in mood may be the result of a more serious condition, such as bipolar disorder.
A bipolar disorder diagnosis is most common during the late teens and early adult years. For teenagers, the more common symptoms of a manic episode include:
- being very happy
- “acting out” or misbehaving
- taking part in risky behaviors
- abusing substances
- thinking about sex more than usual
- becoming overly sexual or sexually active
- having trouble sleeping but not showing signs of fatigue or being tired
- having a very short temper
- having trouble staying focused, or being easily distracted
For teenagers, the more common symptoms of a depressive episode include:
- sleeping a lot or too little
- eating too much or too little
- feeling very sad and showing little excitability
- withdrawing from activities and friends
- thinking about death and suicide
Diagnosing and treating bipolar disorder can help teens live a healthy life.
Bipolar disorder can have two extremes: up and down. To be diagnosed with bipolar, you must experience a period of mania or hypomania. People generally feel “up” in this phase of the disorder. When you’re experiencing an “up” change in mood, you may feel highly energized and be easily excitable.
Some people with bipolar disorder will also experience a major depressive episode, or a “down” mood. When you’re experiencing a “down” change in mood, you may feel lethargic, unmotivated, and sad. However, not all people with bipolar disorder who have this symptom feel “down” enough to be labeled depressed.
For instance, for some people, once their mania is treated, a normal mood may feel like depression because they enjoyed the “high” caused by the manic episode.
While bipolar disorder can cause you to feel depressed, it’s not the same as the condition called depression. Bipolar disorder can cause highs and lows, but depression causes moods and emotions that are always “down.”
Causes of bipolar disorder
Bipolar disorder is a common mental health disorder, but it’s a bit of a mystery to doctors and researchers. It’s not yet clear what causes some people to develop the condition and not others.
Possible causes of bipolar disorder include:
If your parent or sibling has bipolar disorder, you’re more likely than other people to develop the condition (see below). However, it’s important to keep in mind that most people who have bipolar disorder in their family history don’t develop it.
Your brain structure may impact your risk for the disease. Abnormalities in the structure or functions of your brain may increase your risk.
It’s not just what’s in your body that can make you more likely to develop bipolar disorder. Outside factors may contribute, too. These factors can include:
- extreme stress
- traumatic experiences
- physical illness
Each of these factors may influence who develops bipolar disorder. What’s more likely, however, is that a combination of factors contributes to the development of the disease.
Is bipolar disorder hereditary?
Bipolar disorder can be passed from parent to child. Research has identified a strong genetic link in people with the disorder. If you have a relative with the disorder, your chances of also developing it are four to six times higher than people without a family history of the condition.
However, this doesn’t mean that everyone with relatives who have the disorder will develop it. In addition, not everyone with bipolar disorder has a family history of the disease.
Bipolar disorder diagnosis
A diagnosis of bipolar disorder I involves either one or more manic episodes, or mixed (manic and depressive) episodes. It may also include a major depressive episode, but it may not. A diagnosis of bipolar II involves one or more major depressive episodes and at least one episode of hypomania.
To be diagnosed with a manic episode, you must experience symptoms that last for at least one week or that cause you to be hospitalized. You must experience symptoms almost all day every day during this time. Major depressive episodes, on the other hand, must last for at least two weeks.
Bipolar disorder can be difficult to diagnose because mood swings can vary. It’s even harder to diagnose in children and adolescents. This age group often has greater changes in mood, behavior, and energy levels.
Bipolar disorder often gets worse if it’s left untreated. Episodes may happen more often or become more extreme. But if you receive treatment for your bipolar disorder, it’s possible for you to lead a healthy and productive life. Therefore, diagnosis is very important.
Bipolar disorder symptoms test
One test result doesn’t make a bipolar disorder diagnosis. Instead, your doctor will use several tests and exams. These may include:
- Physical exam. Your doctor will do a full physical exam. They may also order blood or urine tests to rule out other possible causes of your symptoms.
- Mental health evaluation. Your doctor may refer you to a mental health professional such as a psychologist or psychiatrist. These doctors diagnose and treat mental health conditions such as bipolar disorder. During the visit, they will evaluate your mental health and look for signs of bipolar disorder.
- Mood journal. If your doctor suspects your behavior changes are the result of a mood disorder like bipolar, they may ask you to chart your moods. The easiest way to do this is to keep a journal of how you’re feeling and how long these feelings last. Your doctor may also suggest that you record your sleeping and eating patterns.
- Diagnostic criteria. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an outline of symptoms for various mental health disorders. Doctors can follow this list to confirm a bipolar diagnosis.
Your doctor may use other tools and tests to diagnose bipolar disorder in addition to these.
Bipolar disorder treatment
Several treatments are available that can help you manage your bipolar disorder. These include medications, counseling, and lifestyle changes. Some natural remedies may also be helpful.
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 such as alprazolam (Xanax) that may be used for short-term treatment
Recommended psychotherapy treatments may include:
Cognitive behavioral therapy
Cognitive behavioral therapy is a type of talk therapy. You and a therapist talk about ways to manage your bipolar disorder. They will help you understand your thinking patterns. They can also help you come up with positive coping strategies. You can connect to a mental health care professional in your area using the Healthline FindCare tool.
Psychoeducation is a kind of counseling that helps you and your loved ones understand the disorder. Knowing more about bipolar disorder will help you and others in your life manage it.
Interpersonal and social rhythm therapy
Interpersonal and social rhythm therapy (IPSRT) focuses on regulating daily habits, such as sleeping, eating, and exercising. Balancing these everyday basics can help you manage your disorder.
Other treatment options
Other treatment options may include:
- electroconvulsive therapy (ECT)
- sleep medications
There are also some simple steps you can take right now to help manage your bipolar disorder:
- keep a routine for eating and sleeping
- learn to recognize mood swings
- ask a friend or relative to support your treatment plans
- talk to a doctor or licensed healthcare provider
Other lifestyle changes can also help relieve depressive symptoms caused by bipolar disorder.
Some natural remedies may be helpful for bipolar disorder. However, it’s important not to use these remedies without first talking with your doctor. These treatments could interfere with medications you’re taking.
The following herbs and supplements may help stabilize your mood and relieve symptoms of bipolar disorder:
- Fish oil. A 2013 studyTrusted Source shows that people who consume a lot of fish and fish oil are less likely to develop bipolar disease. You can eat more fish to get the oil naturally, or you can take an over-the-counter (OTC) supplement.
- Rhodiola rosea. This researchTrusted Source also shows that this plant may be a helpful treatment for moderate depression. It may help treat depressive symptoms of bipolar disorder.
- S-adenosylmethionine (SAMe). SAMe is an amino acid supplement. The researchTrusted Source shows it can ease symptoms of major depression and other mood disorders.
If you or someone you know has bipolar disorder, you’re not alone. Bipolar disorder affects about 60 million peopleTrusted Source around the world.
One of the best things you can do is to educate yourself and those around you. There are many resources available. For instance, SAMHSA’s behavioral health treatment services locator provides treatment information by ZIP code. You can also find additional resources at the site for the National Institute of Mental Health.
If you think you’re experiencing symptoms of bipolar disorder, make an appointment with your doctor. If you think a friend, relative, or loved one may have bipolar disorder, your support and understanding is crucial. Encourage them to see a doctor about any symptoms they’re having.
People who are experiencing a depressive episode may have suicidal thoughts. You should always take any talk of suicide seriously.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Bipolar disorder and relationships
When it comes to managing a relationship while you live with bipolar disorder, honesty is the best policy. Bipolar disorder can have an impact on any relationship in your life, perhaps especially on a romantic relationship. So, it’s important to be open about your condition.
There’s no right or wrong time to tell someone you have bipolar disorder. Be open and honest as soon as you’re ready. Consider sharing these facts to help your partner better understand the condition:
- when you were diagnosed
- what to expect during your depressive phases
- what to expect during your manic phases
- how you typically treat your moods
- how they can be helpful to you
One of the best ways to support and make a relationship successful is to stick with your treatment. Treatment helps you reduce symptoms and scale back the severity of your changes in mood. With these aspects of the disorder under control, you can focus more on your relationship.
Your partner can also learn ways to promote a healthy relationship.
Living with bipolar disorder
Bipolar disorder is a chronic mental illness. That means you’ll live and cope with it for the rest of your life. However, that doesn’t mean you can’t live a happy, healthy life.
Treatment can help you manage your changes in mood and cope with your symptoms. To get the most out of treatment, you may want to create a care team to help you. In addition to your primary doctor, you may want to find a psychiatrist and psychologist. Through talk therapy, these doctors can help you cope with symptoms of bipolar disorder that medication can’t help.
You may also want to seek out a supportive community. Finding other people who’re also living with this disorder can give you a group of people you can rely on and turn to for help.
Finding treatments that work for you requires perseverance. Likewise, you need to have patience with yourself as you learn to manage bipolar disorder and anticipate your changes in mood. Together with your care team, you’ll find ways to maintain a normal, happy, healthy life.
While living with bipolar disorder can be a real challenge, it can help to maintain a sense of humor about life.