Bipolar disorder is a condition characterized by extremes in mood. Someone living with bipolar disorder typically experiences significant shifts in mood that affect their ability to function in their day-to-day life. For instance, during the manic phase, the individual may be overly excitable or have challenges with concentration and focus. On the other hand, the depressive phase of the disorder may bring feelings of extreme sadness, hopelessness and worry. Both extremes seriously impact normal functionality, and those with bipolar disorder often struggle to maintain healthy relationships with family, friends, neighbors and coworkers.

Because bipolar disorder is commonly mischaracterized and too often left undiagnosed and untreated, many people living with this condition are unable to benefit from effective treatment options and supports. Understanding bipolar disorder is necessary for addressing stigmas and harmful stereotypes and normalizing access to mental health care services. In the sections that follow, we highlight the types of bipolar disorder, along with its symptoms and the things health care professionals look for when diagnosing this illness. We also provide an overview of the most common treatment options, along with some self-management strategies that may benefit those living with this condition.

Understanding Bipolar Disorder

Bipolar disorder is a complex illness that presents differently in different people. Mental health care professionals recognize several types of this disorder and use specific diagnostic criteria to promote an active diagnosis.

The Types of Bipolar Disorder

The three separate types of bipolar disorder in order of severity are bipolar I disorder, bipolar II disorder and cyclothymic disorder. Bipolar I disorder is characterized by intense manic episodes that often require hospital care. By contrast, individuals living with bipolar II experience hypomanic episodes, which are less severe and rarely require immediate medical attention. Both conditions have depressive episodes that last for two weeks or more, though those living with bipolar II may experience longer depressive episodes. Cyclothymic disorder is similar to bipolar II but milder, though people living with this diagnosis are at an increased risk of developing bipolar I or bipolar II disorder.

Those whose symptoms don’t fall within the criteria for these three conditions but nonetheless experience significant mood fluctuations may be diagnosed as having unspecified bipolar disorder.

Symptoms and Diagnostic Criteria

Bipolar disorder was historically called manic-depressive disorder, which is fairly descriptive of how the illness typically manifests. Signs of bipolar disorder are often more obvious to those close to the person with this mental illness.

Bipolar symptoms manifest as periods of unusually intense emotions along with changes in sleep patterns and activity levels. During an episode, symptoms generally persist all day and often for weeks at a time. Bipolar depression is often more long-lasting than manic episodes. Bipolar 1 symptoms include manic episodes that last for at least 7 days and depressive episodes that persist for 2 weeks or more.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the guide mental health care professionals use to determine if a patient has bipolar disorder and what type they have. For any bipolar diagnosis, a patient must have a history that includes at least one episode of mania or hypomania. Symptom presentation and the person’s level of impairment can then help guide the final diagnosis.

Prevalence and Demographics

Information from National Comorbidity Survey Replication indicates that about 2.8% of adults in the United States had bipolar disorder in the past year, with diagnosis rates coming in at roughly the same among males and females. Over the course of their lives, about 4.4% of U.S. adults have had this condition. Typically, individuals develop bipolar disorder around age 25, though it’s not unusual for the condition to develop earlier or later in life.

Causes and Risk Factors

While virtually anyone can develop a mental health disorder, certain risk factors can increase an individual’s odds of being diagnosed with bipolar disorder.

  • Biological Factors
    While there isn’t a single gene responsible for bipolar disorder, researchers have linked two key genes with this condition, CACNA1 and ANK3, though these acknowledge the likelihood of other genes also contributing to this condition. Along with this, some studies suggest that abnormal brain structure and neurotransmitter functioning may be factors.
  • Genetic Predisposition
    Bipolar disorder tends to run in families, with a 2012 study published in the Journal of Psychiatry and Neuroscience indicating that those who have a first-degree relative living with bipolar have a 15-35% greater chance of developing the condition. Additionally, more than two-thirds of individuals living with this diagnosis have a close relative with unipolar depression, suggesting that there’s likely a heritable component to this condition.
  • Environmental Triggers
    Certain environmental factors can trigger or worsen bipolar disorder, such as stressful life events or seasonal changes. Additionally, alcohol or substance use can trigger this condition and make symptoms more intense.

Manic Episodes

The manic episode is one of the defining phases of bipolar disorder, though severity differs based on the type of bipolar disorder the individual is living with.

Characteristics of Manic Episodes

During manic episodes, individuals experience emotional highs that bring an elevated mood, excessive excitability and intense energy levels. They may feel extremely optimistic and appear to be highly motivated to take on new tasks and challenges. Additionally, many people experience impaired judgment and are more likely to participate in risky behaviors.

Behavioral and Emotional Manifestations

Manic episodes can bring on a range of symptoms, including:

  • Feeling more active or jumpy
  • Feeling very up or elated
  • Higher than normal energy
  • Over-the-top positivity and confidence
  • Energized and able to tackle lots of tasks before getting tired
  • Talking too fast and jumping around in conversation
  • Racing thoughts
  • Don’t need as much sleep
  • Feeling extremely irritable or touchy
  • A desire for lots of food/sex/other pleasurable activities
  • Feeling particularly talented or powerful
  • Unusual confidence and talkative
  • Easily distracted
  • Poor decision-making/impulse control

Impact on Daily Functioning

The manic phase often comes with difficulty concentrating, which can make it challenging for the individual to stay focused at work or school or when talking to a friend or family member. Their reduced ability to sleep can lead to exhaustion, further impacting concentration and decision-making abilities. Additionally, the stress of managing a manic episode can take a physical toll, causing increased blood pressure and a rapid heart rate.

Depressive Episodes

In general, the depressive episode lasts for at least two weeks up to several months and brings on low moods, offering a sharp contrast to the manic highs the individual experiences.

Characteristics of Depressive Episodes

During depressive episodes, individuals have a low mood and a loss of interest in hobbies, activities and daily responsibilities. These episodes generally last considerably longer than manic episodes and can result in noticeable difficulties when it comes to social and work-related activities.

Behavioral and Emotional Manifestations

For those in a depressive episode, common manifestations may include:

  • Feeling very down/sad/low energy
  • Feeling restless
  • Feeling anxious
  • Troubled sleep cycle, difficulty falling asleep, staying asleep or getting enough sleep
  • Talking slowly, feeling at a loss for words or forgetting what you were about to say
  • Concentration and decision-making issues
  • Unable to start even simple tasks
  • No interest in most activities
  • Suicidal ideation and/or feeling worthless/hopeless

Impact on Daily Functioning

The depressive episode is just as disruptive to the individual’s daily functioning and quality of life as the manic episode, impeding their ability to participate in social activities, maintain contact with friends and family, attend school or work and practice self-care.

Bipolar Disorder Treatment Options

The good news is that bipolar disorder is highly treatable, particularly for mental health care professionals who use multiple treatment modalities.

  • Medication Therapy
    Mood stabilizers are considered the main cornerstone of treating bipolar disorder with prescription medication. These drugs are typically prescribed shortly after the initial diagnosis to stabilize the patient as quickly as possible. Along with mood stabilizers, antianxiety drugs and antidepressants are sometimes prescribed. Types of medication and dosages often involve a period of trial and error to find the right combination.
  • Psychotherapy Approaches
    Also known as talk therapy, psychotherapy involves the exploration of feelings, thoughts and patterns of behavior that cause problems with relationships, family, work and daily functioning. Psychotherapy helps patients identify issues and learn better coping mechanisms, cultivate a positive self-image and stay on their prescribed medication.
  • Lifestyle Changes and Self-Management Strategies
    Maintaining regular sleep schedules and establishing consistency in everyday routines help those with bipolar disorder manage their symptoms and over time may decrease the need for prescription medication. Because stress may trigger episodes of mania or depression, relaxation techniques such as yoga, meditation, deep breathing exercises and journaling are also recommended. Other healthy habits include eating a nutritious, well-balanced diet and getting physical exercise on a regular basis.
    Some patients with bipolar disorder find that having an emotional support or psychiatric service animal helps them manage their symptoms. Emotional support animals provide companionship and emotional support, while psychiatric service animals are trained to perform tasks such as reminding you when it’s time to take your medication, go to bed and get up at specified times to maintain a healthy sleep schedule and bringing you the phone to call support people in the event of emotional distress.

Living with Bipolar Disorder

Long-term management strategies include developing and maintaining a good work/life balance, sticking to a treatment plan, developing healthy habits and cultivating positive relations with family and friends. One of the most important factors in the long-term management of this condition is consistency, so it’s essential for patients to continue with their treatment program even if they feel they no longer need it. As time goes by, the patient typically learns to identify triggers of incoming mood swings and utilize proven strategies for managing them.

Coping Mechanisms

Coping with bipolar disorder can be challenging, but there are several strategies that can help individuals manage symptoms, including:

  • Learning as much as possible about the disorder
  • Complying with their treatment plan
  • Paying attention to their symptoms and triggers
  • Establishing consistent daily routines, with plans for modifications during the low periods
  • Practicing relaxation techniques
  • Avoiding alcohol and recreational drugs
  • Participating in regular exercise

Support Systems

A strong support system can be a lifeline for those living with bipolar disorder. Cultivating healthy relationships with friends and family, as well as attending support groups, can reduce isolation and alleviate loneliness. Additionally, support systems can provide practical assistance during difficult times, helping the individual keep up with household chores and remember to stick to their treatment plan.

Managing Relationships and Work and School Life

For those living with bipolar disorder, it’s important to be honest about their condition when talking with friends and family, as well as employers or educators. A supportive network can make all the difference when it comes to managing this condition. Additionally, it’s important to understand rights regarding workplace accommodations and medical leave under laws such as the Americans with Disabilities Act.

Frequently Asked Questions

  • What are the different types of Bipolar Disorder?
    There are three main types of bipolar disorder, including bipolar I disorder, bipolar II disorder and cyclothymic disorder. Additionally, some people may experience significant mood swings but otherwise have symptoms outside of the norms, resulting in a diagnosis of unspecified bipolar disorder.
  • How is Bipolar Disorder diagnosed?
    Diagnosing bipolar disorder is usually a multipart process. First, a doctor will rule out physical causes for the symptoms using an exam, interview and lab tests. These tests help eliminate issues such as hyperthyroidism, which can have many similar symptoms. When a doctor can’t identify a physical cause, they’ll often refer you to a mental health care provider. Some doctors may perform a psychological evaluation if they have the credentials and expertise to do so.
    The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the most commonly accepted authority when it comes to diagnosing conditions such as bipolar disorder. This manual includes a list of symptoms for professionals to identify and specifies how long someone must live with symptoms to be diagnosed.
  • What are the common medications used to treat Bipolar Disorder?
    Mental health care professionals use a variety of medications to treat bipolar disorder, including mood stabilizers, antianxiety drugs and antidepressants. It may take some time to find the right balance of medications to control symptoms.
  • Can Bipolar Disorder be cured?
    Medical science has not found a cure for bipolar disorder. It’s a long-term condition that requires management for the duration of the patient’s life. However, with the right combination of prescription medication, healthy lifestyle choices and therapy, many of those who are affected by bipolar disorder live fulfilling lives.
  • What are some lifestyle changes that can help manage Bipolar Disorder?
    For those living with bipolar disorders, implementing some lifestyle changes can help with long-term management. Because stress is a common trigger, relaxation techniques such as meditation and yoga can be beneficial. It’s also helpful to incorporate healthy habits such as getting enough sleep, enjoying nutritious meals and getting regular exercise.
  • Is it possible to lead a normal life with Bipolar Disorder?
    Yes, it’s possible to lead a normal life with bipolar disorder. For many people, this means finding the right balance of counseling, medication, support and self-care. In some instances, treatment can reduce the severity of episodes or even delay their onset, making them less frequent.
  • Are there any support groups for individuals with Bipolar Disorder?
    Support groups provide those who struggle with bipolar disorder the opportunity to engage with others who are facing similar challenges. Many feel less isolated and alone as a result of participating in support groups. They also have access to different perspectives that may help them refine their coping strategies as well as gain emotional support from others who truly understand what they’re going through.
    Loved ones of those with bipolar disorder may also benefit from joining support groups. Regularly talking with people in their situation helps them learn coping mechanisms and gain an understanding of the condition. These groups also provide a safe place to vent about the challenges that are often involved in living with someone with bipolar disorder.
  • How can family and friends support someone with Bipolar Disorder?
    Friends and family members can support a loved one with bipolar disorder first by educating themselves on this disease, including its symptoms, triggers and the challenges it brings to those living with it. Second, they can strive to maintain regular contact with a loved one, even when their calls and texts go unanswered for days or weeks. In some cases, they may be able to provide practical support, including helping their loved one clean and preparing food for them. Finally, they can support their loved ones by encouraging them to seek treatment and accompanying them to support groups.


Bipolar is a serious mental health condition that brings on cyclical manic and depressive phases, taking a toll on the individual’s ability to maintain social connections, financial stability and a good quality of life. Fortunately, this condition is treatable with the right balance of counseling, medication and lifestyle changes. By learning about bipolar disorder and understanding what it is – and just as importantly, what it isn’t – we can normalize access to mental health services for those living with this and other mental illnesses.

At Restore, we’re familiar with the challenges involved in establishing and maintaining a normal daily routine while experiencing bipolar disorder. We also know that with the right diagnosis and treatment program, those with this condition can still live good lives. Please feel free to contact us if you suspect you or a loved one is suffering from bipolar disorder or any other mental health condition that’s impacting the ability to live a happy and productive life. Someone is standing by 24 hours a day waiting to talk with you about beginning your journey to a better life.