Bipolar Disorder: Symptoms, Causes, and Treatment Options

Bipolar Disorder: Understand the symptoms, causes, and explore effective treatment options for managing manic and depressive episodes in this comprehensive guide.

Bipolar disorder, once called manic depression, is an illness that leads to severe mood changes.1 People with this disorder can go through emotional highs and lows. These shifts can disrupt sleep, energy, and even the way they think and act.2 Mood swings can happen occasionally or more frequently. Most will notice some symptoms even during stable times. Although it lasts a lifetime, its impacts can be controlled with the right mix of drugs and talking therapies.

Key Takeaways

  • Bipolar disorder is characterized by extreme mood swings, including periods of mania and depression.
  • The onset of bipolar disorder typically occurs in the teenage years or early 20s.1
  • Manic and hypomanic episodes involve three or more symptoms, while depressive episodes include five or more symptoms.1
  • Bipolar disorder is a lifelong condition, but treatment can help manage symptoms.2
  • Effective treatment often involves a combination of medication and psychotherapy, such as cognitive behavioral therapy.

What is Bipolar Disorder?

Bipolar disorder is a mental illness known for causing extreme mood changes. It was formerly called manic-depressive illness. These changes can shift from high, elated behavior to sad, hopeless periods.13

Definition and Overview

This illness leads to intense shifts in mood, energy, and daily functioning.1 People with bipolar disorder have episodes of being overly energetic and happy, followed by very low moments.

Types of Bipolar Disorder

There are three main types: Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder.1 You can see each type through the mix of mania, hypomania, and depression. Bipolar I has extreme manic episodes. Bipolar II has depressive and hypomanic episodes. Meanwhile, Cyclothymic shows mild changes between highs and lows.

Symptoms of Bipolar Disorder

People with bipolar disorder feel intense emotions at times. They sleep differently, act in unusual ways, and experience mood swings. The symptoms of bipolar disorder are unique to each person.

Manic Episodes

There are times when those with bipolar disorder feel extremely happy, full of energy, or very irritable. They might not sleep much during these manic episodes. Symptoms include an overly positive mood, fast thoughts, or taking sudden and dangerous actions.

Depressive Episodes

On the other hand, depressive episodes can bring feelings of deep sadness, hopelessness, and disinterest in life. Sleep and eating patterns could also change. These episodes usually involve five or more symptoms, such as feelings of worthlessness or thoughts of suicide.

Mixed Episodes

For some, there are mixed episodes, combining both manic and depressive symptoms.2 Feeling both excited and down at the same time can be confusing and overwhelming.

Symptoms in Children and Teens

Symptoms of bipolar disorder in children and teenagers might look different.1 Diagnosing it in young people can be hard because it resembles other conditions, like ADHD or normal mood swings. Seeking help from a doctor who knows about pediatric bipolar disorder is key to getting the right care.

Bipolar Disorder Symptoms

Causes and Risk Factors

The cause of bipolar disorder is a mystery. Experts think it involves differences in the brain, family history, and outside forces.4

Biological Differences

Through brain imaging, scientists have found unique brain patterns in those with bipolar disorder. It seems their brains handle emotions and mood differently.4


Having a close family member with bipolar disorder raises your risk. If one parent has it, their child might have a 10%-25% chance. With two affected parents, this chance grows to 10%-50%.5 Surprisingly, identical twins show that it’s not just genes at play. The environment also plays a part in causing the disorder.4

Environmental Factors

Stress, traumatic events, or substance abuse might start bipolar disorder.4 Not getting enough sleep is another risk. It can lead to more manic episodes in people with the disorder.5 Using antidepressants alone might cause a manic switch in some folks with bipolar disorder.5

Bipolar Disorder and Co-occurring Conditions

Many people with bipolar disorder also face other mental and physical health issues. These can either worsen bipolar symptoms or hinder treatment success. These extra conditions might include anxiety disorders, ADHD, substance abuse, and eating disorders. Physical health problems like heart disease or thyroid issues are also common.6 It’s crucial to pinpoint and treat these additional conditions to effectively manage bipolar disorder.

7 About 82.6% of people with bipolar disorder experience an additional psychiatric issue.7 38.6% also contend with an anxiety disorder. Moreover, substance abuse affects around 10.8% of these individuals.7 Nearly half of bipolar disorder patients, 45.7%, struggle with overweight or obesity.

7 In addition to these, migraines are prevalent, affecting 21% to 28% of patients with bipolar disorder.7 There is also a notable increase in diabetes and metabolic syndrome among them, with 18.6% having metabolic syndrome.7 These patients also face higher risks of hypertension, heart diseases, and a 3.2% higher risk of pulmonary embolism.7 The occurrence of these co-existing medical conditions spans different age groups among bipolar patients.

8 Bipolar disorder poses a significant risk of attempted suicide, seen in 10% to 25% of cases.8 Effective treatment that tackles both bipolar disorder and addiction is essential in managing these challenges and preventing relapse.

Bipolar Disorder Co-occurring Conditions

Diagnosis of Bipolar Disorder

Getting the right diagnosis and treatment for bipolar disorder is key. Doctors look at a person’s symptoms, life history, and family background.2 This disorder often starts during late teenage years or early in adulthood. But, kids can show signs too.2

Diagnostic Criteria

2Bipolar I disorder has manic episodes lasting at least 7 days. These are usually followed by depressive episodes over 2 weeks.2 There’s also something called rapid cycling. This is when a person goes through mania or depression four times in a year. Bipolar II disorder is similar but with milder symptoms.2 Then, there’s Cyclothymic disorder with its own set of ups and downs that are not as extreme.

People with bipolar disorder might also have anxiety, ADHD, or use substances. Eating disorders can be part of it too.2

Challenges in Diagnosing Children and Teens

9Diagnosing bipolar disorder in kids and teens is trickier. This is because their symptoms can look different, mixing up the usual signs.9 Criteria are similar to adults but with kid-specific issues like ADHD considered. This makes diagnosis more complicated.9

2Getting a correct diagnosis, especially in young people, is very important.2

Treatment Options for Bipolar Disorder

Bipolar Disorder is best treated with a mix of medicine and talking therapies.9 Doctors often use mood stabilizers and antipsychotic drugs to handle ups and downs.10 Talking with a therapist, like in cognitive behavioral therapy (CBT), also plays a big role. It offers helpful support, knowledge, and ways to deal with symptoms.9


Medication is a key part of managing Bipolar Disorder.9 This includes mood stabilizers, antipsychotics, and sometimes antidepressants or anti-anxiety drugs. Each person gets tailored medicines.9 It can take time to find the right meds. Adjustments are normal and might take weeks or months to fully work out.9 Side effects are common but often go away as you keep taking the drugs. Still, always talk to your doctor if the side effects worry you.9 For women, some medicines can be risky if taken during pregnancy. They may affect birth control or cause birth defects.9

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Talking therapy, also known as psychotherapy, is very important for Bipolar Disorder.9 It includes different types like CBT and family-focused therapy. These therapies help a lot.10

Other Treatments

For some, extra treatments may be needed when usual medicines don’t work.9 This could include things like ECT or TMS.9 Treating Bipolar Disorder in kids depends on the child. It might involve both medicines and talking with a therapist. Plus, support is crucial from family, teachers, and friends.9

It’s pivotal to stick with your treatment for Bipolar Disorder.9 By managing it well, many people lead full, active lives.10

Living with Bipolar Disorder

Living with bipolar disorder brings its own set of challenges. However, with the right treatment and care, many can handle their symptoms and live full lives.11 It’s important to spot early signs of mood changes, stay away from drugs and alcohol, and take your meds regularly.12 Even though bipolar disorder is a lifelong condition, it’s manageable with proper support. This support helps those with the disorder do well.

Managing Symptoms

If you have bipolar disorder, you can learn to see when mood changes might happen. Look for signs like feeling too happy for long, doing more things, needing less sleep, and taking risks.12 By watching for these signs and taking action early, you can keep mood episodes from getting severe.11 Also, staying away from alcohol and drugs is key. These substances can make your bipolar disorder worse.

Support Systems

It’s great to have family, friends, and mental health pros who support you.11 Places like Bipolar UK, Carers UK, Mind, and Samaritans offer online help. They help you feel part of a community.11 Programs from Bipolar UK can also help you take charge of your recovery. They teach you how to manage your condition well.

11 It’s good to have regular health check-ups. This includes checking your weight, blood pressure, and blood tests. These tests help watch out for any new health problems or how your bipolar treatment is affecting you.11 Taking good care of your health is a big part of managing bipolar disorder.

11 Sadly, people with bipolar disorder have a higher risk of suicide. Studies show about half have tried to take their own life.11 It’s really important to have a strong support network and to get help right away if you feel suicidal. This can help prevent terrible outcomes.

Bipolar Disorder in Women

Women and men may have different experiences with bipolar disorder. Women often go through rapid cycling more than men do. This means they have four or more mood shifts in a year. They also spend more time feeling depressed than manic.13 Hormones, health issues, and the way bipolar disorder interacts with general health can also play a role.

Bipolar disorder and women’s health go hand in hand. Women with bipolar disorder are more likely to feel depressed than men.13 A review from 2015 showed that women with bipolar disorder attempt suicide more than men with the same condition.13

There are noticed differences between men and women in having mania and bipolar disorder.14 More women experience rapid cycling in bipolar disorder than men.14

Menstrual cycles and life events like pregnancy can change how bipolar disorder affects women.14 It’s important to address these issues to give the best care to women with this mental health issue.

Bipolar Disorder in Children and Adolescents

Bipolar disorder can start when a child or teen is young. It can be hard to spot early on, unlike in adults.15 Those with bipolar disorder go through big mood and behavior swings.15 We’re not sure what exactly causes it, but if it runs in the family, there’s a bigger chance you might have it.15 Kids and teens with the disorder struggle daily.15

You might notice they go from very high to very low moods. They may act in ways that surprise you or seem out of character.15 These signs can often look like other issues such as ADHD or anxiety. It’s really important to figure out if it’s bipolar since it’s often mistaken for other health problems or just typical growing up.15

Getting the right evaluation is key.15 Healthcare experts look at the symptoms to make a diagnosis. There’s no one test that says for sure.15 Treatment includes medicine, talking with a therapist, and keeping an eye on how things are going.15

16BP affects 1-3% of young people, mainly as they get older.16 Many adults with BP say they first saw mood changes before they turned 21.16 Episodes of feeling really down can go on for 3-8 weeks in kids and teens.16 Again, many adults say their issues started before they were 21.16 Forgetting to take their meds might bring back depression or mania.16

16Pinpointing manic symptoms in youth can be difficult because they show up differently.16 But, experts agree that BP can be spotted in young people.16 Kids who show signs of mania and have it in the family stand a high chance of having BP-I or BP-II.16 This can lead to struggles in a few areas like drug use or legal trouble.16

15Medicines don’t work the same for all kids with bipolar.15 It might take some trial and error to find what works best.15 It’s very important to keep up with the treatment.15 Tracking moods and behaviors can help you see if the treatment is helping.15 Having a strong support system around, including family and healthcare providers, is also crucial.15

Rapid Cycling in Bipolar Disorder

Rapid cycling happens when someone with Bipolar Disorder Rapid Cycling goes through four or more mood changes in a year.17 It’s seen more in women. And it’s tough to deal with.17 This type of cycling usually involves major lows and can make someone feel like they might want to hurt themselves.17

Rapid Cycling Bipolar Disorder is pretty common among people who have bipolar disorder. In fact, up to half of them could experience rapid cycling at one point.17 In a given year, about 5% to 33.3% of bipolar patients might go through rapid cycling.18 And over their lifetime, between 25.8% to 43% will experience it.18

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For some, rapid cycling is a brief phase. But, a few people might go through it all the time.17 Those who rapid cycle tend to have a longer battle with the disorder. They start facing it at a younger age too.18 They might also turn to drugs or alcohol more. And they have a higher risk of thinking about or trying to hurt themselves.18

Figuring out what makes rapid cycling happen is key in solving it. Things like keeping track of your moods, talking with a counselor, and managing medicine might help.17 But, dealing with rapid cycling can be tricky. Antidepressants might not always be a good idea. They could actually make the cycling happen more often in people with bipolar disorder.17

Year prevalence of rapid cycling among all bipolar patients5% – 33.3%18
Lifetime prevalence of rapid cycling among all bipolar patients25.8% – 43%18
Proportion of individuals with bipolar disorder who may develop rapid cyclingAs many as 50%17
Increased risk of suicide associated with rapid cyclingSignificant18

Substance Abuse and Bipolar Disorder

People with bipolar disorder often have substance abuse problems. Around 60% of them have dealt with substance abuse.1920 Those with bipolar and addiction may suffer more and start feeling sick earlier than others.19

Addiction and bipolar disorder together can cause many problems. These include money and legal issues, trouble with loved ones, and even a higher chance of suicide.20 Both issues might happen together because some try to feel better by using drugs or alcohol.20

Those with bipolar and addiction tend to be more unhappy and moody. They might not respond well to treatment and need to stay in the hospital more.19 Also, their reaction to a common bipolar treatment, lithium, might be bad.19

Dealing with substance abuse is key in managing bipolar disorder well. It enhances the success of treatments and reduces symptom aggravation.19 Studies propose that certain drugs may be better for these patients than lithium.19

Doctors often use certain medicines to help with both bipolar disorder and addiction symptoms.20 More research is needed to figure out the best ways to diagnose and treat patients with both issues.19

Prevalence of comorbid bipolar and substance use disorders in UK328–333 cases21
Prevalence of comorbidity of bipolar and substance use disorders in national surveys across 1990–2015321–330 cases21
Prevalence of comorbid bipolar and alcohol use disorder in psychiatric patients331–349 cases21
Prevalence of comorbid drug abuse and bipolar disorder105–115 cases21
Prevalence of smoking in individuals with mental illness2606–2610 individuals21
Prevalence of DSM-IV alcohol abuse and dependence in the United States830–842 cases21
Lifetime comorbidity of DSM-IV mood and anxiety disorders with specific drug use disorders247–257 cases21
Prevalence of co-occurring mood and substance use disorders23–30 cases21
Prevalence of cannabis use and cannabis use disorder among patients with bipolar disorder78–84 cases21
Prevalence of alcohol abuse and dependence in individuals with psychiatric comorbidity219–229 cases21
Prevalence of substance use disorders in psychiatric patients in Denmark129–140 individuals21
Impact of substance use disorders on recovery from episodes of depression in bipolar disorder patients289–297 individuals21
Prevalence and clinical correlates of substance abuse in bipolar heroin addicts at treatment entry23 individuals21
Axis I psychiatric comorbidity and its relationship to historical illness variables in patients with bipolar disorder420–426 cases21
Suicidal behavior in individuals with bipolar disorder491–511 cases21
Substance use disorders and suicide attempts in individuals with bipolar subtypes230–238 cases21
Treatment delay and excessive substance use in bipolar disorder628–633 cases21
Treatment of depressed bipolar patients with alcohol use disorders262–268 cases21
Prevalence of violent crime among individuals with bipolar disorder931–938 cases21

Suicide Prevention and Bipolar Disorder

People diagnosed with bipolar disorder often think about or attempt suicide. Therefore, preventing suicide is a key part of helping them.22 Research shows that bipolar disorder and suicide are strongly linked.22 It has also revealed important statistical patterns and risk factors for suicide.22

If someone with bipolar disorder feels like ending their life, they need to reach out right away. This could mean calling 911, a suicide hotline, or their doctor.23 Supporting the person, sticking to their treatment plan, and noticing warning signs can lower the suicide risk.23

As well, being open about suicidal thoughts can help them get better care.23 Quick action and honest talks with healthcare providers or loved ones are critical steps to avoid suicide.23

Researchers have looked deeply into suicide and bipolar disorder. They have studied how often suicide attempts happen, as well as the main triggers.22 By following up for five years, they’ve pinpointed factors that lead to suicide tries in people with bipolar I and II.22

They’ve also checked if there’s a genetic link to suicidal actions in people with bipolar disorder in their families.22 Furthermore, a thorough study has explored what causes someone to try suicide or be successful at it when they have bipolar disorder. This research has given important information about suicide in this group.22

By focusing on preventing suicide in people with bipolar disorder, doctors and support groups can save lives and make a significant difference.2223

Bipolar Disorder: Symptoms, Causes, and Treatment Options

Bipolar disorder leads to extreme mood shifts, from high energy to low, depression.2 Its causes are complex, possibly involving genes, biology, and the environment.1 The most successful approach combines meds with talking therapy.2 Thankfully, many can manage the disorder well.

It’s marked by noticeable changes in how you feel, your energy, and what you do.2 It’s often seen in teens or young adults and sometimes in kids. Treatments last a lifetime, often needing more than just medicine.2 High stress can trigger the first episode.1

Getting the right diagnosis and treatment is key for a good life. Doctors look at symptoms, history, and family to understand things.2 Treatment mixes meds with talking to manage and prevent mood swings.2 Carefully using certain meds can avoid making things worse.2

Therapies like CBT that are tailored for bipolar disorder offer support and skills.2 ECT and lifestyle changes can also help by reducing stress and improving sleep.2

Without treatment, bipolar disorder can lead to severe outcomes.1 Seeing a professional when you feel off is crucial.1 Having a relative with the disorder increases your risk.1

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It might co-occur with anxiety, eating disorders, ADHD, and substance abuse.1 The Mayo Clinic offers a thorough treatment approach.1

Ongoing Research and Future Directions

Scientists keep studying what causes bipolar disorder and how to treat it better.24 The BD2 Integrated Network wants to sign up 4,000 people for a big study. It will check their brain yearly and see the changes in their sleep and moods.24 Shockingly, up to 70% of those with bipolar get diagnosed wrong the first time. This shows we really need precise tools to spot it and treatments made just for them.24

[Bipolar Disorder Research] keeps going into genetics, looking for specific signs, and finding better drugs.25 The Wellcome Trust did a huge study that looked at genomes from 14,000 people with seven major diseases, including bipolar disorder.25 Researchers are also checking out if using ketamine can help fight bipolar depression.25

We’re learning more all the time about [Advances in Bipolar Disorder Treatment]. Our aim is to treat people with bipolar better and in a more personal way.24 The BD2 group is building a huge data system that will speed up turning data into things we can do to better care for patients.24 Maybe in the future, we’ll look deeper into how mood issues and bipolar are linked to cell problems and obesity.24

To handle [Bipolar Disorder Management] well in the future, everyone – doctors, patients, and scientists – needs to work together.24 The BD2 team is creating a setup where everyone can share and learn to improve treatment fast.24


Bipolar disorder is a mental health condition marked by extreme mood swings. It swings between high energy or mania and low, depressed feelings.26 A mix of biological, genetic, and environmental elements seems to lead to it.26

The best way to treat it is with a mix of medication, talking therapy, and lifestyle changes. Through this approach, many cope well with bipolar disorder.27 There’s a lot of research still going on to improve how we understand and deal with it.28

To sum up, bipolar disorder is a big challenge for mental health. It affects up to26 4.5% of people. Those with bipolar disorder have26 12 times more risk of suicide.26 Yet, with the right treatment and support, many can live full and meaningful lives.


What is bipolar disorder?

Bipolar disorder is a mental illness that affects someone’s mood, energy, and behavior. It causes big shifts from high energy or happiness (manic) to extreme sadness (depressive). These mood swings can be severe and last for days or even weeks.

What are the main types of bipolar disorder?

The three main types of bipolar disorder are Bipolar I, Bipolar II, and Cyclothymic. Each type shows a different mix of manic, hypomanic, and depressive episodes. For diagnosis, a doctor looks at how the symptoms impact daily life.

What are the symptoms of bipolar disorder?

People with bipolar disorder can feel overly happy or sad in extreme ways. During manic episodes, they might feel like they can do anything or not need sleep. In depressive episodes, they can feel very down, losing interest in things they once enjoyed, and might have sleeping or eating changes.Some may feel both manic and depressive at the same time, which is called a mixed episode.

What causes bipolar disorder?

The exact cause of bipolar disorder is not clear but is likely a mix of genetic and environmental factors. If a family member has it, you might be at a higher risk. High stress, trauma, or drug use can also trigger the first symptoms for some.

Can bipolar disorder co-occur with other mental health conditions?

Yes, bipolar disorder may exist along with other mental or physical health issues. Conditions like anxiety, ADHD, or substance abuse can affect how bipolar disorder appears, making it harder to treat. It’s important to consider these when managing bipolar symptoms.

How is bipolar disorder diagnosed?

Doctors diagnose bipolar disorder by looking at symptoms and personal or family history. It can be tricky, especially in kids or teens, as the symptoms might seem like other conditions. Diagnosis in children is key to start the right treatment.

What are the treatment options for bipolar disorder?

Managing bipolar disorder often involves a mix of medicines and talking therapies. Doctors might prescribe mood stabilizers or antipsychotics. Psychotherapy, especially CBT, can also help by offering support and teaching skills to cope with symptoms. Electroconvulsive therapy is an option for some, too.

How can someone with bipolar disorder manage their condition?

People can help manage bipolar symptoms by staying alert to their moods and avoiding drugs or alcohol. It’s key to take medicines as directed. A strong support network of family and friends, along with mental health professionals, can provide crucial support.

Are there any gender-specific considerations for bipolar disorder?

Women might face different challenges with bipolar disorder than men. They tend to have more depressive episodes and rapid cycling, which means shifting moods quickly. Hormonal changes and other health issues can also influence how bipolar disorder shows up in women.

Can bipolar disorder develop in children and teenagers?

Yes, bipolar disorder can appear in young people, although it’s harder to spot than in adults. Symptoms can include big mood swings, changes in energy, and unusual behaviors. It’s important to accurately diagnose as it can often be mistaken for other mental health issues.

What is rapid cycling in bipolar disorder?

Rapid cycling means experiencing at least four mood episodes in a year. It’s more common in women. Dealing with rapid cycling can be tough, and it often leads to more time spent in a depressive state. This condition also carries a higher risk for suicidal thoughts or behaviors.

How does substance abuse impact bipolar disorder?

Using drugs or alcohol with bipolar disorder can make symptoms worse. It can lead to more mood episodes. A dual diagnosis of bipolar disorder and substance abuse needs special treatment. Addressing substance misuse is essential in managing bipolar disorder effectively.

What is the link between bipolar disorder and suicide?

Suicide is a serious concern for those with bipolar disorder. Prevention is a key part of treatment. Seeking help in moments of crisis is critical. Support from family, sticking to treatment plans, and knowing warning signs are vital in preventing suicide among those with bipolar disorder.

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