Let’s Talk About Bipolar Disorder

We’ve got the doctor-approved scoop on bipolar causes, symptoms, treatments, and a ton of other facts and tips that can make life with this mental health condition easier.

Whether you’ve just been diagnosed with bipolar disorder or are concerned you, or someone you love, might have it, you’re probably confused and scared. Take a deep breath and know this: Everyone featured on HealthCentral with a chronic condition felt like you do now. But we—and they—are here for you. Here, you’ll discover the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, where to find your bipolar community, and all the crucial information to help you not merely manage—but hopefully thrive. We’re sure you have a lot of questions…and we’ve got the answers you need.

Bipolar Disorder

Our Pro Panel

We went to some of the nation’s top experts in bipolar disorder to bring you the most up-to-date information possible.

Po Wang, M.D. headshot

Po Wang, M.D.

Psychiatrist and Clinic Chief

Bipolar Disorders Clinic at Stanford University Department of Psychiatry

Amit Anand, M.D. headshot

Amit Anand, M.D.

Professor and Vice-Chair for Research

Center for Behavioral Health at the Cleveland Clinic

Linda Hubbard, L.M.F.T. headshot

Linda Hubbard, L.M.F.T.

Therapist

Department of Behavioral Health, Psychiatry & Psychology at the Mayo Clinic

Bipolar Disorder
Frequently Asked Questions
Is manic depression the same as bipolar disorder?  

Many people use the terms interchangeably, and they do usually refer to the same condition. But because some think that terms like “mania” and “manic” (which carry the ring of the pejorative “maniac”) have a negative connotation, professionals often discourage use of the term “manic depression.”  Some people prefer the term “bipolar” because it sounds more scientific and less stigmatized than “manic depression.”  

Is mania the same as psychosis?  

No. With mania, a person’s mood is strangely elevated, irritable, or both. People have feelings of grandiosity, they don’t sleep, their thoughts race, and they may speak fast or engage in abnormally risky behavior. Psychosis causes a person’s thoughts and perceptions to become so off that they lose touch with reality and can have delusions. During a manic state, a person with bipolar can experience elements of psychosis (that said, not all mania includes psychosis). But psychosis can happen with depression, a very high fever, other mental disorders, or all sorts of other reasons. 

Is bipolar disorder genetic? 

Bipolar disorder does tend to run in families, suggesting that genes are involved. However, studies of identical twins have found that even when one twin develops the condition, the other twin may not, so while genes can make a person more prone to bipolar, many factors have to collide for a person to actually develop the disorder. 

Are bipolar symptoms different in men and women? 

For the most part, they’re the same, although women have a higher risk of rapid cycling: when someone has four or more manic, hypomanic, or depressive episodes in a year. Women also tend to have more depression than their male counterparts.

What Is Bipolar Disorder, Anyway?

Bipolar disorder is a serious mental condition that causes major abnormalities in mood, thoughts, energy, and behavior—the kind of changes that cause noticeable impairments to your day-to-day life. We all have ups and downs, but people with bipolar disorder experience these in extreme states, called mania and depression (though they may also go for stretches when they have no symptoms at all). These intense mood shifts can interfere with personal relationships, harm careers, and disrupt your ability to just get through the day.

Bipolar disorder statistics, age of bipolar diagnosis, how bipolar affects men vs women, number of Americans with bipolar disorder, percentage of patients with severe bipolar symptoms, number of bipolar forms
Nikki Cagle

But bipolar is manageable. The right combination of medication, therapy, and healthy lifestyle changes can help most people with bipolar live productive lives full of fun, meaning, and connection.

Bipolar Facts

  • Bipolar disorder is, on average, diagnosed around age 25, but it can be spotted in teens and more rarely even younger children, or begin for someone in their 40s or 50s.

  • An estimated 4.4 % of adults, in this country will experience the condition in their lifetime.

  • Rates of bipolar are equal among men and women in the U.S.

  • Nearly 83% of people with bipolar disorder are classified as “severe,” which means their illness causes serious impairments.

Are There Different Types of Bipolar Disorder?

Yes—four, in fact. The first two types listed below are the most common, but all involve substantial changes in mood, energy, thought patterns, and behavior.

Bipolar I Disorder

The most serious form of bipolar, bipolar I disorder is marked by manic episodes that last at least seven days or are so serious that the person needs immediate hospital care. Separate depressive episodes usually last at least two weeks. Both mania and depression can also occur simultaneously. Men and women are equally affected by bipolar I, but women are often diagnosed later in life than men. Most cases of bipolar I are diagnosed between the ages of 25 and 50, with 10% of cases diagnosed after 50 (known as late-onset bipolar I disorder).

Bipolar II Disorder

Similar to bipolar I, but the manic episodes are less intense for those living with bipolar II. Mania for this type is called hypomania—which episodes tend to last a few days compared to mania’s that last a week. Women are affected by bipolar II and experience depressive episodes more than men.

Cyclothymic Disorder

Also known as cyclothymia, this is a milder form of bipolar disorder, where symptoms fluctuate between short periods of hypomania and mild depression that occur over a period of two years for adults, and one year in teens and children. During that time, symptoms are ongoing and mood remains stable for no more than two months in a row. The emotional fluctuations are shorter than for bipolar I or II. Cyclothymia affects men and women equally. Less than half of those who experience cyclothymia will go on to develop bipolar disorder; in others, these milder mood symptoms can continue as a chronic condition or eventually disappear entirely.

Other Specified and Unspecified Bipolar and Related Disorders

As it sounds, this is a catch-all phrase. Here, the symptoms are similar to bipolar disorder but don’t meet the full range of criteria that would lead doctors to make an actual bipolar diagnosis.

Signs of Bipolar Disorder, signs of mania, signs of depression
Nikki Cagle

What Are Bipolar Signs and Symptoms?

The symptoms of bipolar vary from person to person, but there are common symptoms related to each mood. Here is what to look out for.

Symptoms of Bipolar-related Depression

Unlike situational depression, bipolar depression is a medical condition that may occur without a life experience trigger. It’s important to understand if the depressive symptoms you feel are related to bipolar disorder since it will dictate treatment. Commonly used anti-depressants can make the situation worse in a bipolar individual. Let your doctor know if you are experiencing any of these symptoms.

  • Feeling sad

  • Feeling lethargic or tired

  • Feeling worried or anxious

  • Eating more than usual and/or gaining weight

  • Difficulty falling asleep, staying asleep or sleeping too much

  • Inability to complete simple and/or daily tasks, such as going to work or school

  • Having difficulty concentrating, remembering, or making decisions

  • Not enjoying activities that once gave pleasure, including having diminished sex drive

  • Feeling worthless, empty, or hopeless

  • Having thoughts of death or suicide, or attempting suicide

Bipolar-related Psychosis Symptoms

Psychosis is a break with reality. More than half of individuals diagnosed with bipolar disorder experience psychotic mood episodes during their lifetime. Here are the symptoms to look for:

  • Experiencing hallucinations of seeing, smelling, hearing, tasting, or physically feeling something that isn’t there

  • Experiencing delusions or strongly held false beliefs but unable to see the thoughts are not true

Symptoms of Bipolar-related Mania and Hypomania

Mania is more intense than hypomania but they share the same symptoms. For instance, mania can last for a week or more, while hypomania lasts for a few days. If you experience four or more of these symptoms, your doctor may diagnose you with mania.

  • Having high levels of energy and exhilaration

  • Experiencing grandiose or overblown self-esteem

  • Speaking so loudly or quickly others can't understand you

  • Having racing thoughts

  • Starting many projects, but not completing them

  • Not sleeping well and/or having little need to sleep

  • Not eating well, and/or having loss of appetite

  • Engaging in risky behaviors like unprotected sex, gambling, or shopping sprees

  • Excessive drinking or alcohol use

  • Being easily distracted

  • Being easily irritated or feeling touchy or jumpy

There’s a catch-22 with recognizing the symptoms of bipolar, particularly when it comes to mania: Some people with bipolar disorder simply don’t realize what’s going on, often because they enjoy the high—it can make them feel like they’re on top of the world. They have an abundance of energy, they’re more creative than ever, they’re friendly and talkative. They may even feel that it’s the best part of their lives. Mania has been described as being on speed without the speed, which makes sense: The same chemicals that are released in the brain from amphetamines may be released in the manic phase.

But whether it is mania, depression, or psychosis, experiencing four or more episodes in a year is known as “rapid cycling.” This pattern of cycling occurs in 10% to 20% of people living with bipolar disorder.

What Causes Bipolar Disorder and What Are the Risk Factors?

Experts don’t know exactly why someone develops bipolar, and there’s no one thing that sparks it. It’s likely a combination of environmental and genetic factors, meaning events that occur and how your body responds to them. These are some of those possible factors.

Your Brain/Biological Traits

Abnormalities in the brain’s structure and function can increase the risk for bipolar disorder. Chemicals in the brain that regulate thoughts, moods, and behavior can also be out of balance in those with bipolar.

Genetic Factors

Bipolar disorder is one of the most hereditary mental illnesses; however, its occurrence only happens about 25% of the time. Recent genetic studies have found that bipolar disorder may have genetic markers that overlap with schizophrenia, major depression, and other conditions. More research is needed to pinpoint specific markers. This may explain why having a parent, sibling, or child with bipolar disorder increases a person’s chances of having it themselves.

Sex

In general, men and women get bipolar disorder at equal rates, including bipolar I and cyclothymia. Still there are some key differences in how sex affects bipolar disorder.

Bipolar Disorder in Men

Men have a higher incidence of manic episodes and unipolar mania, (manic episodes without depression). Also, men with bipolar II tend to have significantly better ability to function in their daily lives than women with bipolar II. Men with bipolar disorder also have higher reported rates of conduct and substance use disorders.

Bipolar Disorder in Women

Compared to men, women are more likely to have bipolar II and experience more rapid cycling (going up and down in mood quickly). Women also experience more episodes of bipolar depression than men. They also have more frequently reported rates of other mental health conditions such as phobia, panic disorder, PTSD, eating disorders, and borderline personality disorder in addition to bipolar disorder. Among adolescents, the prevalence of bipolar disorder is slightly higher for girls than boys. Women also experience biological changes that increase their risk of bipolar symptoms, including:

  • Hormonal changes. Fluctuating hormones during menstrual cycles and menopause can make women’s bipolar symptoms more severe, but they do not cause the disorder.

  • Pregnancy and birth. Giving birth can also trigger symptoms, especially depression, in women who have bipolar disorder. Women who experience bipolar symptoms after giving birth are also more likely to have episodes following other pregnancies, and are greater risk of developing postpartum psychosis, which is a medical emergency.

Age

Bipolar disorder is predominantly diagnosed before age 50—usually around age 25. Bipolar disorder that begins early in life, known as early onset, tends to be more severe throughout life, has a worse prognosis, and has a higher rate of suicide.

Identifying bipolar early can help children and teens be treated sooner; studies have found that early treatments tend to have a more beneficial impact. Let’s take a closer look at how bipolar appears in children and teens.

Bipolar Disorder in Children

Overall, 1.8% of the pediatric population has bipolar disorder. Irritability is the most frequent manic symptom, as well as a decreased need for sleep. Poor sleep, racing thoughts, inappropriate responses in social situations, and family history of bipolar have all been linked with a higher risk of experiencing bipolar symptoms, such as mania, as a child.

Bipolar Disorder in Teens

Nearly 3% of the population age 13 to 18 have bipolar disorder, with 2.6% of them experiencing severe symptoms. While hyperactivity is the most frequent manic feature in adolescents with bipolar disorder, preliminary research in teens found that the onset of mania may start gradually with three or more symptoms, including irritability, decreased functioning, mood swings, and increased energy.

High Stress/Trauma

Highly upsetting events—like divorce, the death of a family member, or losing a job—can trigger a bipolar incident. Also, people who’ve experienced a traumatic event—such as sexual or physical abuse, neglect, or the death of a parent early in life—have an increased chance of developing bipolar disorder later.

Drug or Alcohol Abuse

There is a legitimate chicken-or-egg questions when it comes to bipolar disorder and substance abuse. Some researcher suggests that those who abuse drugs or alcohol are at a higher risk for developing bipolar disorder, while other research suggests that drug and alcohol abuse is a common way people with bipolar try to deal with symptoms. Frequently, substance use disorders (SUDs) and mental health issues occur at the same time, including bipolar disorder, with 9.5 million U.S. adults experiencing both SUDs and mental health disorders.

Certain Health Conditions

Other mental and physical conditions, known as comorbidities, can also occur with bipolar disorder. As with substance abuse, it’s not always clear which comes first, but what we do know is that between one half to two thirds of people with bipolar have an underlying mental health comorbidity, especially anxiety disorders, SUDs, and behavioral disorders. Attention-deficit hyperactivity disorder (ADHD) and eating disorders are also common with bipolar disorder. Traumatic brain injuries have also been linked with bipolar disorder.

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How Is Bipolar Disorder Diagnosed?

Usually, people wait an average of almost six years after the first sign of bipolar disorder to get diagnosed and treated—often because of that positive reaction to mania we explained above. Many people seek help only when they’re in a depressive state. But antidepressants can make bipolar disorder worse, so it’s important that a professional gets a full medical history to ensure a proper diagnosis. Steps to getting a bipolar diagnosis can include the following:

Physical Exam

To diagnose bipolar disorder, a healthcare provider may perform a complete physical exam and order medical testing, including blood and urine analysis, to rule out other conditions that can affect brain function or mood. Hypothyroidism, for example, where the body doesn’t produce enough thyroid hormone, can look like bipolar.

Mental Health Evaluations

If physical issues don’t explain symptoms, a primary doctor or other healthcare provider can also conduct a mental health evaluation. They’ll ask about your moods, thoughts, feelings, and behaviors and how these things affect work, school, relationships, and other aspects of life. Evaluations are usually conducted using questionnaires and in-person interviews.

If bipolar or another mental health disorder is suspected, your primary doctor may refer you to a trained mental health professional for further evaluation, such as a psychiatrist, psychologist, licensed clinical social worker, or licensed professional counselor.

Mood and Sleep Journal

You may be asked to keep a daily record of mood and sleep patterns. This can help determine the underlying mental health issue and severity of the disorder, as well as whether poor sleep quantity or quality could be contributing to your symptoms.

Diagnostic Criteria

Mental health professionals base a diagnosis on criteria established through the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), also known as DSM-5. With bipolar I specifically, a person does not actually have to have experienced a period of depression to be diagnosed; one manic episode, however, is enough for a bipolar I diagnosis.

Diagnostic criteria are used to rule out or identify other mental health issues, including major depressive disorder (MDD). While those with bipolar disorder experience depressive symptoms severe enough to be classified as having MDD, MDD differs in that it does not involve extreme highs and shifts in mood, thoughts, and behavior.

It’s important to get an accurate diagnosis because the initial use of antidepressant medications to treat depression can trigger a manic episode in those with bipolar disorder.

Treatments for Bipolar Disorder

Bipolar disorder is a complex condition that frequently requires a combination of therapies to manage its symptoms. Below are the treatment options that you and your healthcare team will tap into.

Bipolar Medications

We can’t stress this enough: Medication is crucial after a diagnosis of bipolar disorder as it can help keep disruptive mood swings at bay. The immediate goal is to help stabilize mood and reduce symptoms. Once those are under control, prescription drugs can help prevent, or reduce the intensity, of future manic and/or depressive episodes. The two most commonly prescribed treatments for bipolar are mood stabilizers and anti-depressants.

Mood stabilizers include lithium-based medications and anticonvulsants:

  • Lithium-based medications have been shown to reduce the severity and frequency of manic and hypomania episodes, as well as lessen depression and risk of suicide. These are usually prescribed as:

    • Eskalith (lithium)

    • Lithonate (lithium)

    • Lithobid (lithium)

  • Anticonvulsants can be prescribed for those who can’t tolerate the side effects of lithium. Originally prescribed to stop those with epilepsy from having seizures, anticonvulsants can work to stabilize mood, researchers believe, by allaying the electrical activity in the brain. Commonly prescribed anticonvulsants for bipolar disorder include:

    • Depakote (valproate)

    • Lamictal (lamotrigine)

    • Tegretol (carbamazepine)

Antipsychotic drugs can work in a few hours, so doctors often prescribe these in conjunction with mood stabilizers, which can take up to two weeks to achieve their full effect.

  • Antipsychotics include:

    • Abilify (aripiprazole)

    • Geodon (ziprasidone)

    • Haldol (haloperidol)

    • Latuda (lurasidone)

    • Risperdal (risperidone)

    • Saphris (asenapine)

    • Seroquel (quetiapine)

    • Vraylar (cariprazine)

  • Second-generation antipsychotics (SGAs) are used to treat manic or mixed episodes. SGAs that are FDA-approved to treat bipolar depression include:

    • Seroquel/XR (quetiapine)

    • Symbyax (combination of fluoxetine and olanzepine), which acts as both a depression treatment and a mood stabilizer.

Other medications used to treat bipolar disorder symptoms include:

  • Antidepressants are medications used to treat depression and might be used for bipolar depressive symptoms. These are include:

    • Aplenzin, Forfivo XL, Wellbutrin/SR/XL, Zyban (bupropion)

    • Celexa (citalopram)

    • Cymbalta (duloxetine)

    • Effexor, Effexor XR (venlafaxine)

    • Lexapro (escitalopram)

    • Paxil, Paxil CR, Pexeva (paroxetine)

    • Prozac, Serafem (fluoxetine)

    • Zoloft (sertraline)

    • Older antidepressant medications, including tricyclics, tetracyclics, and monoamine oxidase inhibitors (MAOIs).

  • Anti-anxiety medications reduce the symptoms of fear, worry, and panic attacks, and include three benzodiazepines, which can also help with sleep issues:

    • Ativan, Lorazepem Intensol (lorazepam)

    • Klonopin (clonazepam)

    • Niravam, Xanax/XR (alprazolam)

  • Sleep medications may help people sleep and are prescribed based on the type of insomnia that occurs.

    • Lunesta (eszopiclone)

    • Rozerem (ramelteon)

    • Sonata (zaleplon)

    • Edluar (zolpidem)

Medication isn’t one-size-fits-all, of course—everyone reacts individually—but it’s a very effective first line of treatment. And it is a very necessary part of being able to live a productive life with bipolar disorder. Effectiveness of medications change overtime so be sure to talk to your doctor if you start seeing symptoms, as it may mean that it is time to change your course of treatment.

Like many medications, those used for bipolar treatment have side effects. Some of the most common are:

  • Diarrhea

  • Hair loss

  • Kidney damage

  • Liver damage

  • Nausea

  • Sexual problems

  • Tremors

  • Weight gain

Psychotherapies

When paired with medication, psychotherapies can help people understand what’s going on and provide coping strategies to better handle the challenges you face with the disorder. Interpersonal and social rhythm therapy, cognitive behavioral therapy, family therapy, and psychoeducation are all types of psychotherapies that have shown to be effective for bipolar disorder. Find out more about each below.

Interpersonal and Social Rhythm Therapy (ISRT)

This therapy helps improve people’s moods by looking at their biological and social rhythms. It focuses on stabilizing circadian rhythm disruptions that commonly occur with bipolar, usually by stabilizing daily routines. Specifically, the goal is to better manage life’s disruptions, so that medication adherence and quality of life are improved. A preliminary study in the Annals of General Psychiatry found that six months of ISRT helped improve symptoms of anxiety, depression, and mania in people with bipolar disorder, as well as making daily life easier and improving their response to mood stabilizers.

Cognitive Behavioral Therapy (CBT)

Through CBT, those with bipolar depression learn to change their negative thinking and behavior and incorporate coping strategies to manage their negative thoughts and behaviors. It has been found to decrease the relapse rate and improve depressive and manic symptoms, along with daily functioning, though the effect is mild-to-moderate. A review of the studies centering around bipolar and CBT published in PLoS One concluded that CBT sessions of 90 minutes or longer improved depression and mania.

Psychoeducation

Learning about what bipolar disorder means is often the first step to getting needed help. Psychoeducation’s goals are typically to help you understand the causes, symptoms, prognosis, and treatments for your mental health condition. Once you know what to expect, you can start taking steps to improve your condition, so you can prevent relapses and improve medication adherence. It can occur in group or individual settings.

Family-Focused Therapy

Bipolar disorder isn’t just difficult for you, it’s a challenge for anyone caring for you, including family and friends. As the name implies, family-focused therapy (FFT) brings the family together to identify any difficulties and conflicts and help find ways to resolve them. It may also include psychoeducation, so that everyone close to you understands bipolar. Children and teens with bipolar disorder have been shown to benefit from family-focused therapy. And a review of 30 years of research has found that when FFT is paired with mood stabilizing medications, recovery from mood episodes is accelerated, and relapse reoccurrence and symptom severity is reduced.

Other Treatment Options

  • Electroconvulsive therapy (ECT) is another option for people who have intense depression that hasn’t responded to medications, or for those who can’t be on certain meds, such as pregnant women. This controversial therapy uses electric currents placed on specific locations on the head while the person is sedated.

  • Transcranial magnetic stimulation (TMS) is a newer brain stimulation that uses magnetic waves to treat some types of depression. It’s still unclear how this treatment affects those with bipolar disorder.

  • Clinical trials might offer new treatment options for those with bipolar disorder. If you are interested in participating, talk to your doctor about these opportunities and if they are right for you.

Lifestyle Changes

Lifestyle changes can be more influential than you might think. They include:

  • Charting your mood. Sometimes specific things can trigger an episode. Recognizing these particulars can help you manage them more effectively—or even avoid them altogether.

  • Sticking to a regular routine. Keeping to a schedule seems to help those with bipolar sidestep unexpected triggers for mood swings. Sleep, in particular, is clutch: Deprivation can set off manic episodes. A regular exercise habit can help, too, not least because it aids in deeper, more refreshing sleep.

  • Practicing stress-management techniques. Since bipolar disorder can be triggered by stress, activities such as yoga or meditation can help calm the mind.

  • Create a support network. Having a network full of people who provide a source of strength to help you manage the challenges and feel less alone during treatment and beyond is important. Family and friends or a support group of others living with bipolar can provide encouragement.

  • Find healthy hobbies or sports. Regular exercise promotes better sleep, and other enjoyable hobbies can help reduce or manage stress.

  • Don’t drink alcohol or use recreational drugs. These can exacerbate the symptoms of bipolar disorder.

Hospital Treatment

Being hospitalized can be necessary in emergency situations, when psychosis is involved, or when there are thoughts of or attempts at self-harm or suicide.

Common Bipolar Treatments, medication, lifestyle, alternative therapies, psychotherapies
Nikki Cagle

Can Natural Remedies Help Bipolar Symptoms?

Natural remedies may be en vogue, but when it comes to treating bipolar disorder you should stick with the tried-and-true—at least for now. Science hasn’t found that popular complementary therapies, such as acupuncture and dietary supplements, do anything to control the symptoms of bipolar. That said, here’s what we know so far about natural remedies and their effect on bipolar. Maybe one day they will be found to improve symptom severity—until then, proceed with caution.

Acupuncture

Acupuncture, the ancient Chinese practice of inserting fine needles on specific points on the body to confer physiological benefits, is being studied for its effects on depression. One early study suggests acupuncture may be more effective and safer than no treatment at all, and could work as well as tetracyclic antidepressants. However, the evidence is low and of poor quality. More rigorous studies are needed before acupuncture can be considered a viable alternative to traditional, well-studied treatments.

Supplements

Herbal, vitamin, and mineral supplements haven’t been researched enough to understand their effect on individuals with bipolar. Some supplements that show some promise or are being studied for their use for bipolar disorder include:

  • Fish oil. Specifically, the omega-3 fatty acids common in fish oil continue to be studied for their effect on depression and mental health disorders. So far there are no conclusive or meaningful results. What’s more, there’s research that indicates some benefit might be experienced when omega-3 fatty acids are used in addition to an antidepressant, rather than as a replacement for it.

  • Rhodiola rosea. Urban lore has it that this herb promotes energy, stamina, mental capacity, and athletic performance, and reduces the effects of stress, depression, and anxiety. However, there are no rigorous studies using people with bipolar. And while some preliminary studies show the herb could be helpful when used with mood stabilizers to control depressive symptoms and occasional mild mania, it shouldn’t be used without a physician’s supervision.

  • SAMe. Also known as s-adenosyl-l-methionine, SAMe is a naturally formed chemical found in the body. Those with depression tend to have abnormal levels of it in their bodies, but when it comes to bipolar disorder, SAMe supplementation may not be safe because it may worsen the symptoms of mania. People with bipolar disorder should not take SAMe unless under the supervision of a health care provider.

What’s the Bipolar Outlook?

For most, bipolar disorder is a lifelong illness. To manage symptoms, it requires long-term, continuous treatment. On average, the life expectancy for those with bipolar disorder is 11 to 20 years less than for the general population. Reasons for reduced life expectancy include:

  • Engaging in high-risk behaviors

  • Delayed diagnosis and treatment

  • Not having access to mental health care

  • Symptoms of bipolar interfering with treatment for other chronic diseases, such as heart disease or cancer, worsening the prognosis for those diseases

  • Increased risk for suicide

What You Should Know About Bipolar Disorder and Suicide

Thoughts of self-harm or suicide, and attempts at self-harm or suicide can happen during both manic and depressive episodes. Overall, an estimated 25% to 50% of those with bipolar disorder will attempt suicide at least once in their lives, with between 6% and 19% dying by suicide.

Signs of Suicide

Recognizing the signs of suicide is the first step toward prevention and getting needed help. Signs of suicide include:

  • Talking about self-harm, wanting to die or suicide

  • Expressing feelings of worthlessness, guilt, or shame

  • Feeling as if you are a burden to others, or that you’re trapped or have no reason to live

  • New or increased alcohol and drug use

  • Researching suicide methods

  • Giving away possessions or making a will

  • Withdrawing from people and activities

  • Sleeping too much or too little

  • Saying goodbye to family and friends

  • Angry or aggressive behavior

  • Engaging in risky behavior, such as driving too fast

Getting Help During a Crisis

If you recognize the above signs in yourself or someone you love, it’s important to get help. If you’re in a crisis, get help as soon as possible by:

Bipolar and Relationships

Living with bipolar disorder is not always easy—for you, if you’ve got it, but also for the people around you. Bipolar disorder can take a toll on relationships with friends, family, spouses, romantic interests, and work colleagues.

The manic phase of this disease can be exhilarating when you’re experiencing it, but it can be harrowing for your friends and family. The person with bipolar feels like they can do anything, often causing them to engage in risky behaviors—impulsively quitting their jobs, gambling away their savings, and other types of sweeping life changes—which can hurt themselves or loved ones.

The depression phase of bipolar can also be debilitating—but in the opposite way. If you have bipolar, not knowing how you’re going to feel on a day-to-day basis can cause insecurity, anxiety, and panic. Therapy can be very beneficial in helping you see the effect you’re having on others. It can also teach you ways to educate those around you about your mental health challenges and how they can best help you. There are also opportunities for your loved ones to also participate in therapy, specifically through family-focused therapy.

When Someone You Love Has Bipolar

If you have a friend or family member with bipolar, there are specific ways to help. Since it can be difficult for a person in the manic phase to realize anything’s off, it’s important for you to be aware of the signs and get help for them if necessary.

How would you be able to tell? The person wouldn’t be acting like their usual self, typically for several days or even weeks. If someone you care about has been diagnosed with bipolar and stops taking their medicine, that’s another reason to call the doctor ASAP or urge them to do so.

You might also consider asking your friend or family member about attending doctor appointments with them to ask some questions or give your perspective on how your friend is doing. While there’s a chance your loved one might feel this ask is too intrusive, talk it through: Communication—lots and lots of it—can help build trust. People with bipolar sometimes feel like a burden, so let them know you love them and you’re there to listen, without judgment.

Where Can I Find Bipolar Disorder Communities?

Sometimes it can feel like you’re the only one in the world struggling with bipolar disorder. Because of the stigma of mental health disorders and the misunderstanding about bipolar, not everyone talks openly about it. Even if you have friends and family who love and care for you, you may still feel like nobody understands exactly what you’re going through. Spending time with others who share similar struggles can make you feel less isolated and alone.

In addition to feeling understood, a support group can help you live better with the disease: Hearing about others’ experiences handling issues—like managing medication side effects or how they’ve told people about the condition—gives you tangible advice you can use in your own life.

Top People With Bipolar Disorder to Follow on Social Media

Follow because: As an award-winning writer and speaker, Natasha not only has the expert chops to bring you evidence-backed information, but she has the first-person experience to bring you the realities of living with bipolar disorder. The combo explains why her blog and social media pages are deemed by many as best in the bipolar biz. She’s also the author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Follow because: She’s not just an inspiration because she graces The New York Times best-selling author list (for I'm Telling the Truth, but I'm Lying), or even because she’s a strong Nigerian-American woman speaking her truth—but also because she doesn’t let her bipolar define her or hold her back. When the fog clears, she pushes through. When the fog is present, you can find personal reminders to herself to not let fear and disaster consume her…right on her Insta feed.

Follow because: She’s young, cool, and as modern-day as it gets—giving you inspiration and direction for how to live in a healthy mental state in a world of social media. Not limited to: relationships and dating, personal stories, and the occasional quote that speaks to your soul.

Follow because: She shares every step of her balanced life, which is quite busy because, as her LinkedIn shows, she hops around quite a bit, in careers (from real estate to marketing, now author) and in life—which is a fairly normal trait for someone with bipolar disorder. Join her on her journey and pick up everything she’s learned over the years (and through the careers). She’s also the author of Balancing Act–Writing Through a Bipolar Life.

Follow because: When you’re the original consultant for Claire Danes on Homeland (who plays a CIA agent with bipolar disorder) and won the Mental Health American Journalism Award for the best mental health column in the U.S., then yeah, you just follow her. She’s also the author of several books on mental health, including Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner and Take Charge of Bipolar Disorder.

Follow because: What doesn’t he do? Gabe makes his rounds as an award-winning writer and speaker and hosts a PsychCentral.com podcast (keep scrolling for deets). His blog taps into how today’s environment and pop culture are affecting the mental health community. He’s also the author of Mental Illness is an Asshole.

Top Bipolar-Related Podcasts

  • Not Crazy. This PsychCentral.com podcast is for people with mental health conditions…who hate mental health podcasts. Hosts Gabe Howard (who has bipolar) and Jackie Zimmerman (who has depression, generalized anxiety disorder, MS, and UC) eliminate all of the psycho-babble: They know first-hand that most people don’t generally wonder about the “state of their mental health” but might very well worry about whether or not, in their words, they’re “crazy.”

  • The Bipolar Family. Just as it sounds, this podcast is hosted by a family of people with bipolar disorder (mom, dad, and two of their three kids). From vacations to work life, relationships to family dynamics, The Bipolar Family is real, raw, and so addicting (in a perfectly normal and healthy way).

Top Bipolar Support Groups and Nonprofits

  • Depression and Bipolar Support Alliance (DBSA). Front and center, its message “You are not alone” speaks volumes. The most powerful resource? Connecting you with in-person and online support by your zip code. There’s also an online community for parents of children with bipolar or depression.

  • U.S. Department of Health & Human Services Substance Abuse and Mental Health Administration. Its mission is to provide programs, policies, funding, and personnel to advance mental and substance use disorder prevention, treatment, and recovery services. You’ll find links to help you locate treatments as well as lots of helpful information.

  • National Alliance on Mental Illness (NAMI). The nation’s largest grassroots mental health organization, NAMI is an umbrella for nearly 1,000 community-based chapters that offer programs, provide skills training, and can help you find treatment and other resources.

  • Mental Health America. This nonprofit does a ton of advocacy to protect the rights of those living with mental illness. They engage with legislators and policymakers to work toward laws and regulations focusing on prevention, early intervention, and fair insurance rules for people with mental health conditions.

  • International Bipolar Foundation. Whether you’re living with bipolar disorder or caring for someone who does, this group is like a shoulder to lean on. Get connected for volunteer opportunities, or simply dive deep into their resources on everything from relationships and therapy to medication and coping strategies.

Leslie Pepper
Meet Our Writer
Leslie Pepper

Leslie Pepper is a freelance writer specializing in health, nutrition, fitness, and wellness. Her work has appeared in dozens of consumer magazines including Better Homes and Gardens, Woman’s Day, and Parents, as well as on websites such as EverydayHealth.com, WebMD and BHG Interactive.