Let's Talk About Bipolar Disorder
We've got the doctor-approved scoop on bipolar causes, symptoms, treatments, and a jillion other facts and tips that can make life with this mental health condition easier.by Leslie Pepper
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. On this page alone, 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.
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.
Psychiatrist and Clinic Chief
Bipolar Disorders Clinic at Stanford University Department of Psychiatry
Amit Anand, M.D.
Professor and Vice-Chair for Research
Center for Behavioral Health at the Cleveland Clinic
Linda Hubbard, L.M.F.T.
Department of Behavioral Health, Psychiatry & Psychology at the Mayo Clinic
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.”
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.
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.
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.
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.
Some quick bipolar stats:
Bipolar disorder is, on average, diagnosed around age 25, but it can be spotted in teens and more rarely even younger children.
About 3% of adults in this country experience the condition, which means about 10 million Americans have bipolar disorder.
Rates of bipolar are equal among men and women in the U.S.
More than 80% of people with bipolar disorder are classified as “severe,” which means their illness causes serious impairments.
Do I Have the Signs of Bipolar?
The symptoms of bipolar vary. Here are some signs to look out for.
Symptoms of bipolar-related mania may include:
Having high levels of energy and exhilaration
Experiencing grandiose or overblown self-esteem
Speaking so loudly or quickly others can't understand you
Not sleeping well and/or having little need to sleep
Engaging in risky behaviors like unprotected sex or gambling
Being easily distracted
Being easily irritated
Symptoms of bipolar-related depression may include:
Eating too much or too little
Having thoughts of suicide
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 actually 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.
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 is the most serious form of bipolar. Manic episodes last at least seven days or are so serious that the person needs immediate hospital care. Depressive episodes usually last at least two weeks.
Bipolar II Disorder is similar to bipolar I, but the manic episodes are less intense. Mania for this type is called hypomania.
Cyclothymic Disorder (or cyclothymia) is a milder form of bipolar disorder, where moods fluctuate between short periods of hypomania and mild depression for a period of at least two years. The emotional fluctuations are shorter than for bipolar I or II.
Other Specified and Unspecified Bipolar and Related Disorders is, as it sounds: 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.
What Causes Bipolar Disorder?
Experts don’t know exactly why someone develops bipolar, and there’s no one factor that sparks it. It’s likely a combination of some or all of the following:
Genetics: It’s unclear specifically how, but genes can play a large role, and bipolar disorder tends to run in families.
Gender: While men and women get bipolar at equal rates, women have a higher risk of rapid cycling (going up and down in mood quickly), and they tend to have more depression than men.
Stress: 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 getting bipolar later.
Substance abuse: Those who abuse drugs or alcohol are at a higher risk for developing bipolar disorder.
How Do Doctors Diagnose Bipolar Disorder?
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.
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.
If physical issues don’t explain the symptoms, a trained mental health professional (such as a psychiatrist) will discuss a person’s moods, thoughts, feelings, and behaviors. The psychiatrist may also give you a questionnaire, as well as ask you to keep a daily record of moods and sleep patterns.
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
What Is the Best Treatment for Bipolar Disorder?
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.
Because mood stabilizers can take up to two weeks to achieve their full effect, doctors usually also prescribe an anti-psychotic, which can start to work in as quickly as a few hours. Medication isn’t one-size-fits-all, of course—everyone reacts individually—but it’s a very effective first line of treatment. It can also work hand in hand with these other types of helpful treatments:
Talk therapy can help people understand what’s going on and provide coping strategies to better handle the issues you face with the disorder.
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.
Electroconvulsive therapy (ECT) is an 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.
What’s Life Like for People with Bipolar Disorder?
Living with bipolar disorder is not always easy—for you, if you’ve got it, but also for the people around you.
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. Therapy can be very beneficial to help you see the effect you’re having on others.
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.
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 a doctor’s appointment 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
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.
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).
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.
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.
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).
Bipolar Style. When pop culture and politics meet a bipolar perspective, all bets are off. You can even join in on the conversation surrounding the podcast on a Slack channel and chime in on how you feel about host John Emotions’ latest pop topic.
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.
Statistics on Bipolar Disorder: National Institute of Mental Health. (2017). "Bipolar Disorder". nimh.nih.gov/health/statistics/bipolar-disorder.shtml
Other Statistics on Bipolar: Depression and Bipolar Support Alliance. (n.d.). "Bipolar Disorder Statistics." dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/
Screening and Symptoms: Depression and Bipolar Support Alliance. (n.d.). "Mental Health Screening Center." dbsalliance.org/education/mental-health-screening-center/
Related Conditions and Anxiety: National Alliance for Mental Health. (2017). "Bipolar Disorder." nami.org/learn-more/mental-health-conditions/bipolar-disorder
Mania vs. Depression: National Institute of Mental Health. (2016). "Bipolar Disorder." nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
Genetics and Bipolar Disorder: U.S. National Library of Medicine. (2019). "Bipolar Disorder: Inheritance Pattern." ghr.nlm.nih.gov/condition/bipolar-disorder?_ga=2.9407221.1145550372.1574352502-706078380.1573652664#inheritance
Drug v. Non-Drug Therapies: U.S. Department of Health and Human Resources. (2018). "Treatment for Bipolar Disorder in Adults: A Systematic Review." effectivehealthcare.ahrq.gov/products/bipolar-disorder-treatment/final-report-2018
Bipolar and Alcohol: Mayo Clinic. (2019). "Bipolar disorder and alcoholism: Are they related?". mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder/FAQ-20057890?p=1
Recognizing Psychosis: The New England Journal of Medicine. (2019). "Unsteady Thoughts — Telling the Truth of Psychosis" nejm.org/doi/full/10.1056/NEJMp1905350