Bipolar Disorder

Table of Contents


Bipolar disorder affects almost 5 million people in the US and is more often diagnosed in women. Bipolar is a brain disorder that is indicated by extreme mood swings, including extreme emotional highs and lows.

When experiencing depression, a person could feel melancholy or despair and stop enjoying most activities. They can feel ecstatic, energized, or particularly irritable when their mood swings to mania or hypomania (less severe than mania). These mood swings occur over several weeks to months. It is important to understand that bipolar disorder does not mean someone is “moody.”

A person’s capacity for clear thought, energy levels, interest in activities, judgment, and behavior can all be impacted by these mood changes.

While those diagnosed will have bipolar disorder for life, by adhering to a treatment plan, those living with it can control their mood swings and other symptoms. Psychological treatment and medication are typically used to treat bipolar disorder (psychotherapy).


  • Bipolar I disorder: One manic episode with one or more hypomanic or severe depressive episodes either before or after.
  • Bipolar II disorder: At least one major depressive episode and at least one hypomanic episode, but never a manic episode.
  • Cyclothymic disorder: Many periods of hypomanic symptoms and depressive symptoms for at least two years, or one year if a child or teen.

Bipolar disorder can happen at any age but is usually discovered when people are in their teens or early 20s. Symptoms are different for each person, and they can change over time.


Researchers still don’t know what causes bipolar disorder. It’s assumed to be a complicated mix of genes, brain chemistry, and life events.

Bipolar disorder runs in families. The American Psychiatric Association estimates that between 80% and 90% of people with bipolar disorder have a family member with either depression or bipolar disorder.

Research also shows that childhood trauma increases the chance of having bipolar disorder and increases the likelihood of having worse symptoms.


Manic Episode

A manic episode is a timespan of at least one week when a person is very happy or angry most of the time, has more energy than usual and has noticeable changes in their behavior in at least three of the following ways:

  • Less need for sleep
  • Increased or more rapid speech
  • Racing thoughts or rapid changing of ideas while talking
  • Easily distracted
  • Engaging in dangerous behavior

These actions must be different from how the person usually acts, and friends and family should be able to notice. The symptoms must be bad enough to make it hard to maintain work, family, or social responsibilities and activities.

When a person is having symptoms of a manic episode, they often need to go to the hospital to stay safe.

Some people who have manic episodes also have psychotic features, such as disorganized thinking, false beliefs, or hallucinations.

Hypomanic Episode

Hypomanic symptoms are less severe than manic symptoms and only need to last four days in a row instead of a week. Hypomanic symptoms don’t cause the big problems with everyday life that manic symptoms usually do.

Major Depressive Episode

A major depressive episode is when a person has at least five of the following symptoms for at least two weeks, including at least one of the first two:

  • Severe unhappiness or despair
  • Disinterest in things the person used to enjoy
  • Feelings of inadequacy
  • Fatigue
  • Change in sleep pattern
  • Change in appetite
  • Restlessness/slow speech or movement
  • Having trouble focusing
  • Repeatedly experiencing thoughts of death or suicide


Many people can get better with treatment. Medications and psychotherapy are often used together as part of an effective treatment plan.

Bipolar disorder is an illness that lasts for life. Manic and depressive episodes tend to happen again and again over time. Treatment that lasts for a long time and keeps going can help people deal with these symptoms.


Some people may have to try a few different medicines and talk to their doctor before they find the ones that work best. Mood stabilizers and “atypical” antipsychotics from the second generation are used to treat bipolar disorder. Medication to help with sleep or anxiety may be part of a treatment plan. When someone with bipolar disorder has a depressive episode, doctors often give them antidepressants along with a mood stabilizer to keep the person from having a manic episode. Those who take medicine should:
  • Talk to their doctor or nurse about the risks and benefits of the medicine.
  • Tell their doctor about any supplements, over-the-counter drugs, or prescription drugs they are taking.
  • Tell a health care provider right away if you are worried about any side effects. The doctor or nurse might have to change the dose or try a different drug.
Remember that if you have bipolar disorder, you must take your medicine as prescribed, even if you feel fine.
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  2. National Institute of Mental Health (NIMH). Bipolar Disorder. Last Revised January 2020. Available at NIMH.
  3. Mayo Clinic. Bipolar Disorder. February 16, 2021. Available at  Mayo Clinic.
  4. American Psychiatric Association(APA). What Are Bipolar Disorders? 2022. Available at APA.
  5. Aas, M., Henry, C., Andreassen, O.A. et al. The role of childhood trauma in bipolar disorders. January 13, 2016. Available at International Journal of Bipolar Disorders.
  6. National Alliance on Mental Illness. Lamotrigine (Lamictal). September 2021. Available at NAMI.
  7. Valproate. Last Update January 1, 2021. Available at
  8. National Library of Medicine. Carbamazepine. Last Revised May 15, 2022. Available at Medline Plus.
  9. National Library of Medicine. Quetiapine. Last Revised June 15, 2020. Available at Medline Plus.
  10. National Library of Medicine. Fluoxetine. Last Revised January 15, 2022. Available at Medline Plus.
  11. National Library of Medicine. Duloxetine. Last Revised March 15, 2022. Available at Medline Plus.
  12. National Library of Medicine. Alprazolam. Last Revised May 15, 2015. Available at Medline Plus.
  13. National Library of Medicine. Clonazepam. Last Revised May 15, 2021. Available at Medline Plus.
  14. National Library of Medicine. Diazepam. Last Revised May 15, 2021. Available at Medline Plus.

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