Bipolar disorder is a mental health condition characterized by distinct episodes of prominent changes in mood and energy — ranging from depression to unusually high moods (euphoria) or irritability. These episodes affect how a person thinks, sleeps, and functions day to day. Bipolar disorder is defined by manic (or hypomanic) episodes and depressive episodes.
Bipolar disorder can strain relationships. It can make it hard to work, go to school, or carry out daily activities.
Bipolar disorder can be a lifelong condition. You can manage symptoms effectively with treatment, including medicine and therapy. There is no cure, but many people lead stable, fulfilling lives with the right support.
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What Is Bipolar Disorder?
Bipolar disorder is a mood disorder that causes wide swings in a person’s mood, energy, activity level, and concentration. It was previously called manic depression.
The disorder involves episodes of:
- Mania or hypomania.
- Depression.
A person with bipolar disorder experiences complex symptoms that can look different from person to person and even from one episode to the next. It can affect thinking, sleep, physical well-being, and day-to-day functioning.
Bipolar disorder is common. Nearly 6 million people in the United States live with bipolar disorder.
Bipolar disorder is treatable.
What are the types of bipolar disorder?
The main types of bipolar disorder include:
- Bipolar I — Involves manic episodes lasting at least seven days or manic symptoms so severe that hospitalization is necessary. Depressive episodes are also common and typically last two weeks or longer. Bipolar I can also include mixed episodes, when elements of depression and mania occur at the same time.
- Bipolar II — Involves depressive episodes and episodes of hypomania. Hypomania is a less severe version of mania.
Someone with bipolar disorder frequently has times when they feel more normal and don’t have depression or mania. Even if their symptoms aren’t extreme, it doesn’t mean they don’t have bipolar disorder. It’s important to talk with a doctor or psychiatrist about these symptoms.
How common is bipolar disorder?
Nearly 6 million Americans have bipolar disorder.
Bipolar disorder is a serious mental health condition. It is associated with significant disability and difficulties in multiple areas of life.
What causes bipolar disorder?
Bipolar disorder does not have a definitive cause. Different factors can contribute to a bipolar diagnosis, including:
- Genetics or family history.
- Brain structure and functioning.
- Stressful or traumatic life events.
- Brain injury.
Bipolar disorder risk factors
Risk factors for bipolar disorder include:
- Altered brain structure.
- Childhood trauma.
- Drug and alcohol use.
- Family history.
- Related mental health conditions, such as anxiety disorders or attention-deficit/hyperactivity disorder (ADHD).
- Traumatic or stressful life events.
Complications of bipolar disorder
In severe cases, people may need to be hospitalized for their own safety.
- Severe depression can lead to suicidal thoughts.
- Severe mania can lead to dangerous actions or life-threatening risks.
What Are the Signs and Symptoms of Bipolar Disorder?
Symptoms of bipolar disorder can vary, but they typically occur in mood episodes.
Depression
- Changes in appetite or weight.
- Difficulties with concentrating or making decisions.
- Feeling extremely sad or hopeless.
- Fatigue or lack of energy that makes it hard to do anything.
- Loss of interest in activities.
- Sleeping too much or having trouble sleeping.
- Thoughts of suicide.
Mania
- Feeling “high.”
- Feeling “wired” or “jumpy,” like after drinking too much caffeine.
- Insomnia or reduced need for sleep.
- Loss of appetite.
- Racing thoughts.
- Increased risk-taking, such as heavy alcohol use, reckless driving, impulsive spending, or risky sexual behavior.
- Feeling overconfident or invincible.
When should I see a doctor about my bipolar disorder symptoms?
Seek medical or mental health care if:
- Mood changes are extreme, last a long time, or affect your everyday life.
- Symptoms are getting worse or new concerns appear.
- Your current treatment is not helping.
Even if symptoms don’t feel extreme, bipolar disorder is still possible. The only way to know is to talk with a medical provider or psychiatrist.
How Do You Diagnose Bipolar Disorder?
A psychiatrist, psychologist, or another qualified mental health professional can diagnose bipolar disorder. In some cases, primary care providers, neurologists, or emergency medicine doctors may also be involved.
Tests to diagnose bipolar disorder
There is no single test to diagnose bipolar disorder. A health care provider may use:
- A physical exam.
- A review of medical and health history, including symptoms, lifetime history, experiences, and family history.
- Medical tests to rule out other causes.
- A mental health evaluation.
Your doctor may ask questions such as:
- Do you have a close relative with bipolar disorder? — Family history can increase risk.
- Have you experienced recent major trauma or disruptive life events? — Stress can trigger mood episodes.
- Do you use drugs or alcohol? — Substance use can mimic bipolar disorder symptoms and may also trigger mood episodes.
Bipolar disorder prognosis
There is no cure for bipolar disorder. It is treatable and manageable in the long term. Many people find stability through consistent care, including:
- Ongoing medical treatment.
- Therapy.
- Lifestyle changes.
- Taking prescribed medicines as directed.
How Do You Treat Bipolar Disorder?
Treatment aims to manage symptoms, stabilize mood, and improve overall quality of life. Most treatment plans include a combination of medicine, therapy, and lifestyle changes. These help reduce the risk of manic and depressive episodes.
Lifestyle changes
Lifestyle adjustments can support mood stability, such as:
- Engaging in regular aerobic/higher-intensity exercise. Even a daily 30-minute walk can help boost your mood and improve sleep.
- Practicing better sleep habits, including a consistent sleep schedule.
- Avoiding screens in the evening.
- Limiting bright light and device use before bed to help you fall asleep more easily.
- Avoiding caffeine and large meals late in the day.
Medicine to treat bipolar disorder
Medicines help with different symptoms and may include:
- Antidepressants for depressive episodes.
- Mood stabilizers and antipsychotics for mania or mood stabilization.
- Anti-anxiety medicines for anxiety symptoms.
- Sleep medicines for insomnia (especially during manic episodes, under a medical provider's guidance).
Talk therapy for bipolar disorder
A mental health counselor can help you:
- Build healthier habits and coping strategies.
- Understand how your mind and body respond to stress.
- Use positive “self-talk” to improve self-management skills and support recovery between episodes.
Other treatments for bipolar disorder
Other potential treatments for bipolar disorder include:
- Electroconvulsive therapy (ECT) — A common option for severe, treatment-resistant depression. While people are under anesthesia, ECT delivers electric currents through the brain to trigger a brief seizure. It can change your brain chemistry to relieve symptoms.
- Transcranial magnetic stimulation (TMS) — Uses magnetic waves to stimulate the brain. It is less powerful than ECT but does not require general anesthesia. TMS can help relieve symptoms of depression.
Day treatment programs or hospitalization for bipolar disorder
A doctor may recommend day treatment programs or hospitalization if symptoms become severe or safety is a concern:
- People with extreme depression can become suicidal.
- People with extreme mania may take life-threatening risks.
How effective is treatment?
With ongoing treatment, many people manage symptoms effectively and work toward a healthy, stable life.
How long does it take to recover after treatment for bipolar disorder?
For some, bipolar disorder is a lifelong condition. Ongoing treatment with a dedicated care team can help you manage your symptoms and improve your quality of life.
Why Choose UPMC for Bipolar Disorder Care?
At UPMC, we provide compassionate, expert care for bipolar disorder. Here, you can expect:
- Mental health expertise — We are a nationally recognized leader in mental health care, research, and education. U.S. News & World Report consistently ranks UPMC Western Psychiatric Hospital nationally for excellence in psychiatry.
- Advanced and individualized treatment options — We provide a wide range of treatment, including advanced options. We treat each person individually, finding the best treatment options for them.
- Research-backed care — We are integrated with the Department of Psychiatry at the University of Pittsburgh School of Medicine. The department consistently ranks first in the nation in psychiatric research funding from the National Institutes of Health. We support research that improves mental health care.
Additional Common Questions
How is bipolar disorder different from other mental health disorders?
Bipolar disorder can resemble depression because depressive episodes are common. What distinguishes it from other types of depression is the presence of distinct episodes of mania which are distinct from an individual's normal baseline thinking and function. This cycling between extremes is a hallmark of bipolar disorder.
What other conditions can occur alongside, or sometimes appear similar to features of bipolar disorder?
- Anxiety disorders.
- Substance use disorders.
- Attention-deficit/hyperactivity disorder (ADHD).
- Obsessive-compulsive disorder (OCD).
When should I see a provider for bipolar disorder?
You should see a provider if you're experiencing symptoms of bipolar disorder, even if they're not severe. You should also see a provider if:
- Your symptoms are affecting your daily life.
- Your symptoms are getting worse.
- Your treatment isn't effective.
- You're experiencing new symptoms.
What questions should I ask my provider about bipolar disorder?
You might ask your provider:
- Do my symptoms meet the criteria for bipolar disorder?
- What’s the difference between Bipolar I and Bipolar II?
- Which type do I have?
- What treatments are available for bipolar disorder?
- What treatments do you recommend for me, and why?
- Why have you decided on medicines for my situation?
- What are the medicines designed to treat?
- What side effects should I be aware of?
- Are there any lifestyle risks?
- Since I have other health conditions, how can I manage them alongside bipolar disorder?
