While some symptoms of bipolar disorder are more common than others, there’s no “one way” to be bipolar — every person’s experience of bipolar disorder is unique.

Bipolar disorder is characterized by severe shifts in mood and energy levels.

This means that you may have periods of extreme ups (mania or hypomania) or extreme downs (depression) that last for 1 or 2 weeks, and sometimes longer. Many people experience both up and down mood episodes.

On an upswing, you might feel like you’re on top of the world and think you can accomplish anything. Or you might just feel agitated and angry. On a downswing, you might feel sad, hopeless, and bone-achingly tired.

According to the National Institute of Mental Health (NIMH), bipolar disorder is a lifelong mental health disorder — but it is treatable. Therapy, medications, support resources, and daily coping methods can all help you lead a healthy and fulfilling life.

To diagnose bipolar disorder, a healthcare or mental health professional uses the criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

There are three main types of bipolar disorder:

  • Bipolar I disorder: This involves experiencing manic episodes for 1 week or longer. Some people also experience depressive episodes for at least 2 weeks. You do not have to have depressive episodes to be diagnosed with bipolar I disorder — one episode of mania satisfies the diagnostic criteria.
  • Bipolar II disorder: This involves experiencing hypomanic episodes for 4 days and depressive episodes for 2 weeks. Hypomania is less intense than mania, while the depressive episodes in bipolar II tend to be incredibly debilitating.
  • Cyclothymic disorder: This is a milder form of bipolar disorder. People with cyclothymic disorder experience less severe symptoms of hypomania and depression that may not fit the full criteria for bipolar I or bipolar II disorder.

For both bipolar I and bipolar II disorders, you can experience episodes with mixed features. This is when you experience both manic or hypomanic symptoms along with symptoms of bipolar depression.

Many people find that following a treatment plan for bipolar disorder helps them manage these highs and lows.

Bipolar disorder symptoms typically start when you’re a teen or young adult. In some cases, bipolar disorder can occur in kids.

During an episode of mania, bipolar symptoms can include:

  • inflated self-esteem or the belief that you’re more important, talented, or powerful than others
  • endless energy
  • talking very quickly
  • racing thoughts
  • seeming or feeling easily distracted
  • feeling like you can accomplish anything
  • intense irritability or acting aggressively
  • not needing much sleep
  • acting impulsively, such as engaging in activities that can lead to negative outcomes, such as practicing sex without a condom or another barrier method, overspending, and driving irresponsibly

During a hypomanic episode, people experience milder symptoms of mania.

For many people with bipolar II disorder, a hypomanic episode feels good, especially if they’ve just emerged from the darkness and fog of depression. They feel energized and are able to complete essential tasks.

But hypomanic episodes can also cause harmful outcomes. In addition to engaging in behaviors that can affect them negatively during hypomania, people with bipolar II may develop severe mania or depression.

Mania and hypomania feel good for many people, but it might not always be a pleasurable energy boost. Some people feel irritable, anxious, and agitated. They might feel bad about themselves or lash out at loved ones.

During a depressed phase, bipolar symptoms can include:

  • feeling sad or hopeless
  • losing interest in pleasurable or usual activities
  • having trouble sleeping
  • feeling exhausted or lethargic
  • feeling guilty or worthless
  • experiencing trouble focusing
  • having negative thoughts about the future
  • gaining or losing weight
  • having suicidal thoughts or engaging in suicidal actions

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.

Was this helpful?

Bipolar disorder can be difficult to diagnose because it often looks like depression. Symptoms are particularly similar if you have bipolar II disorder.

Both major depressive disorder (MDD) and bipolar depression can produce unpleasant feelings, such as:

  • exhaustion
  • hopelessness
  • worthlessness
  • guilt

In both disorders, you also might:

  • criticize yourself
  • see everything in a negative light
  • have thoughts of suicide

Also, because mania and hypomania tend to feel good, it’s common for people to seek professional help for only depressive episodes. As a result, your provider might not get a complete picture of your symptoms and might provide a misdiagnosis of depression.

Getting the right diagnosis is critical because treatment differs for bipolar disorder and MDD.

For example, antidepressants, which are commonly prescribed to reduce symptoms of depression, can trigger a manic episode in some people with bipolar disorder.

Bipolar disorder commonly occurs with substance use.

Research from 2021 indicated that people with mania were more likely to have substance use disorder (SUD). Alcohol use disorder was the most prevalent diagnosis.

Study authors involved in a different 2021 research review found that people with bipolar I and bipolar II disorder had the same rates of SUD. Alcohol use was also determined to be the most common type.

According to the latter 2021 research review, substance use disorders in people with bipolar disorder are more common in:

  • males
  • people with a higher number of manic episodes
  • those who experience suicidality

Having a SUD can interrupt treatment and make some symptoms of bipolar disorder worse.

Research suggests that having both bipolar disorder and a SUD is associated with an increased risk of suicide attempts and death by suicide.

If you or someone you know is finding that substance use is getting in the way of their lives, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a list of helplines and other ways to find treatment and support.

Bipolar disorder can also affect children between ages 6 and 10 years old. However, it comes with a different set of symptoms and is called disruptive mood dysregulation disorder (DMDD).

DMDD is a newer diagnosis that first appeared in the DSM-5.

According to the NIMH, kids with DMDD have severe, frequent, and ongoing temper outbursts three times per week or more. These outbursts are not in proportion to the situation and are inconsistent with the child’s developmental level.

Between outbursts such as tantrums, kids are also irritable and angry around their caregivers, teachers, and peers. And their irritability makes it really hard for them to function at school and at home.

Treatment for DMDD includes behavioral therapy for children and training for caregivers. Sometimes kids with DMDD also take medication, such as stimulants and antidepressants.

If you’re experiencing any symptoms of bipolar disorder, consider making an appointment to talk with your healthcare or a mental health professional. You also might find it helpful to take Psych Central’s short bipolar disorder test.

Living with bipolar disorder can be difficult. It sometimes might feel utterly overwhelming. These are natural reactions.

But remember that you’re not alone and that bipolar disorder is highly treatable.

It can help to reach out and talk with others with similar experiences or read about people’s experiences online.

You might also find it helpful to try some self-help strategies for bipolar disorder as one part of your comprehensive treatment plan.

Treatment and support can help you manage bipolar disorder and lead a healthy, fulfilling life.