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 lifelong — 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 provider or mental health professional uses the criteria in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Bipolar disorder consists of two main types:
- 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 don’t have to have depressive episodes to be diagnosed with bipolar I disorder — one episode of mania is enough for this diagnosis.
- 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.
For both 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 allows them to 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 and finding yourself in riskier situations, such as unprotected sex, overspending, or reckless driving
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 finally complete essential tasks.
But hypomanic episodes can also be dangerous: Besides engaging in unhealthy behaviors 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. Instead, 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
- trouble sleeping
- exhaustion or feeling lethargic
- feeling guilty or worthless
- trouble focusing
- negative thoughts about the future
- gaining or losing weight
- suicidal thoughts or actions
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:
In both disorders, you also might:
- berate 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.
The researchers also found that people with bipolar disorder I and bipolar disorder II had the same rates of substance use disorder. Alcohol use was the most common type.
According to a 2017 review, substance use disorders in people with bipolar disorder are more common in:
- people with a higher number of manic episodes
- those who experience suicidality
Having a substance use disorder can interrupt treatment and make some symptoms of bipolar disorder worse.
A 2017 study including 837 outpatients from mental health and substance abuse centers suggested that having both bipolar disorder and a substance use disorder is associated with an increased risk of 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 ways to find treatment.
Bipolar disorder can also affect children between ages 6 and 10. 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 tantrums three times per week or more. These tantrums are out of proportion for the situation and inconsistent with the child’s developmental level.
Between 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 provider 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 absolutely normal 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 who have similar experiences or read about people’s experiences online, such as following blogs devoted to bipolar disorder.
You might also find it helpful to try some self-help strategies as one part of your comprehensive treatment plan.
With treatment and support, you can live with bipolar disorder and lead a healthy, fulfilling life.