People with high functioning bipolar disorder may seem to have a handle on their symptoms, but that doesn’t mean their condition is any less severe.
People with bipolar disorder experience extreme shifts in mood and energy levels. They often experience periods of manic “highs” and depressive “lows” that can significantly impact their thoughts, feelings, and actions.
Many people seek treatment — such as medication or therapy — to cope with the condition. Those with high functioning bipolar disorder, however, attempt to manage the condition on their own.
Those with high functioning or acute bipolar disorder might have the ability to mask their symptoms in some cases — but hiding them doesn’t mean that their symptoms are no longer present.
Bipolar disorder (aka bipolar affective disorder) affects roughly
If you have high functioning bipolar disorder (HFBD), you might be able to manage your bipolar disorder symptoms and complete your daily responsibilities and functions. You might do this so well that it doesn’t seem as if you have the condition at all.
However, being considered “high functioning” doesn’t mean that you have fewer or less severe symptoms. You could have any type of bipolar disorder and be high functioning.
While high functioning bipolar disorder identifies those who can effectively manage their symptoms, it’s not recognized as an actual type of bipolar disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), there are four types of bipolar disorder:
- Bipolar I disorder. This involves having manic episodes that last at least 1 week or longer. Some also have depressive episodes than can last up to 2 weeks.
- Bipolar II disorder. This involves having depressive episodes that can last for 2 weeks, while experiencing less severe manic episodes, aka hypomania for up to 4 days.
- Cyclothymic disorder. This involves having frequent shifts between depressive symptoms and hypomania. These symptoms are less severe than in either bipolar I or II disorder.
- Bipolar disorder not elsewhere classified (NEC). This includes all other forms of bipolar disorder that don’t fall into either of the other categories.
Each type of bipolar disorder has its own unique set of symptoms and treatment options. You could have any type of bipolar disorder and still be considered high functioning, based on how you cope with your condition.
People with high functioning bipolar disorder could appear as if they don’t have any bipolar disorder symptoms at all. This might be because they have developed strategies to manage their condition while masking their symptoms.
The need to hide their feelings and behaviors could create a more stressful and anxious environment, making it even more of a challenge to cope with their symptoms.
While there are different types of bipolar disorder, each is characterized by periods of mania and depression. If you live with bipolar disorder and are high functioning, you may still experience these symptoms.
Symptoms of a manic episode include:
- endless energy
- engaging in risky or impulsive behavior
- restlessness
- not needing much sleep
- eating less
- acting aggressively or intense irritability
- racing thoughts
- speaking rapidly or too fast
- feeling invincible or important
- feeling jumpy or on edge
- feeling or seeming easily distracted
Symptoms of a depressive episode include:
- low energy
- intense fatigue
- feeling sad or hopeless
- withdrawing from loved ones
- increased anxiety
- lack of focus and motivation
- difficulty doing simple tasks
- sleeping either too much or too little
- memory problems
- difficulty making decisions
- slow speech
- considering or attempting self-harm
In crisis? Help is available right now
If you’re having thoughts of suicide or self-harm, seek support immediately. You can:
- Call the National Suicide Prevention Lifeline at 800-273-8255
- Text HOME to the Crisis Text Line at 741741
If you’re not in the United States, you can visit Befrienders Worldwide for help.
Treatment options for bipolar disorder often include a combination of medications and psychotherapy.
A variety of medications are commonly used to help manage bipolar disorder symptoms, including:
- atypical antipsychotics
- mood stabilizers
- antidepressants
- anticonvulsants
It may take some trial and error to figure out what medication is right for you, and finding balance between the manic and depressive states caused by bipolar disorder can take time. Having patience during this process is key in determining the types of medication and dosage to best manage your symptoms.
Psychotherapy, aka talk therapy, can help identify and understand your unique symptoms and develop strategies to help manage them. Some therapy options for bipolar disorder include:
- cognitive behavioral therapy (CBT)
- psychoeducation
- dialectical behavioral therapy (DBT)
- family focused therapy (FFT)
- interpersonal and social rhythm therapy (IPSRT)
Experts have also explored other treatments in managing bipolar disorder symptoms, including electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). Though some success has been found using these methods, more research is needed to determine whether or not they are truly effective.
Self-care strategies — such as managing your stress and developing healthy daily routines — might also help you manage your symptoms when done in addition to therapy and medication.
A person with high functioning bipolar disorder may be managing their symptoms but not treating them. Because they might be more adept at hiding their symptoms, their condition could go overlooked, undiagnosed, or untreated.
When left untreated, symptoms could worsen over time and become more difficult to manage.
If you have bipolar disorder or think you do, consider talking with a healthcare or mental health professional. Try to be open and honest about your symptoms.
This will help you receive an accurate diagnosis and put you on a path to treatment that won’t simply mask your symptoms but help you create the balance you need to treat them.