Bipolar disorder causes changes in mood, energy, and activity levels. A person with bipolar disorder typically experiences at least one episode of “high” mood, or mania, and a period of “low” mood, or depression.

Bipolar disorder was formerly known as manic depression. It can severely affect a person’s daily life. The specific effects varies between individuals. With appropriate treatment and support, many people with bipolar disorder live a full and productive life.

On average, symptoms begin around age 25 years but can appear during the teenage years or later in life. It affects all people, regardless of sex.

This article further explains what bipolar disorder is. It goes over the symptoms and types of the condition. Finally, it explains the diagnosis, treatment, and causes of bipolar disorder.

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According to the National Alliance on Mental Illness (NAMI), bipolar disorder affects around 2.8% of the U.S. population. It is a mental health condition that causes unusual shifts in a person’s concentration, mood, activity level, and energy.

The National Institute of Mental Health (NIMH) describes the main symptoms of bipolar disorder as alternating episodes of high and low mood.

Changes in energy levels, sleep patterns, ability to focus, and other symptoms can severely affect a person’s behavior, work, relationships, and other aspects of life.

Most people experience mood changes at some time, but those related to bipolar disorder are more intense than regular mood changes. Other symptoms can also occur. For example, some people with bipolar disorder experience psychosis, which can include:

  • delusions
  • hallucinations
  • paranoia

Between episodes, a person’s mood may be stable for months or years, especially if they are following a treatment plan.

Treatment helps many people with bipolar disorder work, study, and live a full and productive life. However, when treatment helps a person feel better, they may stop taking their medication. If this happens, symptoms can return.

Some aspects of bipolar disorder can make a person feel good. During an elevated mood, they may find they are more sociable, talkative, and creative.

However, an elevated mood is unlikely to last. Even if it does, it may be hard to sustain attention or follow through with plans.

According to NAMI, bipolar disorder symptoms vary between individuals. For some people, an episode can last for several days or weeks. People with bipolar disorder also generally experience extended periods without symptoms.

Others may experience “highs” and “lows” simultaneously or in quick succession. When these mood episodes occur simultaneously, it is known as a mixed state. When they occur in quick succession, it is known as rapid cycling.

Mania or hypomania

Mania and hypomania are elevated moods. Mania is generally more intense than hypomania.

Symptoms can include:

  • an increase in energy and activity
  • a feeling of restlessness
  • excessively good, euphoric, or “high” mood
  • racing thoughts, talking quickly, or jumping from one thought to another
  • severe irritability
  • difficulty concentrating
  • a feeling of needing less sleep than usual
  • unrealistic beliefs in one’s own powers and abilities
  • increased sex drive
  • behaviors that may be harmful, aggressive, or dangerous
  • denying that something may be wrong

Some people with bipolar disorder may spend a lot of money, use recreational drugs, consume alcohol, and participate in dangerous and inappropriate activities.

Learn more about the differences between mania and hypomania.

Depressive symptoms

During an episode of depression, a person may experience:

  • sadness and anxiety
  • changes in sleep patterns, such as:
    • difficulty falling asleep
    • waking up too early
    • sleeping too much
  • restlessness or lethargy
  • difficulty concentrating or making decisions
  • talking slowly or finding it difficult to say anything
  • forgetfulness
  • a lack of interest in activities, even ones the person typically enjoys
  • feeling unable to complete simple tasks
  • feelings of worthlessness or hopelessness

In severe cases, a person may also experience suicidal thoughts or behaviors.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Read about the differences between bipolar disorder and depression.


If a manic or depressive episode is very intense, a person may experience symptoms of psychosis. They may have trouble differentiating between fantasy and reality.

More than 50% of people with bipolar disorder experience symptoms of psychosis at some point, according to a 2022 research review.

Symptoms of psychosis may include hallucinations, delusions, or both.

Hallucinations are when someone sees, hears, or smells something that is not there. Delusions are when a person believes something despite evidence to show it is false.

Learn how bipolar disorder symptoms can differ in females.

There are three types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymia.

They have different diagnostic criteria based on their symptoms and duration.

Type of bipolar disorderDiagnostic criteria
bipolar I disorderAn episode of depression or hypomania may precede or follow an episode of mania.
bipolar II disorderA person experiences an episode of hypomania and an episode of depression without experiencing clinical mania.
cyclothymiaA person has symptoms of hypomania and depression that do not meet the criteria for full episodes of hypomania or depression. Symptoms last for at least 2 years.

Bipolar I disorder

The criteria for bipolar I disorder include:

  • manic episodes that last at least 7 days, or manic symptoms severe enough they require immediate medical care
  • possible depressive episodes, typically lasting up to 2 weeks
  • possible mixed episodes of both manic and depressive symptoms

Learn more about bipolar I disorder.

Bipolar II disorder

Bipolar II disorder involves periods of hypomania. Depression is often the dominant state.

For a diagnosis of bipolar II disorder, a person must have had:

  • one or more episodes of depression
  • at least one hypomanic episode
  • no other diagnosis to explain the mood changes

A person with hypomania may feel good and function well, but their mood will not be stable. There is a risk that depression will follow.


The National Health Service (NHS) in the United Kingdom states that cyclothymia is a mild form of bipolar disorder.

Also known as cyclothymic disorder, it involves recurring symptoms of hypomania and depression that are not intense enough or do not last long enough to qualify as full hypomanic or depressive episodes.

Learn more about how cyclothymia and bipolar disorder differ.

A mental health or healthcare professional can diagnose bipolar disorder using criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

The NIMH explains that to receive a diagnosis of bipolar I disorder, a person must have experienced symptoms of mania for at least 7 days, or fewer than 7 days if symptoms were severe enough to require hospitalization. They may also have had a depressive episode lasting at least 2 weeks.

To receive a diagnosis of bipolar II disorder, a person must have experienced at least one cycle of hypomania and depression.

A healthcare professional may perform a physical examination and order some diagnostic tests, including blood and urine tests, to help rule out other causes of symptoms.

It can be challenging for a healthcare professional to diagnose bipolar disorder. People are more likely to seek help with a low mood than a high mood. As a result, it can be difficult for a healthcare professional to distinguish it from depression.

If a person has psychosis, a healthcare professional may misdiagnose their condition as schizophrenia.

Other complications that may occur with bipolar disorder are:

The NIMH urges healthcare professionals to look for signs of mania in the person’s history to prevent misdiagnosis. Certain antidepressants can trigger mania in some people.

While a person with bipolar disorder may experience periods of neutral mood without symptoms, bipolar disorder is a lifelong condition.

Learn more about bipolar disorder vs. schizophrenia.

Treatment aims to stabilize the person’s mood and reduce the severity of symptoms. The goal is to help the person function effectively in daily life.

Treatment involves a combination of therapies, including:

It can take time to get a correct diagnosis and find a suitable treatment. Each person with bipolar disorder has different needs, and symptoms vary widely.

Learn more about treatment for bipolar disorder.

Bipolar disorder appears to develop from a combination of factors, according to the NIMH:

  • Genetic factors: Bipolar disorder is more common in people who have a family member with the condition. Several genetic features may be involved.
  • Biological traits: Imbalances in neurotransmitters or hormones that affect the brain may play a role.
  • Environmental factors: Life events, such as abuse, mental stress, a significant loss, or another traumatic event, may trigger an initial episode.

The following are some questions people frequently ask about bipolar disorder.

At what age does bipolar disorder start?

The average age of onset for bipolar disorder is 25 years old. However, it can occur in the teenage years. It rarely occurs in childhood.

Can bipolar disorder go away?

There is no cure for bipolar disorder. It is a lifelong condition. However, people with bipolar disorder may experience periods of no symptoms. Ongoing treatment can help manage symptoms and reduce the severity of episodes.

What can trigger bipolar disorder manic or depressive episodes?

Triggers for bipolar disorder mood episodes can include stress, changes in sleep, traumatic events, and substance use. Triggers may vary from person to person.

Bipolar disorder resources

Visit our dedicated hub for more research-backed information and in-depth resources on bipolar disorder.

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Bipolar disorder is a serious mental health condition. It involves changes in mood, energy levels, and attention, alongside other symptoms.

It can severely disrupt a person’s life, but treatment can drastically improve a person’s outlook and well-being.

Treatment may not eliminate mood changes entirely, but working closely with a healthcare professional can make symptoms more manageable and maximize quality of life.

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