Bipolar disorder is a mental health condition that causes unusual shifts in mood, energy, and activity levels. It can affect different populations in various ways, and some groups of people experience more barriers to diagnosis and treatment.

People with bipolar disorder cycle between depressive episodes — when their mood and energy levels are low — and manic or hypomanic episodes, where their mood and energy levels are elevated or high. Manic episodes cause more intense symptoms than hypomanic episodes.

The condition can affect people of any age, sex, gender, ethnicity, or race, but it tends to affect members of different populations in different ways.

Some groups of people with bipolar disorder are more likely than others to have certain symptoms and some experience more barriers than others to getting an accurate diagnosis and treatment.

The average age of onset for bipolar disorder is about 25 years old, but some people develop symptoms at a younger age.

Those who develop it in childhood or adolescence are more likely to:

  • experience long delays in treatment
  • have severe depressive symptoms
  • develop anxiety or substance use disorders

Bipolar disorder affects men and women at roughly equal rates.

Compared with men, women with bipolar disorder are more likely to:

  • have hypomanic rather than manic episodes
  • have mixed mood episodes with both depressive and manic symptoms
  • rapidly cycle between depressive and manic or hypomanic episodes
  • receive a misdiagnosis of major depressive disorder
  • develop post-traumatic stress disorder or eating disorders

Certain medications for bipolar disorder may interact with hormonal birth control or increase the risk of birth abnormalities in pregnancy, which can add to the challenges of managing this condition.

Bipolar disorder affects people of different races and ethnicities at similar rates.

Compared with non-Hispanic white Americans, Black and Hispanic Americans with the condition are:

  • more likely to receive a misdiagnosis
  • less likely to receive adequate treatment or follow-up
  • less likely to receive mood-stabilizing medications

Although anyone can potentially develop bipolar disorder, symptoms tend to vary across age groups, sex, and gender.

There are also differences in diagnosis and treatment patterns for this condition across age, sex, gender, race, and ethnicity.

Some groups face more barriers than others to getting an accurate diagnosis and adequate treatment. Studies have shown that treatment outcomes are unfavorable among African American participants, possibly due to social economic disadvantages.

As genomic studies on bipolar disorder and psychiatric medications focus mostly on people of European ancestry and underrepresent people of other racial and ethnic backgrounds, available data have scope limitations.

Including more people of different racial and ethnic origins in the long-term studies of bipolar disorder and its diagnosis and treatments will help better understand how the condition affects different population groups. This can then address the issue of under- and misdiagnosis and how treatments can tailor to each group’s needs.