Bipolar I disorder describes a mental health condition where a person experiences manic episodes. This refers to periods of euphoria, delusions, and overactivity. Typically, a person will also experience periods of depression or a neutral mood.

Bipolar disorder refers to a mental health condition that can lead to unusual shifts in mood, energy, and activity levels. There are different types of bipolar disorder, which health experts differentiate depending on the severity and pattern of mood swings.

People with bipolar I disorder — also known as type 1 bipolar disorder — experience mania, which describes periods of high energy and excitement that may last for a week or more.

The median age for bipolar disorder to present at is 25 years, but it can start in childhood or older age. The condition affects males and females equally. Approximately 2.8% of the United States population receives a diagnosis of bipolar disorder, and doctors classify nearly 83% of cases as severe.

Research suggests that roughly 1% of the general population will have bipolar I disorder in their lifetime.

This article discusses the symptoms, causes, and treatment options for bipolar I disorder. It also answers some common questions about the condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Bipolar disorder describes a mental health condition that affects a person’s mood, energy, and ability to function.

People with the condition experience intense emotional states that occur during distinct periods known as mood episodes. These mood changes may fluctuate between manic or hypomanic episodes and depressive episodes.

There are three main types of bipolar disorder:

Some people may also experience other types of bipolar disorder when the symptoms do not fall into the above categories. A healthcare professional may refer to this as “other specified” and “unspecified” bipolar and related disorders.

The main difference between bipolar I and other types of bipolar disorder relates to the intensity and duration of manic periods.

For example, mania with bipolar I disorder is severe and lasts at least a week. However, a person with bipolar II disorder may experience hypomania, which refers to a milder version that lasts for a shorter period.

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The defining characteristic of bipolar I disorder is episodes of mania that last at least 1 week. While mania can present differently in different people, a person typically has similar behaviors during these periods of mood disturbance. These can include:

  • feeling very high or elated
  • inflated self-esteem
  • not sleeping
  • having lots of energy
  • being more talkative or speaking very quickly
  • racing thoughts
  • feeling able to do many things without getting tired
  • impulsive behaviors and excessive appetite for pleasurable activities
  • feeling easily distracted or irritated

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a person must meet the criteria for a manic episode that a doctor cannot better explain due to another mental health condition.

Researchers are unsure about the exact cause of bipolar disorder. However, most agree that a number of factors likely contribute to a person’s chance of developing the condition.

Evidence indicates that the following factors may play a role in the development of bipolar disorder:

  • Genetics: Evidence suggests that individuals with certain genes are more likely to develop bipolar disorder. A 2020 review notes that researchers have identified genetic markers and rare gene variants for it. As such, a person who has a close family relative with the condition will not necessarily develop the disorder but has an increased risk of doing so.
  • Brain structure and function: Other research adds that bipolar disorder has an association with various structural and functional changes in the brain. The brains of people with bipolar may have subtle differences in the size or activation of certain structures. For example, a 2022 study noted that people who experienced frequent manic episodes often had thinning of certain structures in the brain.
  • Stress: A stressful circumstance or situation can trigger a manic episode. As such, stress plays an important role in initiating and maintaining the condition. Research from 2021 suggests that a disruption in how the brain processes stress may result in the development of bipolar disorder.

The two main types of treatment options available for bipolar I disorder are medications and psychotherapy. Evidence suggests that an effective treatment plan usually includes a combination of these options.

Psychological treatments are unlikely to be beneficial if a person is currently experiencing a manic episode. However, they can be helpful during a depressive episode or in between episodes of mania and depression. Types of therapies that may be helpful for bipolar I include:

Medication options for treating bipolar typically involve mood stabilizers and antipsychotics. These drugs can help to prevent mood episodes or reduce their severity. A person may also require antidepressants to help manage depressive episodes.

A person may need to try several different medications and work with their doctor to find the most suitable medicines. These may include:

  • lithium
  • valproate
  • lamotrigine
  • carbamazepine

Learn more about medications for bipolar disorder here.

If a person suspects that they are experiencing manic episodes and the symptoms are severe enough to disrupt their day-to-day functioning, they should seek medical help.

A doctor will be able to assess symptoms and make an appropriate diagnosis. They may perform a physical examination, conduct an interview, and order laboratory tests. These tests can help rule out other conditions.

A mental health professional will typically conduct a mental health evaluation and consider multiple factors to help reach a diagnosis.

Below are some common questions and answers about bipolar I disorder.

Are people born with bipolar?

People are not born with bipolar disorder. However, genetics play a significant role in its development. Evidence notes that bipolar disorder is often inherited and can run in families. Certain genes may make a person more likely to develop the condition, but no one gene can cause it and multiple factors contribute to its development.

Does trauma cause bipolar disorder?

Researchers are still unsure about the exact cause of bipolar disorder but note that a combination of factors, including childhood trauma, may contribute. A 2020 review indicates that experiencing a lot of emotional distress as a child may increase the risk of developing bipolar disorder.

What is the difference between bipolar I and bipolar II?

Bipolar I and bipolar II both involve shifts in mood, energy, and activity levels.

However, they differ in the intensity of manic episodes and the prevalence of major depressive episodes. Bipolar I involves full episodes of mania, while people with bipolar II experience hypomania, which is less severe.

Additionally, those with bipolar I may or may not experience a major depressive episode, while a major depressive episode is a diagnostic requirement for bipolar II.

Bipolar I refers to a mental health condition that involves changes in mood. The characteristic feature is episodes of mania. This refers to periods of high energy and euphoria that alter the way a person thinks or behaves and can affect their relationships.

Researchers are unsure about the exact cause of bipolar disorder but believe that a combination of genetics, brain structure, and stress likely plays a role.

The treatment options for bipolar I often involve a combination of psychotherapy and medications.