Bipolar disorder is a mental health condition marked by significant changes in mood, energy, activity, and functioning. Bipolar disorder symptoms generally involve periods of mania or hypomania and periods of depression, although the pattern varies by person and by bipolar disorder type.
Recognizing the difference between ordinary mood changes and clinically significant episodes is important because bipolar disorder requires a professional evaluation. NIMH notes that diagnosis is based on the person’s symptoms, experiences, and course of illness rather than on a simple test.
What are common bipolar symptoms?
Bipolar symptoms can affect emotions, thoughts, sleep, behavior, energy, and daily activities.
During a manic episode, a person may experience:
- An unusually elevated, expansive, or irritable mood
- Increased energy or activity
- Reduced need for sleep
- Racing thoughts
- Talking more than usual
- Feeling unusually powerful or capable
- Increased impulsivity or risk-taking
- Difficulty concentrating
During bipolar depression, symptoms can include:
- Persistent sadness or low mood
- Loss of interest in activities
- Low energy
- Changes in sleep
- Changes in appetite
- Difficulty concentrating
- Feelings of worthlessness or hopelessness
- Thoughts of death or suicide
NIMH describes bipolar disorder as involving clear shifts in mood, energy, and activity, with episodes that can significantly affect everyday functioning.
What are the signs of bipolar disorder?
Signs of bipolar disorder are most concerning when mood and behavior changes are unusually intense, persist over time, and interfere with relationships, work, school, or daily functioning.
A person experiencing mania may sleep very little while still feeling highly energetic, speak rapidly, start numerous projects, spend excessively, or engage in risky activities.
During depression, the same person may experience a dramatic reduction in energy and motivation, social withdrawal, difficulty functioning, or severe hopelessness.
Not every person experiences the same symptoms or the same sequence of episodes. That is one reason self-diagnosis based on a few symptoms can be misleading.
What are the bipolar disorder types?
The major bipolar disorder types include bipolar I disorder, bipolar II disorder, and cyclothymic disorder.
NIMH explains that these conditions differ based on the type and duration of mood episodes experienced.
What is bipolar 1 disorder?
Bipolar 1 disorder is defined by manic episodes that last at least seven days or are severe enough to require hospital care.
Depressive episodes commonly occur as well, although a person does not need a history of depression to meet the defining criterion for bipolar I.
Mania can become severe enough to impair judgment, relationships, employment, finances, or personal safety.
What is bipolar 2 disorder?
Bipolar 2 disorder involves depressive episodes and hypomanic episodes rather than the full manic episodes characteristic of bipolar I.
Hypomania is less severe than mania, but it can still produce noticeable changes in mood, energy, behavior, sleep, and functioning.
Bipolar II should not be considered simply a “milder” version of bipolar disorder because depressive illness can be substantial and disruptive. NIMH notes that people with bipolar II may spend extended periods experiencing depressive symptoms.
What does bipolar depression feel like?
Bipolar depression can involve more than ordinary sadness. A person may lose interest in activities they normally enjoy, have difficulty getting out of bed, struggle with concentration, experience changes in appetite or sleep, and feel deeply hopeless.
Because depressive symptoms can resemble major depressive disorder, a clinician needs to ask about previous periods of mania or hypomania when evaluating someone for depression.
This distinction matters because treatment approaches can differ when depression occurs as part of bipolar disorder.
What does bipolar mania look like?
Bipolar mania involves an abnormal and sustained increase in mood, energy, or activity accompanied by other symptoms.
Someone experiencing mania may:
- Sleep much less without feeling tired
- Speak unusually quickly
- Have rapidly changing thoughts
- Become unusually active
- Take significant financial or personal risks
- Believe they can accomplish unrealistic goals
- Become severely irritable or agitated
Severe mania can require urgent psychiatric treatment or hospitalization, particularly when judgment, behavior, or safety becomes significantly impaired.
What is a manic episode?
A manic episode is a distinct period of elevated, expansive, or irritable mood with increased energy or activity and other associated symptoms.
For bipolar I, NIMH identifies mania lasting at least seven days or being severe enough to require hospital care as the defining feature.
A manic episode is not simply a day when someone feels especially productive or energetic. The change is typically substantial enough to be noticeable and to affect functioning or behavior.
How is bipolar disorder treated?
Treatment for bipolar disorder commonly involves medication, psychotherapy, or a combination of both.
NIMH identifies mood stabilizers and atypical antipsychotics among commonly prescribed medication categories. Treatment may differ during a manic episode, depressive episode, and long-term maintenance.
Psychotherapy can support treatment by helping people recognize warning signs, build coping strategies, manage routines, and improve communication.
Are mood stabilizers used for bipolar disorder?
Mood stabilizers are commonly used to manage bipolar disorder and help reduce the severity or recurrence of mood episodes.
Lithium is a well-established mood stabilizer. NIMH notes that people taking lithium generally require monitoring of lithium levels and kidney and thyroid function.
Medication decisions must be individualized. The right medication depends on the person’s symptoms, other conditions, previous response, side-effect risks, and other clinical factors.
When should someone seek professional help?
Someone should consider professional evaluation when mood changes are persistent, unusually intense, difficult to control, or interfering with daily life.
Urgent help is particularly important when there are symptoms such as severe impulsivity, psychosis, inability to care for oneself, or thoughts of suicide or self-harm.
In the United States, people in immediate emotional distress or having suicidal thoughts can call or text 988. Life-threatening emergencies require 911.
FAQs
Can bipolar disorder cause both mania and depression?
Yes. Bipolar disorder can involve manic, hypomanic, and depressive episodes depending on the type and course of illness.
What is the difference between bipolar 1 disorder and bipolar 2 disorder?
Bipolar I includes manic episodes, while bipolar II includes hypomanic and depressive episodes without full mania.
Can anxiety happen with bipolar disorder?
Yes. Anxiety can occur alongside bipolar disorder, which may make evaluation and treatment more complex.
Are mood stabilizers always required?
Treatment varies by individual. A qualified healthcare professional determines whether a mood stabilizer or another treatment approach is appropriate.
Conclusion
Bipolar disorder symptoms can affect mood, energy, sleep, behavior, thinking, and everyday functioning. The most important differences between bipolar disorders involve the nature of manic, hypomanic, and depressive episodes.
Bipolar I disorder is defined by mania, while bipolar II involves hypomania and depression. Because symptoms can overlap with other mental health conditions, diagnosis should be based on a comprehensive professional evaluation rather than online symptom matching.
Early assessment and consistent treatment can help people manage bipolar symptoms and reduce the disruption caused by recurring mood episodes.