Depression and Anxiety

Bipolar Disorder: Understanding the Signs & Symptoms of Bipolar Disorder

Bipolar disorder is a term for several severe mental disorders involving intense mood swings. They're also treatable with the right help.

What is Bipolar Disorder? Understanding its Symptoms and Types

Table of contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

October 23, 2023

The Forge Recovery Center

Imagine a roller coaster of feelings and actions:

Sometimes, a person with bipolar disorder feels incredibly high and active, like they can do anything (a manic or hypomanic episode).

Other times, they feel shallow and sad (a depressive episode). These ups and downs can make it hard for them to go about their everyday life.

Bipolar disorder, which used to be called manic-depressive illness, is a mental health problem where a person's emotions and energy levels go through big and frequent changes. As per statistics shared by the Depression and Bipolar Support Alliance, bipolar disorder ranks as the sixth leading cause of disability worldwide.

Bipolar Disorder by the Numbers:

According to a fact sheet published by the American Psychiatric Association, each year, approximately 3% of US adults, which translates to around 7 million people, experience bipolar disorder.

Is Bipolar Disorder the Same Thing as Manic Depression?

Bipolar disorder is no longer referred to as manic-depressive illness primarily due to changes in our understanding of the condition. The shift from "manic-depressive illness" to "bipolar disorder" also helps reduce stigma.

The older term "manic-depressive" could imply that people with the condition switch between extreme happiness and sadness, which can oversimplify their experiences. "Bipolar disorder" emphasizes that it's a complex condition with a wide range of mood changes and a legitimate mental health concern.

What Causes Bipolar Disorder?

As per Mental Health America, unlike other mental illnesses, males and females can develop bipolar disorder, and the prevalence rates are similar across genders.

Understanding what causes bipolar disorder can be complex, as it's likely a mix of different things working together.

The following are some key factors that might contribute to it:

Bipolar Disorder: Genetics

If someone in your family has bipolar disorder, like a parent or sibling, you might also have a higher chance of developing it. Several genes seem to be involved, but scientists are still figuring out the details.

Bipolar Disorder: Brain Chemistry

Bipolar disorder is linked to changes in certain chemicals in your brain called neurotransmitters. These chemicals, like serotonin and dopamine, affect your mood. When they're not balanced, it can lead to mood swings.

Bipolar Disorder: Brain Structure and Function

Studies of the brain show that in people with bipolar disorder, there are differences in how the brain looks and works. These differences might affect how emotions are regulated and processed.

Bipolar Disorder: Hormonal Changes

Sometimes, major hormonal shifts like those during pregnancy, childbirth, or menopause can influence the start or worsening of bipolar symptoms.

Bipolar Disorder: Stressful Events

High-stress events, trauma, or big life changes can trigger bipolar episodes in people already prone to the disorder. However, not everyone exposed to stress will develop bipolar disorder.

Bipolar Disorder: Medical Conditions

Certain health conditions like thyroid problems, multiple sclerosis, or head injuries can increase the risk of bipolar disorder.

Even if you have some of these risk factors, it doesn't mean you'll definitely get bipolar disorder. And many people with bipolar disorder don't have a family history. Also, how all these factors come together is still not completely clear. 

Types of Bipolar Disorder

There are several types of bipolar disorder, including:

Bipolar I Disorder

This type is marked by at least one major manic episode that lasts for at least a week or requires hospitalization. People with Bipolar I Disorder may also experience depressive episodes, where they feel really down. It includes both intense highs and intense lows.

Bipolar II Disorder

In Bipolar II Disorder, individuals mainly have depressive episodes but experience at least one hypomanic episode. Hypomania is like a milder form of mania, not as extreme. So, it also has high and low moments, but the highs aren't as intense as in Bipolar I.

Cyclothymic Disorder

This type is characterized by ongoing mood swings, but they aren't as extreme as full-blown mania or depression. People with cyclothymic disorder have many symptoms of hypomania and depression. Still, they don't quite meet the criteria for a full manic or depressive episode. 

Suppose someone experiences mood elevations that don't fit the specific criteria for Bipolar I, Bipolar II, or Cyclothymic Disorder but still have noticeable and clinically significant mood changes. In that case, they might be diagnosed with "Other Specified Bipolar Disorder" or "Unspecified Bipolar Disorder."

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Bipolar Episodes: The Main Symptom of Bipolar Disorder

Bipolar disorder is known for its extreme mood swings. 

Bipolar Disorder: What is a Manic Episode?

Manic episodes are when a person feels super high and energetic. They might be overly happy, confident, and creative. They may not need much sleep and can act recklessly, like spending lots of money or participating in risky activities. Their thoughts may race, making it hard to focus, and they may talk fast about different topics.

During a manic episode, someone feels like they're on top of the world and might not realize the consequences of their actions.

Mania and hypomania represent the high and energetic end of the mood spectrum. They have similarities but important differences in how they affect your life.


Mania is the more severe of the two. During a manic episode, a person feels incredibly high and energetic. They might think they have superpowers and can do anything. This over-the-top mood can make them do risky things like spending too much money, using drugs, or having reckless sex. Their thoughts race so fast that they can't focus and talk fast.

Manic episodes usually last at least a week and often require hospitalization because they seriously disrupt a person's life.


Hypomania is a milder version of mania. A person has similar symptoms during a hypomanic episode, like feeling more energetic, creative, and confident, but it's not as intense. They might actually see it as a productive and positive time. Unlike full-blown mania, hypomania usually doesn't require hospitalization and doesn't cause significant problems in daily life.

However, it can still lead to issues in relationships or decision-making.

Both mania and hypomania are essential features of bipolar disorder, typically followed by depressive episodes. 

Bipolar Disorder: What is a Depressive Disorder?

Depressive episodes are periods of intense sadness and low energy. People going through a depressive episode might struggle to sleep or sleep too much, change their eating habits, and feel guilty, hopeless, and worthless. It's hard for them to concentrate or make decisions; sometimes, they even think about death or suicide.

Depressive episodes can make daily life really tough, affecting work and relationships.

What Makes Bipolar Disorder Unique?

What's unique about bipolar disorder is that it involves going back and forth between these manic and depressive states. Some folks may have more manic episodes, while others have more depressive ones. Some even experience mixed episodes, feeling both high and low simultaneously or switching between them quickly. 

Symptoms of Bipolar Disorder

The signs and symptoms of bipolar disorder can vary in severity and presentation, making it challenging to diagnose. Even further complicating the issue, some reports say that it takes about 10 years from the initial experience of symptoms to receiving a formal diagnosis of bipolar disorder.

Do not self-diagnose or diagnose others based on the following factors. Always make a point to visit your doctor if you feel like you may have bipolar disorder or any other mental illness. 

Manic Episodes

  • Super happy and energetic

  • Restlessness

  • Insomnia

  • Rapid speech

  • Risky behavior

  • Poor judgment

Hypomanic Episodes

Hypomanic episodes are like light versions of mania. They have some of the same signs but are not as extreme. Sometimes, you may not even realize that you are in a hypomanic state. It can feel like a time when you are extra productive and energetic.

Depressive Episodes

  • A persistent feeling of sadness, hopelessness, or emptiness

  • Loss of interest

  • Insomnia or excessive sleeping

  • Changes in appetite

  • Fatigue

  • Negative thoughts

  • Trouble focusing 

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Mixed Episodes

Mixed episodes are times when you may feel both really high, like in mania, and really low, like in depression, at the same time. It's like a jumble of emotions all at once. You can feel agitated, sad, and impulsive all together. This can be tough to deal with because it's like having two very different feelings fighting inside you simultaneously, which can be very distressing.

Can Bipolar Disorder Be Prevented?

Bipolar disorder cannot be completely prevented because it arises from a complex interplay of genetic, environmental, and neurobiological factors. However, proactive steps can be taken to manage the condition effectively.

Early Diagnosis is Key

The sooner you get diagnosed and treated, the better. Medications and talking to a therapist can help keep your mood stable. Moreover, lifestyle choices such as stress management, maintaining a balanced routine with regular exercise, healthy eating, and adequate sleep, as well as avoiding alcohol and other drugs, can play a role in minimizing the severity and frequency of mood episodes.

The Value of a Support Network

Building a strong support network of friends and family who can recognize early signs of mood changes and offer emotional support is also helpful. While you can't stop bipolar disorder from happening, these steps can make a big difference in living with it.

Co-occurring Conditions 

It's possible for people with bipolar disorder to also have other health issues at the same time. Common co-occurring conditions include anxiety disorders, substance use disorders, and attention-deficit hyperactivity disorder (ADHD).

These additional mental health challenges can complicate diagnosing and treating bipolar disorder. So, doctors and healthcare providers must consider all these aspects to provide the best care for individuals with bipolar disorder. This way, they can get help with everything they're going through.

Is There a Relation Between Bipolar Disorder and Substance Abuse?

If you have bipolar disorder, you may be at a higher risk of developing substance use disorders (SUDs) than the general population. This combo is called a dual diagnosis.

Several factors contribute to this intricate relationship:

Bipolar Disorder: Self-Medication

Some individuals with bipolar disorder use alcohol or drugs to feel better. For instance, they might drink or use drugs when feeling sad or happy.

Bipolar Disorder: Impulsive Behaviors

When they are in a manic phase, people with bipolar disorder can act impulsively. This means they might do things without considering the consequences, like using drugs.

Bipolar Disorder: Genetic Causes

Bipolar disorder and substance problems share some things in common, like having certain genes or changes in the brain's workings. These shared factors can make people more likely to have both conditions.

Bipolar Disorder and Substance Abuse

Sometimes, using drugs or alcohol can make the bipolar disorder symptoms worse, leading to more frequent and severe mood swings. On the flip side, the ups and downs of bipolar disorder can make someone want to use drugs or alcohol to cope.

It can be tricky to tell the difference between the symptoms of bipolar disorder and those caused by drugs or alcohol. This can lead to mistakes in diagnosing and treating these problems.

Having both bipolar disorder and substance abuse problems can make it harder to treat both. It can also affect how well medications for bipolar disorder work. The most effective way to help someone with both bipolar disorder and substance issues is to provide treatment for both at the same time. This includes using medicines, therapy, and programs that address substance problems.

Support from mental health professionals, family, and friends is significant for recovery.

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Bipolar Disorder Diagnosis and Treatment

To figure out if someone has bipolar disorder, a mental health expert does a thorough assessment. They look at the person's medical history, symptoms, and if anyone in their family has the same condition. They might also use interviews and special tests to ensure the diagnosis is correct. Getting the diagnosis right is essential for planning the best treatment.

Treating bipolar disorder involves several things:

  • Mood stabilizers, like lithium or anticonvulsants, are often prescribed to keep mood swings in check. 

  • Sometimes, doctors might also suggest antidepressants to deal with depressive episodes.

  • Cognitive-behavioral therapy (CBT), or interpersonal therapy, can help people learn how to cope better and understand their condition. 

  • Sticking to a regular schedule, managing stress, and staying away from drugs and alcohol are also a big part of treatment. 

  • It's essential to have a team of mental health experts, including therapists and psychiatrists, for ongoing support and management.

Struggling With Bipolar Disorder? You’re Not Alone. The Forge Recovery Center Will Help

Bipolar disorder can be dangerous if left untreated.

This is a problem because too often treatable mental disorders like bipolar disorder go untreated. This traps people in a dangerous cycle of suffering that can end with homelessness, isolation, drug addiction, and even death. Bipolar disorder is treatable and manageable with the right help, giving people a chance at a happy, fulfilling, and successful life.

If you or a loved one are dealing with bipolar disorder, don’t deny yourself this future. The Forge Recovery Center provides effective, evidence-based care for bipolar disorder, dual diagnosis, and more. We offer various services, including crisis intervention, ongoing therapy, family support, and education on managing bipolar disorder.

Guided by a trauma-informed philosophy, we also provide a safe and nurturing environment where you can learn effective coping strategies, gain insights into your condition, and develop the skills necessary to manage mood swings that come with bipolar disorder. The Forge can also help you seek assistance for any co-occurring illness, including drug addiction. 

If you’d like to learn more about our dedicated mental health treatment programs, our evidence-based care for bipolar disorder, and our dedicated mental health housing options, please reach out to The Forge Recovery Center today.

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