Bipolar I Symptoms: Types & Treatments Overview

Bipolar disorder is a mental health condition that causes extreme mood swings between emotional highs (mania or hypomania) and lows (depression). These mood changes go far beyond normal ups and downs and can significantly impact your daily life, relationships, and ability to function.

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Table of Contents | Jump Ahead

What Is Bipolar Disorder?
Types of Bipolar Disorder
Symptoms
Causes and Risk Factors
Diagnosis
Treatment
Living with Bipolar Disorder
Complications
Bipolar Disorder and Other Conditions
Prognosis and Recovery
Prevention
Getting Help
Bipolar Disorder in Different Populations
Related Terms
References

What Is Bipolar Disorder?

Bipolar disorder affects how you feel, think, and behave. During manic episodes, you might feel unusually energetic, euphoric, or irritable. During depressive episodes, you might feel sad, hopeless, or lose interest in activities you normally enjoy.

These mood episodes are distinct periods that last for days, weeks, or even months. Between episodes, you might feel completely normal, or you might have lingering symptoms. The condition is chronic, meaning it's long-lasting, but it's highly treatable with proper care.

Bipolar disorder affects your brain's ability to regulate mood and energy levels. It's not something you can control through willpower alone, and it's not caused by personal weakness or character flaws. It's a real medical condition that requires professional treatment.

Types of Bipolar Disorder

Bipolar I Disorder

Manic episodes - At least one full manic episode lasting seven days or requiring hospitalisation
Depressive episodes - Usually occur but aren't required for diagnosis
Most severe form - Manic episodes can be very disruptive and dangerous
Affects men and women equally - Usually begins in late teens or early twenties

Bipolar II Disorder

Hypomanic episodes - Less severe than full mania, lasting at least four days
Major depressive episodes - At least one major depressive episode
No full manic episodes - If a full manic episode occurs, the diagnosis changes to Bipolar I
More common in women - Often misdiagnosed as depression initially

Cyclothymic Disorder

Milder mood swings - Hypomanic and depressive symptoms that don't meet full criteria
Chronic pattern - Symptoms present for at least two years (one year in children)
Fewer symptom-free periods - Less than two months without symptoms
May progress - Can develop into Bipolar I or II disorder

Other Specified and Unspecified Bipolar Disorders

Doesn't fit typical patterns - Symptoms don't match the three main types exactly
Still significant - Causes distress and problems in daily life
Requires treatment - Even if symptoms don't fit standard categories

Symptoms

Manic Episodes

During a manic episode, you might experience:

Elevated mood - Feeling unusually happy, euphoric, or "high"
Increased energy - Feeling restless, energetic, or "wired"
Decreased need for sleep - Sleeping only 2-3 hours but feeling rested
Grandiosity - Unrealistic beliefs about your abilities or importance
Racing thoughts - Thoughts jumping quickly from one idea to another
Distractibility - Trouble focusing or paying attention
Increased activity - Taking on multiple projects or activities
Poor judgment - Making risky decisions about money, sex, or other areas
Rapid speech - Talking very fast, loudly, or more than usual
Irritability - Getting angry or annoyed easily

Hypomanic Episodes

Hypomania includes similar symptoms to mania but:

Less severe - Symptoms are noticeable but don't severely impair functioning
Shorter duration - Lasts at least four days instead of seven
No hospitalisation - Doesn't require hospital treatment
No psychotic features - No hallucinations or delusions
Functional - You can still work and maintain relationships

Depressive Episodes

During a depressive episode, you might experience:

Persistent sadness - Feeling down, empty, or hopeless most of the day
Loss of interest - No longer enjoying activities you used to like
Fatigue - Feeling tired or lacking energy
Sleep problems - Sleeping too much or having trouble sleeping
Appetite changes - Eating much more or less than usual
Concentration problems - Trouble thinking, remembering, or making decisions
Feelings of worthlessness - Excessive guilt or feelings of being worthless
Physical symptoms - Aches, pains, or digestive problems
Suicidal thoughts - Thoughts of death or suicide

Mixed Episodes

Some people experience symptoms of both mania and depression at the same time:

Agitated depression - Feeling depressed but also restless and energetic
Dysphoric mania - Feeling manic but also sad or irritable
High risk period - Increased risk of suicide during mixed episodes
Difficult to treat - May require specialised treatment approaches

Causes and Risk Factors

Biological Factors

Genetics - Having a parent or sibling with bipolar disorder increases your risk
Brain structure - Differences in brain structure and function
Neurotransmitters - Imbalances in brain chemicals like serotonin, dopamine, and norepinephrine
Hormones - Thyroid problems or other hormonal imbalances

Environmental Triggers

Stressful life events - Major losses, relationship problems, or financial stress
Sleep disruption - Changes in sleep patterns can trigger episodes
Substance use - Alcohol or drug use can trigger or worsen episodes
Seasonal changes - Some people are sensitive to changes in daylight
Medication changes - Starting or stopping certain medications

Risk Factors

Family history - Having relatives with bipolar disorder or other mental health conditions
Age - Usually begins in late teens or early twenties
Stress - High levels of stress or traumatic experiences
Substance use - Using alcohol or drugs, especially during adolescence
Medical conditions - Thyroid disease, multiple sclerosis, or other conditions

Diagnosis

Bipolar disorder is diagnosed by mental health professionals using specific criteria. There's no blood test or brain scan that can diagnose bipolar disorder.

Diagnostic Process

Clinical interview - Detailed discussion of your symptoms and history
Mood tracking - Keeping a record of your moods over time
Medical evaluation - Ruling out other medical conditions
Family history - Information about mental health in your family
Psychological testing - Standardised questionnaires or assessments

Diagnostic Criteria

For Bipolar I Disorder:

At least one manic episode lasting seven days or requiring hospitalisation
Manic episode includes elevated mood plus three other symptoms (four if mood is only irritable)
Symptoms cause significant impairment in functioning

For Bipolar II Disorder:

At least one hypomanic episode and one major depressive episode
No history of full manic episodes
Symptoms cause significant distress or impairment

Challenges in Diagnosis

Misdiagnosis - Often initially diagnosed as depression
Delayed diagnosis - Average of 5-10 years from first symptoms to correct diagnosis
Symptom overlap - Symptoms can look like other mental health conditions
Substance use - Drug or alcohol use can mask or complicate symptoms

Treatment

Bipolar disorder is a lifelong condition, but it's highly treatable. Most people with bipolar disorder can live full, productive lives with proper treatment.

Medications

Mood Stabilisers

Lithium - The gold standard mood stabiliser, prevents both manic and depressive episodes
Anticonvulsants - Valproate (Depakote), lamotrigine (Lamictal), carbamazepine (Tegretol)
Atypical antipsychotics - Olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify)

Antidepressants

Used carefully - Can trigger mania if used alone
Usually combined - With mood stabilisers to prevent mood switching
SSRIs and SNRIs - Most commonly prescribed types

Other Medications

Anti-anxiety medications - For short-term relief of anxiety symptoms
Sleep medications - To help with sleep problems during episodes
Antipsychotics - For severe manic episodes with psychotic features

Psychotherapy

Cognitive Behavioural Therapy (CBT) - Helps identify and change negative thought patterns
Interpersonal and Social Rhythm Therapy (IPSRT) - Focuses on maintaining regular daily routines
Family-Focused Therapy - Involves family members in treatment
Dialectical Behaviour Therapy (DBT) - Teaches skills for managing emotions and relationships
Group therapy - Connecting with others who have similar experiences

Lifestyle Management

Regular sleep schedule - Going to bed and waking up at the same time
Mood tracking - Keeping a daily record of moods, sleep, and activities
Stress management - Learning healthy ways to cope with stress
Regular exercise - Physical activity can help stabilise mood
Avoiding triggers - Identifying and avoiding things that trigger episodes

Living with Bipolar Disorder

Daily Management

Take medications consistently - Even when feeling well
Maintain routines - Regular sleep, meals, and activities
Monitor symptoms - Watch for early warning signs of episodes
Stay connected - Maintain relationships with supportive people
Manage stress - Use healthy coping strategies

Recognising Warning Signs

Early signs of mania might include:

Sleeping less than usual
Feeling unusually energetic or optimistic
Talking more or faster than usual
Making impulsive decisions
Feeling irritable or agitated

Early signs of depression might include:

Sleeping more than usual
Feeling sad or hopeless
Losing interest in activities
Having trouble concentrating
Feeling tired or sluggish

Building Support

Treatment team - Psychiatrist, therapist, and other healthcare providers
Family and friends - People who understand your condition and can offer support
Support groups - Connecting with others who have bipolar disorder
Peer support - Learning from others who have successfully managed the condition

Complications

If Left Untreated

Worsening episodes - Episodes may become more frequent and severe
Relationship problems - Strain on marriages, friendships, and family relationships
Work or school problems - Difficulty maintaining employment or academic performance
Financial problems - Impulsive spending during manic episodes
Legal problems - Risky behaviour during manic episodes
Substance abuse - Using alcohol or drugs to cope with symptoms
Suicide risk - Higher risk of suicide attempts, especially during mixed or depressive episodes

Medical Complications

Cardiovascular disease - Higher risk of heart problems
Diabetes - Some medications can increase diabetes risk
Thyroid problems - Lithium can affect thyroid function
Weight gain - Some medications can cause significant weight gain
Kidney problems - Long-term lithium use requires monitoring

Bipolar Disorder and Other Conditions

Common Co-occurring Conditions

Anxiety disorders - Panic disorder, social anxiety, or generalised anxiety
Substance use disorders - Alcohol or drug abuse
ADHD - Attention-deficit/hyperactivity disorder
Eating disorders - Bulimia or binge eating disorder
Personality disorders - Borderline personality disorder

Treatment Considerations

Integrated treatment - Addressing all conditions simultaneously
Medication interactions - Careful monitoring when treating multiple conditions
Specialised care - May need providers experienced with complex cases

Prognosis and Recovery

What to Expect

Chronic condition - Requires lifelong management
Treatable - Most people can achieve mood stability with proper treatment
Variable course - Some people have frequent episodes, others have long periods of stability
Individual differences - Response to treatment varies from person to person

Factors That Improve Outcomes

Early treatment - Getting help soon after symptoms begin
Medication adherence - Taking medications consistently as prescribed
Therapy participation - Actively engaging in psychotherapy
Lifestyle management - Maintaining healthy habits and routines
Strong support system - Having family and friends who understand and support recovery
Stress management - Learning effective ways to cope with stress

Long-term Outlook

With proper treatment, many people with bipolar disorder:

Experience fewer and less severe episodes
Maintain stable relationships and employment
Live independently and pursue their goals
Develop effective coping strategies
Find meaning and purpose in life

Prevention

Preventing Episodes

While you can't prevent bipolar disorder, you can reduce the risk of episodes:

Take medications consistently - Don't stop taking medications when feeling better
Maintain regular routines - Consistent sleep, meals, and activities
Manage stress - Use healthy coping strategies
Avoid triggers - Stay away from things that trigger episodes
Monitor symptoms - Watch for early warning signs
Stay connected - Maintain relationships with supportive people

Preventing Complications

Regular medical care - Monitor for medication side effects and other health problems
Avoid substance use - Don't use alcohol or drugs to cope
Financial planning - Set up safeguards to prevent impulsive spending
Safety planning - Have a plan for managing suicidal thoughts

Getting Help

When to Seek Help

First episode - Any symptoms of mania, hypomania, or severe depression
Worsening symptoms - Episodes becoming more frequent or severe
Suicidal thoughts - Any thoughts of hurting yourself
Substance use - Using alcohol or drugs to cope
Relationship or work problems - Symptoms interfering with daily life

Types of Providers

Psychiatrists - Medical doctors who can prescribe medications
Psychologists - Provide therapy and psychological testing
Licensed clinical social workers - Provide therapy and case management
Psychiatric nurse practitioners - Can prescribe medications and provide therapy

Crisis Resources

National Suicide Prevention Lifeline: 988 (US)
Crisis Text Line: Text HOME to 741741 (US)
Emergency services: 911 (US)
Local crisis centres - Many communities have 24-hour crisis services
Find a helpline, suicide hotline, or crisis line in your country: https://www.therapyroute.com/article/helplines-suicide-hotlines-and-crisis-lines-from-around-the-world
Find an emergency ambulance number in your country: https://www.therapyroute.com/article/ambulance-emergency-numbers-worldwide-list-by-therapyroute

Bipolar Disorder in Different Populations

Children and Adolescents

Early onset - Can begin in childhood or adolescence
Different presentation - May look different than adult bipolar disorder
Rapid cycling - Children may have more frequent mood changes
Family involvement - Parents and family are crucial in treatment

Women

Hormonal influences - Menstrual cycle, pregnancy, and menopause can affect symptoms
Pregnancy considerations - Some medications may not be safe during pregnancy
Postpartum episodes - Higher risk of episodes after childbirth
More depression - Women with bipolar disorder tend to have more depressive episodes

Older Adults

Late-onset - Can develop later in life
Medical complications - More likely to have other medical conditions
Medication considerations - May be more sensitive to side effects
Cognitive changes - May be confused with dementia

Related Terms

Mania - Elevated mood episodes in bipolar disorder
Hypomania - Less severe manic episodes
Depression - Low mood episodes in bipolar disorder
Mood stabilisers - Medications used to treat bipolar disorder
Cyclothymia - Milder form of bipolar disorder

References

Cleveland Clinic. (2024). Bipolar Disorder (Manic Depression): Symptoms & Treatment. https://my.clevelandclinic.org/health/diseases/9294-bipolar-disorder

Mayo Clinic. (2024). Bipolar disorder - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

Cleveland Clinic Journal of Medicine. (2018). Diagnosing and treating bipolar disorder in primary care. https://www.ccjm.org/content/85/8/601

Cleveland Clinic. (2024). Mood Disorders: What They Are, Symptoms & Treatment. https://my.clevelandclinic.org/health/diseases/17843-mood-disorders

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions about mental health concerns.