Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes extreme changes in mood, energy, and activity levels. Currently, 2.6% of the adult population in the U.S. suffers from bipolar disorder, with 82.9% of these cases being categorized as “severe.” Bipolar disorder can impact the ability to carry out day-to-day tasks, maintain relationships, and even increase the risk of suicide if it’s not treated or treated incorrectly.

There are four basic types of bipolar disorder involving apparent changes in mood, energy, and activity levels ranging from manic episodes to depressive episodes. During manic episodes, patients feel elated, experiencing periods of “up” and energized behavior. The depressive episodes are the opposite where patients are very sad and feel hopeless during periods of “down.”

According to the National Institute of Mental Health, the four types of bipolar disorder are:

Bipolar I Disorder: Defined by manic episodes lasting at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least two weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.

Bipolar II Disorder: Defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.

Cyclothymic Disorder (also called cyclothymia): Defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Other Specified and Unspecified Bipolar and Related Disorders: Defined by bipolar disorder symptoms that do not match the three categories listed above.

What are symptoms of

Bipolar disorder symptoms vary depending on the episode the patient is experiencing at the time.

Manic episodes make the patient feel abnormally and persistently happy, angry, hyperactive, impulsive, and irrational at different times. Manic feelings can last at least one week and may be severe enough to require treatment in a hospital. Other symptoms of mania include:

  • Feelings of special powers and superiority
  • Decreased need for sleep, restlessness
  • Talking excessively
  • Increased activity
  • Racing thoughts
  • Short attention span
  • Inappropriate laughing or joking, or getting into lots of arguments
  • Inappropriate spending sprees or sexual activity

On the flip side, those with bipolar disorder also experience depressive episodes, during which they feel very sad and have trouble doing ordinary things like bathing, getting dressed, and cooking. Other symptoms of depression include:

  • Weight loss or gain (due to changes in how much you eat)
  • Difficulty falling or staying asleep, or sleeping too much
  • Feeling irritated easily
  • Fatigue, loss of energy, sluggishness
  • Feelings of worthlessness or guilt
  • Difficulty concentrating and making decisions
  • Recurring thoughts of death or suicide

Individuals with bipolar disorder can also experience hypomania, which is less severe than mania but causes an abnormal change in mood. As opposed to manic episodes, hypomania may not seriously affect daily activities and some people actually function better during a hypomanic episode. Hypomania should be treated with medicine to avoid leading to a manic or depressive episode.


Bipolar disorder doesn’t have a single cause but some factors that interact, ranging from biological to environmental factors. Studies have shown that there may also be a genetic factor, making it more likely to emerge in a person who has a relative with bipolar disorder.

Neurotransmitter imbalances appear to play a critical role in bipolar disorder and many mood disorders. Additionally, hormonal imbalances may also cause bipolar disorder. Environmental factors such as abuse, mental stress, or traumatic events such as a significant loss may also contribute to bipolar disorder.


Diagnosing bipolar disorder can be difficult due to its overlapping symptoms with other psychiatric disorders. Individuals with bipolar disorder are more likely to seek help when they’re depressed than when they’re experiencing mania. Health care providers must do a careful examination of the patient’s medical history to avoid misdiagnosing bipolar disorder like major depression.

The criteria for diagnosing bipolar disorder is set out in the DSM-5 as the following:
The person must meet certain criteria for mania and depression, including an elevated or irritable mood and “persistently increased activity or energy levels.” These must have lasted at least 7 days, or less if symptoms were severe enough to need hospitalization.

The doctor can also complete a physical exam to rule out other conditions. When it comes to behavioral symptoms, the patient’s family members, colleagues, and friends can help by relating experiences of the patient’s behavior.

Other conditions that may occur with bipolar disorder are:

  • use of drugs or alcohol to cope with symptoms
  • post-traumatic stress disorder (PTSD)
  • anxiety disorder attention-deficit
  • hyperactivity disorder (ADHD)


While there’s no cure for this lifetime disease, treatment for bipolar disorder aims to minimize the frequency of the manic and depressive episodes. With the right treatment, even patients suffering from the most severe forms of bipolar disorder can gain better control of their mood swings. Long-term, continuous treatment of bipolar disorder can include a combination of medication and psychotherapy.

Different types of medications can help control symptoms of bipolar disorder. An individual may need to try several different medications before finding ones that work best. Medications used to treat bipolar disorder include mood stabilizers, atypical antipsychotics, and antidepressants.

When done in combination with medication, psychotherapy, or “talk therapy,” can provide support, education, and guidance to people with bipolar disorder and their families.

Electroconvulsive Therapy (ECT) can also provide relief for people with severe bipolar disorder who have not been able to recover with other treatments. If the patient has other conditions, such as pregnancy, that make taking medications too risky, ECT can be used for bipolar symptoms. Individuals diagnosed with bipolar disorder should discuss possible benefits and risks of ECT with a qualified health professional.