You peek out between the blinds. You watch the light dance between sunlight and shadow. You soak up as much of the glow as possible. This is familiar — and fleeting. 

The stubborn lift cord to open the slats won’t budge. Yanking it doesn’t help. The wand refuses to twist open like it did the last time. There’s so much magic in this mood. 

A cord dangles. This worked last time. Will the rip cord save you from plummeting? Why is controlling the amount of light and privacy so impossible?  This is the world of bipolar disorder.

bipolar disorder

What is Bipolar Disorder?

Bipolar disorder, also known as manic depression, is a chronic mental illness. The mood disorder affects  5.7 million adults in the country. Cycling between manic highs to depressive lows, it varies in severity. These shifts in mood, energy, and activity levels can be debilitating.

Signs of bipolar usually show up before you turn 20. It rarely develops later in life. Bipolar is tricky to diagnose because it shares traits with other mental disorders.

Receiving a diagnosis of bipolar disorder can feel life-changing, but it doesn’t have to be.

Bipolar Disorder Stats in the U.S.

  • An equal number of men and women have bipolar illness. The disorder can affect all ages, races, ethnic groups, and social classes.
  • A history of addiction combined with either type of bipolar has a comorbidity risk of 60%.
  • The rates of lifetime substance abuse were high for both alcohol (48.5%) and drugs (43.9%). 
  • More than two-thirds of people with bipolar disorder have at least one close relative with the illness or with unipolar major depression, showing that the disease has a heritable component.
  • 35% of bipolar people are also obese.
  • Statistics show that 5% to 15% of bipolar patients with other mood conditions will develop rapid cycling.
  • Bipolar disorder results in 9.2 years reduction in expected life span, and as many as one in five patients with bipolar disorder completes suicide. 
  • Though only half of diagnosed patients get treated for bipolar disorder within the same year, the National Institute of Mental Health (NIMH) found that 70% to 85% of patients on the appropriate medication successfully recover. 

Subtypes of Bipolar Disorder 

Bipolar disorders aren’t fully understood yet but we do know they take many forms.

There are three main subtypes and one ‘other’ variety.  

All three types cause noticeable shifts in mood, energy, and activity levels. 

These mood changes can vary from highly energetic, excited, irritable behavior (called manic episodes) to extremely low, sad, indifferent, or hopeless periods (called depressive episodes). 

There are also less severe manic periods called hypomanic episodes.

Bipolar I disorder is at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).

Bipolar II disorder is at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.

Cyclothymic disorder is having at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).

Mixed episodes/unspecified/other types include bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing’s disease, multiple sclerosis, or stroke.

Mass General Brigham Answers: Bipolar Disorder

Symptoms and Signs of a Bipolar Disorder

Bipolar disorder has many different symptoms that disrupt the ordinary patterns of a person’s life. 

Some people may feel only a few symptoms, while others might experience many. 

Mania and hypomania are two types of episodes with similar symptoms. 

Mania is more severe and causes noticeable problems at work, school, and social activities. It can even lead to a break from reality, requiring hospital care.

Signs and symptoms of a manic episode include:

  • Excessive happiness, hopefulness, and excitement.
  • Sudden and severe changes in mood, such as going from being joyful to being angry and hostile.
  • Restlessness.
  • Rapid speech and racing thoughts.
  • Increased energy and less need for sleep.
  • Increased impulsivity and poor judgment, such as suddenly quitting your job.
  • Making grand and unattainable plans.
  • Reckless and risk-taking behavior, such as drug and alcohol misuse and having unsafe or unprotected sex.
  • Feeling like you’re unusually important, talented, or powerful.
  • Psychosis — experiencing hallucinations and delusions (in the most severe manic episodes).

Most of the time, people experiencing a manic episode are unaware of the negative consequences of their actions.

Signs and symptoms of hypomania:

Some people with bipolar disorder have milder manic-like symptoms.  We call this hypomania. With hypomania, you may feel very good and find that you can get a lot done. People with hypomania can often function well in social situations or at work.

Hypomania is when a person has:

  • Having at least 3 of the symptoms listed above for mania that lasts at least 4 days, and
  • A change in their ability to function that is not typical of that person when they aren’t showing symptoms,
  • Changes in mood and ability to function that are noticeable by others,
  • Symptoms that are not severe enough to cause serious impairment in social or work/school functioning, or to necessitate hospitalization, and
  • No psychotic features.  

In summary, hypomania is a less severe and more brief form of mania. After hypomania, you might experience severe depression. The low side of bipolar. 

Signs and symptoms of a  major depressive episode are:

  • Persistent sad, anxious, or empty mood.
  • Changes in sleep such as getting too much or too little, or waking in the middle of the night or unusually early in the morning.
  • Reduced appetite and weight loss, or increased appetite accompanied by weight gain.
  • Irritability or restlessness.
  • Difficulty concentrating, remembering, or making decisions. These may often impact a person’s ability to fulfill work, school, or other life obligations.
  • Fatigue or loss of energy.
  • Persistent physical symptoms that don’t respond to treatment, such as chronic pain or digestive issues (like upset stomach or diarrhea).
  • Feeling guilty, hopeless, or worthless.
  • Thoughts of death or suicide, including suicide attempts.

If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. 

Call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. Or use the Lifeline Chat. These services are free and confidential.

Signs and Symptoms of a Mixed Episode:

Mixed episodes in bipolar disorder involve experiencing symptoms of both mania and depression simultaneously. 

These episodes bring about a combination of negative emotions and thoughts associated with depression, along with feelings of restlessness, agitation, and high energy. 

Individuals who go through mixed episodes often describe them as the most challenging aspect of bipolar disorder.

Additional aspects of bipolar disorder:

Bipolar I and bipolar II disorders share other characteristics.  These signs can include feelings of anxiety, experiencing hallucinations or delusions, and others. Mixed or rapid cycling is when the timing of these symptoms occur in patterns. Bipolar symptoms can happen during pregnancy or change depending on the season.

Danger and Physical Health Problems

Without proper treatment, those living with bipolar disorder may find themselves facing numerous challenges.

The extreme symptoms that can accompany bipolar disorder can influence numerous other aspects of health, and many for the worse. When left untreated, bipolar disorder can contribute to:

  • High blood pressure
  • ​Heart attack
  • Heart disease
  • Diabetes
  • Arteriosclerosis
  • Increased frequency of migraines, asthma, bronchitis, and chronic fatigue
  • Increased mortality rate of two to three times for conditions concerning the endocrine, cardiovascular, or cerebrovascular systems
  • Elevated risks of suicide

Adults living with serious, untreated mental illnesses die, on average, 25 years earlier. They are also more likely to be hospitalized. 

Untreated, individuals with mood disorders face a high risk of suicide attempts and death by suicide. The depressive episode state is when this occurs most often.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

The Importance of Treatment

Bipolar disorder is a complex disorder, and each person’s experience with it is unique. There’s no one-size-fits-all approach to treatment.

Treatment plans typically involve a combination of therapy, counseling, and medication, although the specifics vary from person to person.

There are different types of therapies available for bipolar disorder that should be taken into consideration for your own treatment plan. A dual-diagnosis treatment center specializes in this. Make sure to do your research so you choose a place that has your interests at heart.

6 tips to manage bipolar disorder


By learning coping skills and understanding how bipolar disorder affects you, you may be able to avoid unnecessary periods of mania and depression.

Common forms of therapy for bipolar disorder include:

Cognitive behavioral therapy (CBT)  is an effective form of talk therapy for bipolar disorder and various other mental health conditions. It focuses on changing unhelpful thinking and behavior patterns to improve overall functioning and quality of life.

Family-focused therapy involves including loved ones such as parents, spouses, and children, in counseling sessions. It helps them understand the condition and teaches communication and symptom management for you and your family.

Interpersonal and social rhythm therapy (IPSRT) works to prevent episodes of mania and depression by using cues from your environment. You may track your social routines, sleep patterns, and triggers that can lead to an episode.

Dialectical behavior therapy (DBT) combines cognitive-behavioral treatment with skills training in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. 

It helps you accept challenges, change thinking patterns, cope with stress, and improve your interactions with others.

Mindfulness-based therapies such as mindfulness-based cognitive therapy (MBCT), promote being present in the moment. They can be beneficial in bipolar disorder by reducing stress, enhancing emotional regulation, and preventing relapses.

Therapy can be provided on a one-on-one basis or in a group setting, either in an office or as part of an inpatient or outpatient treatment program. 

Additionally, Improving lifestyle habits like poor diet or lack of exercise only helps so much.

Each therapy has its own strengths, and the choice of therapy depends on your own preferences, how symptoms, and specific treatment goals.


bipolar medications

Common medications used in treating bipolar disorder are lithium, mood stabilizers., and anti-seizure. 

Other medications used include antipsychotics, benzodiazepines, and beta-blockers. These medications can have mild to serious side effects. It’s important to tell your doctors how you feel.

Outpatient Mental Health Facilities

You don’t have to recover alone. Depending on your needs, you can find valuable treatment at reputable recovery centers. Evidence-based treatments are especially useful.

A partial hospitalization program (PHP) offers structured care during the day while allowing you to return home at night. It provides intensive treatment, including medication management and counseling, tailored specifically for bipolar disorder. 

PHP closely watches symptoms, establishes routines, and builds a supportive community. Research shows that PHP significantly improves symptom management and overall quality of life for individuals with bipolar disorder. 

Intensive outpatient programs (IOPs) provide a flexible treatment option that allows you to maintain your daily routines while still addressing your bipolar. IOP aims to stabilize mood swings, manage symptoms, and improve overall functioning.

Inpatient Mental Health Facilities

Inpatient or residential treatment is an effective approach for treating bipolar disorder.

Residential treatment provides intensive care and a stable environment for bipolar individuals. It offers round-the-clock monitoring by behavioral specialists, medication management, and therapy. You can take a pause to get better without distractions.

Inpatient programs focus on stabilizing mood swings and teaching coping skills.

The supportive community in residential treatment helps individuals manage their condition better and relate to others. 

Lifestyle changes can be an important part of overall recovery. 

This includes: sticking to a regular sleep schedule; reducing consumption of alcohol, caffeine, and similar substances; and exercising regularly. Some may use meditation, mind-body practices, and spirituality as resources as well.

Seek the Help You Deserve

If you need more balance in your mental health, we can help. Bipolar does not dictate the outcome of your life. It may have tested your resilience, but it does not define you. 

Seek help at a specialized center that understands mental health struggles.  Discover what recovery feels like. You have the strength within you to overcome bipolar disorder.