Bipolar Disorder

Bipolar disorder is a mood disorder characterized by extreme moods. These moods include both deep depression and feelings of euphoria that are often known as mania.

Sometimes a person with bipolar disorder will experience quick changes from one extreme to the other. Different kinds of bipolar disorder involve different levels of mania, but all bipolar disorders involve periods of clinical depression. Bipolar disorder can also involve extreme changes in a person’s energy level or thought processes.

Feelings of great happiness and sadness are a normal part of life, and it’s also normal to experience mood swings sometimes. However, if your mood changes are frequent and extreme enough to interfere with your day-to-day life on a regular basis, you may be dealing with a form of bipolar disorder.


Prevalence of bipolar disorder

Bipolar disorder is relatively common in the United States.

  • About 2.8% of Americans experience bipolar disorder
  • Among that population, almost 83% has severe symptoms [1]
  • Symptoms commonly set in around the age of 25 (but can start earlier)
  • Bipolar disorder is about equally common for men and women

Symptoms of bipolar disorder

Bipolar disorder can involve a broad range of symptoms, and not everyone experiences every symptom. Some of the most common ones include:

  • Episodes of depression: All people diagnosed with bipolar disorder have experienced episodes of clinical major depression.
  • Episodes of mania: Mania can include variety of symptoms including feeling incredibly happy and excited; feeling so full of energy that you might not need to sleep or eat; impulsive and/or dangerous behavior; and being unable to rest. People with Bipolar II Disorder (see below) experience a milder form of these symptoms known as hypomania.
  • Frequent or extreme mood changes: You might find that your mood changes very quickly or from one extreme to the other.
  • Frequent or extreme changes in energy level: You might go from feeling exhausted and listless to full of energy, or vice versa.
  • Frequent or extreme changes in thought processes: People experiencing mania often feel their thoughts racing, while people experiencing depression may find it hard to think at all.
  • Hallucinations or delusions: Extreme mania can include seeing or hearing things that aren’t actually there (hallucinations) or believing things that aren’t true (delusions).

Types of bipolar disorder

There are two different specific disorders classified as bipolar disorders:

  • Bipolar I Disorder: In Bipolar I Disorder, a person cycles between episodes of major depression and full-blown mania. This mania  is very extreme and may include hallucinations and/or delusions.
  • Bipolar II Disorder: In Bipolar II Disorder, a person still experiences episodes of major depression, but these episodes alternate with a milder state called hypomania. Hypomania is not as extreme as mania but includes less severe versions of many of the same symptoms. For example, a person experiencing hypomania might need less rest, while a person experiencing mania might not need to sleep at all.

In both cases, some people switch between the different extremes more quickly than others.

Additionally, there is a condition called Cyclothymic Disorder that is not technically bipolar disorder but that shares some of its features. In Cyclothymic Disorder, a person experiences frequent and drastic mood changes, but the moods are not extreme enough to qualify as major depression or full-blown mania.

Treatments for bipolar disorder

There are a number of options that may be helpful if you think you have bipolar disorder:

  • Therapy. Therapy can be a very helpful way to gain insight into your condition and work on evidence-based strategies to reduce your symptoms. (See tips on finding a therapist below.)
  • Medication: Medication is a very common treatment option for bipolar disorder. Though most medications come with side effects, a psychiatric professional can help you manage these side effects and find the most effective treatment.
  • Check-ups: Symptoms of bipolar disorder can sometimes be related to underlying medical conditions. It’s important to stay up-to-date with visits to your primary care physician to rule out related medical conditions.
  • Keeping a journal: Keeping track of changes in your mood, thoughts, and behavior can be a great way to gain more insight into your condition. Knowing exactly how and when these changes occur can help you and your treatment team better treat your symptoms. Writing in a journal can also help you process your emotions and reduce anxiety.
  • Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Substance Abuse and Mental Health Services Administration hotline at 1-800-622-4357 can also help you locate resources and treatment options.

What to look for in a therapist for bipolar disorder treatment

Look for a therapist who has a specialty in treating bipolar disorder

Several different kinds of therapy have been shown to be effective for treating bipolar disorder [1]. Most often, psychotherapy is used in combination with medication managed by a psychiatrist.

A few of the most common psychotherapy options for bipolar disorder are:

Prioritize personal fit

While personality fit is a nuanced factor, it is critical to your success in therapy. Multiple studies have revealed the importance of this factor, often referred to as “therapeutic alliance.”

On your initial phone call with the therapist, ask yourself:

  • Could I see myself forming a connection with this therapist?
  • Does their approach suit my personality?
  • Do I feel like I will be heard and respected by this therapist?

Additionally, consider these factors:

  • Some therapists are more reflective and spend most of the session listening and drawing insights about your patterns and coping styles.
  • Some therapists are more directive, establishing weekly agendas and assigning tasks to complete between sessions.
  • Some utilize specific techniques or tools (exposure exercises, eye movements, tapping, breath work, guided imagery, art and music, etc.).
  • Some use a combination of multiple approaches.

Consider cost, location, and scheduling

Therapy will only work if it works for you. Before making an appointment, ask yourself honestly:

  • Can I afford these session fees? The cost of therapy for bipolar disorder depends on location, practitioner, and whether you’re using insurance.
  • Can I commit to attending sessions regularly? Remember to account for travel time, and other demands in your schedule.
  • Do the therapists’ available times work for me? Some therapists offer evening and weekend appointments if you have an otherwise limited schedule.