Bipolar Disorder in Adults: Symptoms, Causes, Diagnosis and Treatment
Key takeaways
- Bipolar disorder causes episodes of depression and episodes of unusually high or irritable mood and energy, called mania or hypomania.
- It is often first seen as depression, so a careful history of mood changes is key to an accurate diagnosis.
- Mood stabilizing medication is the foundation of treatment for most people.
- With steady treatment, sleep and routine, many people with bipolar disorder live full, stable lives.
1. Overview
Bipolar disorder is a long-term mood condition marked by episodes of depression and episodes of mania or hypomania. Between episodes, many people feel like their usual selves. It is a medical condition, not a personality trait or a sign of weakness.
There are 3 main types. Bipolar I disorder includes at least 1 manic episode, which can be severe. Bipolar II disorder includes hypomanic episodes, which are milder than mania, along with depressive episodes. Cyclothymic disorder involves frequent mood ups and downs that are less intense but last a long time. Bipolar disorder usually begins in the late teens or early adult years.
2. Symptoms
During mania or hypomania, a person may feel unusually happy, energetic or irritable, need much less sleep without feeling tired, talk fast, have racing thoughts, feel overly confident, take on many projects at once, or make risky decisions with money, driving or relationships. Mania can be severe enough to require hospital care.
During depression, symptoms are the same as in major depression: low mood, loss of interest, low energy, changes in sleep and appetite, and sometimes thoughts of death or suicide. If you are thinking about harming yourself, call or text 988 or go to the nearest emergency room. The articles below explain specific symptoms in more detail.
3. Causes
Bipolar disorder runs strongly in families, and genetics is one of the largest known factors. Differences in how the brain regulates mood, energy and sleep also play a role.
Stress, major life changes, sleep loss and substance use can trigger episodes in people who are already at risk, but they do not cause bipolar disorder on their own. It is not caused by anything a person or their family did wrong.
4. Diagnosis
There is no blood test or scan for bipolar disorder. A diagnosis comes from a clinical evaluation, where a qualified clinician asks about your mood history over many years, including any periods of unusually high energy, little need for sleep or impulsive behavior. Input from a family member or partner who knows you well can be very helpful.
Because many people first seek help during depression, bipolar disorder is sometimes mistaken for depression alone. Getting this right matters, because the treatment is different. A good evaluation also checks for medical causes, substance use and other conditions.
5. Treatment
Bipolar disorder is treatable, and most people need ongoing care rather than short-term treatment. Medication is the foundation for most people, and it is usually continued even when you feel well, because it helps prevent future episodes.
Therapy and education help you recognize early warning signs, manage stress and keep steady routines. A regular sleep schedule is especially important, since sleep loss can trigger mania. We build the plan with you, check in regularly and adjust it over time.
6. Medications
Mood stabilizers, such as lithium, valproate and lamotrigine, and certain second-generation antipsychotic medications are the main medications used for bipolar disorder. Some treat mania, some treat or prevent depression, and some do both. Some of these medications need regular blood tests to check levels and safety.
Antidepressants are usually not used on their own in bipolar disorder, because in some people they can trigger mania or rapid mood changes. Every medication has possible benefits and side effects, and the right choice depends on your symptoms, health history and preferences. We will monitor how you are doing over time.
7. Co-occurring conditions
Many people with bipolar disorder also live with another condition. Anxiety disorders, substance use, ADHD and sleep problems are among the most common. Some physical conditions, such as thyroid problems and metabolic changes, are also important to watch.
Treating every condition that is present leads to more stable mood. We look at the whole picture so your plan addresses everything that is affecting you.
8. Living with Bipolar Disorder
Routine is one of the most powerful tools. Going to bed and waking at the same times, protecting your sleep, limiting alcohol and avoiding drugs, and keeping a simple daily mood log can help you and your clinician spot changes early.
It helps to make a plan with people you trust for what to do if warning signs appear. Many people with bipolar disorder build stable careers, relationships and lives, especially with steady treatment and support.
9. Getting help and starting care with us
If you have had periods of very high energy or irritability with little need for sleep, or depression that keeps coming back, it is worth talking to a professional. At Peak Wellness Psychiatry, our psychiatric nurse practitioners provide bipolar disorder evaluations and ongoing care through secure video visits for adults in California, Arizona, Washington and Nevada. If you are in crisis, call or text 988 or go to the nearest emergency room.
Your first visit is about 60 minutes. We review your history and symptoms, answer your questions and, when it is appropriate, build a treatment plan with you. You can book online in a few minutes or call us at 888-909-8676. We take most major insurance plans.
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