Bipolar Disorder: Definition, Types, Symptoms, Diagnosis and Treatments

Bipolar disorder, also known as manic depression, is a form of major affective disorder, or mood disorder, defined by manic or hypomanic episodes (changes in everyday mood accompanied by high energy states). It is a severe illness because mania often involves insomnia, sometimes for days, hallucinations, psychosis, delusions, or paranoid rage. Also, depressive episodes can be more devastating and difficult to treat in people who have never had mania or hypomania.

It is a complex disorder likely due to genetic and non-genetic factors; the mood episodes associated with this involve clinical depression or mania (extreme euphoria and high energy) with periods of everyday mood and energy between episodes.

The severity of mood episodes can range from very mild to extreme. It can occur gradually or suddenly over days to weeks, when discrete mood episodes occur four or more times a year. Along with manic or depressive episodes, patients may have disturbances in thinking and perceptual distortions, and impaired social functioning.

Types of bipolar disorder

There are four basic types, all involving apparent changes in mood, energy, and activity levels; these moods range from periods of highly excited and euphoric behavior (known as manic episodes) to very sad, depressed, or no periods—of hope (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar I disorder (manic or mixed episode)

Defined by manic episodes that last at least seven days, they are so severe that the person needs immediate hospital care. Usually, depressive episodes also occur, usually lasting at least two weeks.

Depressive episodes with mixed features (having depression and manic symptoms simultaneously) are also possible. Please read more information about bipolar I disorder. (Required article)

Bipolar II disorder (hypomania and depression)

Defined by a pattern of severe and hypomanic depressive episodes, you don’t experience full-blown manic episodes. Complete content on bipolar II disorder. (Required item)

Cyclothymic disorder (hypomania and mild depression)

Also called cyclothymia, defined by numerous periods of hypomanic symptoms and multiple periods of depressive symptoms lasting at least two years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic and depressive episode. Learn more about the cyclothymic disorder. (Required item)

Bipolar Disorder

Other bipolar disorders

These are disorders that do not meet the full diagnostic criteria for the diseases listed above due to the shorter duration or severity of the disease. They may include:

  • Hypomanic short-term episodes (two or three days) and major depressive episodes.
  • Hypomanic episodes with vague symptoms and major depressive episodes.
  • A hypomanic episode without a previous major depressive episode.
  • Short-term cyclothymia (less than two years).

Depression symptoms of bipolar disorder

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors; these are called “mood episodes,” drastically different from moods and behaviors—typical of the person.

The symptoms of clinical depression seen with bipolar disorder are the same as those seen in major depressive disorder and include:

  • Decreased appetite and weight loss or gain.
  • Difficulty concentrating, remembering, and making decisions.
  • Fatigue decreases energy.
  • Feelings of guilt, worthlessness, helplessness.
  • Feelings of hopelessness, pessimism.
  • Insomnia, waking up early in the morning or sleeping too much.
  • Loss of interest or pleasure in hobbies and activities you once enjoyed, including sex.
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
  • Persistent moods, sadness, and anxiety.
  • Restlessness, irritability.
  • Thoughts of death or suicidesuicide attempts.

Symptoms of mania in bipolar disorder

  • Swift and disconnected thoughts.
  • Great beliefs.
  • Euphoria.
  • Inappropriate irritability.
  • Inappropriate social behavior.
  • We have increased sexual desire.
  • More incredible speed or volume of conversation.
  • Lack of criteria.
  • Less need for sleep due to high energy.

Causes of bipolar disorder

Scientists are studying possible causes; most agree that there is no single cause. Instead, many factors are likely to contribute to the disease or increase the risk.

Structure and function of the brain

Some studies show how the brains of people with bipolar disorder may differ from the brains of healthy people or people with other mental illnesses. Learning more about these differences, along with new information from genetic studies, helps scientists better understand this disorder and predict what types of treatment will work most effectively.


Some research suggests that people with specific genes are more likely to develop bipolar disorder than others. Still, genes are not the only risk factor, as twin studies have shown that the other does not constantly develop it even if one twin develops it. Grows, even though they share all the same genes.

Family history

Bipolar disorder tends to run in families; children with a parent or brother who has it are much more likely to develop the disease compared to children who do not have a family history. However, it is essential to note that most people with a family history will not develop the disease.

Diagnosis of bipolar disorder

Bipolar disorder can be difficult to diagnose because of:

  • Its onset is often marked by a depressive period and can be misdiagnosed as depression.
  • Depressive symptoms are common in bipolar disorder, generally more common than hypomanic or manic symptoms.
  • Episodes of “mixed mood” are common; this could obscure the detection of mania and hypomania, as people report more depressive symptoms when seeking treatment.
  • For some people, it may take years before their disease is accurately diagnosed and treated.

Mental health professionals should carefully evaluate previous episodes of mania or hypomania when working with depressed patients. Some patients with treatment-resistant unipolar depression may have been misdiagnosed with bipolar disorder.

To be diagnosed with a manic episode, you must experience symptoms that last for at least a week, or you must be hospitalized; you must experience symptoms almost all day every day during this time; major depressive episodes, on the other hand, must last for as long as possible minus two weeks.

At what age is a bipolar disorder usually diagnosed?

Generally, appears between 15 and 24 years and persists throughout life; newly diagnosed mania is rarely seen in young children or adults over 65 years.

The severity of symptoms varies with bipolar disorder; while some people have some symptoms, others have many that impair their ability to work and live everyday life.

Marked by relapses and remissions, bipolar disorder has a high recurrence rate if left untreated; patients with severe mania generally require hospitalization to avoid risky behaviors, those who are severely depressed may also need hospitalization to prevent them from acting on suicidal thoughts or psychotic symptoms (delusions, hallucinations, disorganized thinking).

About 90% of people with bipolar I disorder, the most severe form, have at least one psychiatric hospitalization; two out of three will have two or more hospitalizations in their lifetime.

Bipolar disorder treatments and therapies

Treatment helps many people, even those with the most severe forms, gain better control of their mood swings and other bipolar symptoms. An effective treatment plan usually includes a combination of medications and psychotherapy (also called “talk therapy”).

This disorder is a lifelong disease; episodes of mania and depression usually return over time. Between episodes, many people with bipolar disorder are free from mood swings, but some people may have persistent symptoms.


Different types of medications can help control the symptoms of bipolar disorder; a person may need to try several other medicines before finding the ones that work best.

Medications generally used include:

  • Mood stabilizers.
  • Atypical antipsychotics.
  • Antidepressants


When done in combination with medications, psychotherapy can be an effective treatment because it can provide support, education, and guidance to individuals and their families. Some psychotherapy treatments used to treat bipolar disorder include:

  • Cognitive-behavioral therapy. 
  • Family-centered therapy. (Required item)
  • Interpersonal and social medicine. (Required item)
  • Psychoeducation. (Required item)

If you want to know more, click on psychotherapy.

Other treatment options

Electroconvulsive therapy

It can bring relief to people with severe bipolar disorder who have not been able to recover with other treatments. Sometimes used for symptoms when other medical conditions, including pregnancy, make taking medications too risky, it can cause some short-term side effects, including confusion, disorientation, and memory loss. More information on electroconvulsive therapy. (Required item)

Sleep medications

People with bipolar disorder who have trouble sleeping generally find treatment helpful. However, if insomnia does not improve, a doctor may suggest a change in medications; if the problem continues, the doctor may prescribe sedatives or other sleep medications.

Bipolar disorder and other illnesses

Some symptoms of bipolar disorder are similar to other illnesses, making it difficult for a doctor to make a diagnosis. Additionally, many people have it and other diseases such as anxiety disorder, substance abuse, or an eating disorder; they are also at increased risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.


Sometimes a person with severe episodes of mania or depression also has psychotic symptoms, such as hallucinations or delusions. Psychotic symptoms tend to coincide with the extreme mood of the person. For instance:

  • A person who has psychotic symptoms during a manic episode may believe that they are famous, has a lot of money, or has special powers.
  • A person who has psychotic symptoms during a depressive episode may believe that they are broke and penniless or have committed a crime.

As a result, people with bipolar disorder who have psychotic symptoms are sometimes misdiagnosed with schizophrenia.

Read more content on psychosis. (Required item)

Anxiety and Attention Deficit Hyperactivity Disorder

They are often diagnosed in people with bipolar disorder.

Substance abuse

They may also abuse alcohol or drugs, have relationship problems, or perform poorly in school or work. Family, friends, and people experiencing symptoms may not recognize these problems as signs of a significant mental illness such as bipolar disorder.

Georgia Tarrant
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Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.