Bipolar disorder is a mental health condition marked by extreme shifts in mood.

Key symptoms include:

• episodes of mania, or an extremely elevated mood
• episodes of depression, or a low mood

Older terms for bipolar disorder include manic depression and bipolar disease.

Bipolar disorder isn’t a rare condition. In fact, the National Institute of Mental Health says that 2.8 percent of U.S. adults — or about 5 million people — have a bipolar disorder diagnosis.

Although bipolar disorder doesn’t have a cure, many effective treatments are available. These treatment options can help you learn to manage mood episodes, which can improve not only your symptoms, but also your overall quality of life.

Types of bipolar disorder

There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia.

Bipolar I

Bipolar I is defined by the appearance of at least one manic episode. You may experience hypomanic episodes, which are less severe than manic episodes, or major depressive episodes before and after the manic episode. This type of bipolar disorder affects people of all sexes equally.

Bipolar II

People with bipolar II experience one major depressive episode that lasts at least 2 weeks. They also have at least 1 hypomanic episode that lasts about 4 days. According to a 2017 reviewTrusted Source, this type of bipolar disorder may be more common in women.

Cyclothymia

People with cyclothymia have episodes of hypomania and depression. These episodes involve symptoms that are shorter and less severe than the mania and depression caused by bipolar I or bipolar II disorder. Most people with this condition only experience no mood symptoms for 1 or 2 months at a time.

Your doctor can explain more about what kind of bipolar disorder you have when discussing your diagnosis.

Some people experience distinct mood symptoms that resemble but don’t quite align with these three types. If that’s the case for you, you might get a diagnosis of:

• other specified bipolar and related disorders
• unspecified bipolar and related disorders

To receive a diagnosis of bipolar disorder, you must experience at least one period of mania or hypomania.

These both involve feelings of excitement, impulsivity, and high energy, but hypomania is considered less severe than mania. Mania symptoms can affect your day-to-day life, leading to problems at work or home. Hypomania symptoms typically don’t.

Some people with bipolar disorder also experience major depressive episodes, or “down” moods.

These three main symptoms — mania, hypomania, and depression — are the main features of bipolar disorder. Different types of bipolar disorder involve different combinations of these symptoms.

Bipolar I symptoms

A diagnosis of bipolar I disorder requires:

• at least 1 episode of mania that lasts at least 1 week
• symptoms that affect daily function
• symptoms that don’t relate to another medical or mental health condition or substance use

You could also experience symptoms of psychosis, or both mania and depression (known as mixed features). These symptoms can have more impact on your life. If you do have them, it’s worth reaching out for professional support as soon as possible (more on this later).

While you don’t need to experience episodes of hypomania or depression to receive a bipolar I diagnosis, many people with bipolar I do report these symptoms.

Bipolar II symptoms

A diagnosis of bipolar II requires:

• at least 1 episode of hypomania that lasts 4 days or longer and involves 3 or more symptoms of hypomania
• hypomania-related changes in mood and usual function that others can notice, though these may not necessarily affect your daily life
• at least 1 episode of major depression that lasts 2 weeks or longer
• at least 1 episode of major depression, involving 5 or more key depression symptoms that have a significant impact on your day-to-day life
• symptoms that don’t relate to another medical or mental health condition or substance use

Bipolar II can also involve symptoms of psychosis, but only during an episode of depression. You could also experience mixed mood episodes, which means you’ll have symptoms of depression and hypomania at the same time.

With bipolar II, though, you won’t experience mania. If you have a manic episode, you’ll receive a diagnosis of bipolar I.

Cyclothymia symptoms

A diagnosis of cyclothymia requires:

• periods of hypomanic symptoms and periods of depression symptoms, off and on, over 2 years or longer (1 year for children and adolescents)
• symptoms that never meet full criteria for an episode of hypomania or depression
• symptoms that are present for at least half of the 2 years and never absent for longer than 2 months at a time
• symptoms that don’t relate to another medical or mental health condition or substance use
• symptoms that cause significant distress and affect daily life

Fluctuating mood symptoms characterize cyclothymia. These symptoms may be less severe than those of bipolar I or II. Still, they tend to last longer, so you’ll generally have less time when you experience no symptoms.

Hypomania may not have a big impact on your daily life. Depression, on the other hand, often leads to more serious distress and affects day-to-day function, even if your symptoms don’t qualify for a major depressive episode.

If you do ever experience enough symptoms to meet the criteria for a hypomanic or depressive episode, your diagnosis will likely change to another type of bipolar disorder or major depression, depending on your symptoms.

An episode of mania often involves an emotional high. You might feel excited, impulsive, euphoric, and full of energy. You might also feel jumpy or notice your thoughts seem to race. Some people also experience hallucinations and other symptoms of psychosis.

Manic episodes can involve behavior that’s more impulsive than usual, often because you feel invincible or untouchable. Commonly cited examples of this kind of behavior include:

• having sex without using a barrier method
• using alcohol and drugs, or using them more than usual
• going on spending sprees

But impulsiveness and risk taking can show up in plenty of other ways, too. Maybe you:

• quit your job abruptly
• take off on a road trip by yourself without telling anyone
• make a big investment on a whim
• drive much faster than usual, well above the speed limit
• participate in extreme sports you wouldn’t ordinarily consider

Hypomania, generally associated with bipolar II disorder, involves many of the same symptoms, though they’re less severe. Unlike mania, hypomania often doesn’t lead to trouble at work or school, or in your relationships. Episodes of hypomania don’t involve psychosis. They typically won’t last as long as episodes of mania or require inpatient care.

With hypomania, you might feel very productive and energized, but you may not notice other changes in your mood. People who don’t know you well may not, either. Those closest to you, however, will usually pick up on your shifting mood and energy levels.

A “down” change in mood can leave you feeling lethargic, unmotivated, and sad.

Bipolar-related episodes of major depression will involve at least five of these symptoms:

• a lasting low mood, marked by deep sadness, hopelessness, or feelings of emptiness
• loss of energy
• a sense of feeling slower than usual or persistent restlessness
• lack of interest in activities you once enjoyed
• periods of too little or too much sleep
• a sense of guilt or worthlessness
• trouble with concentrating, focusing, and making decisions
• thoughts of death, dying, or suicide
• changes in appetite or weight

Not everyone with bipolar disorder experiences major depressive episodes, though many people do. Depending on your type of bipolar disorder, you might experience only a few symptoms of depression, not the full five needed for a major episode.

It’s also worth noting that sometimes, but not always, the euphoria of mania can feel enjoyable. Once you get treatment for mania, the symptom-free mood you experience might feel more like a “down” shift, or a period of depression, than a more typical mood state.

While bipolar disorder can cause a depressed mood, bipolar disorder and depression have one major difference. With bipolar disorder, you might have “up” and “down” mood states. With depression, though, your mood and emotions might remain “down” until you get treatment.

Men and women are diagnosed with bipolar disorder in roughly equal numbers. However, the main symptoms of the disorder may vary, depending on both sex you were assigned at birth and your gender.

Women with bipolar disorder tend to receive diagnoses later in life, often in their 20s or 30s. In some cases, they might first notice symptoms during pregnancy or after childbirth. They’re also more likely to be diagnosed with bipolar II than bipolar I.

Additionally, women with bipolar disorder tend to experience:

• milder episodes of mania
• more depressive episodes than manic episodes
• rapid cycling, or 4 or more episodes of mania and depression in 1 year
• more co-occurring conditions

Women with bipolar disorder may also experience relapse more often, which may happen in part due to hormone changes related to menstruation, pregnancy, and menopause. In terms of bipolar disorder, relapse means having a mood episode after not having one for some time.

Men with bipolar disorder, on the other hand, may:

• get a diagnosis earlier in life
• experience less frequent but more severe episodes, especially manic episodes
• be more likely to also have a substance use disorder
• show more aggression during episodes of mania

Diagnosing bipolar disorder in children is controversial, largely because children don’t always display the same bipolar disorder symptoms as adults. Their moods and behaviors may also not follow the standards doctors use to diagnose the disorder in adults.

Many bipolar disorder symptoms that occur in children also overlap with symptoms of other conditions that commonly occur in children, such as attention deficit hyperactivity disorder (ADHD).

However, in the last few decades, doctors and mental health professionals have come to recognize the condition in children. A diagnosis can help children get treatment, but reaching a diagnosis may take many weeks or months. It may be worth seeking care from a professional who specializes in treating children with mental health conditions.

Like adults, children with bipolar disorder experience extreme mood shifts. They can appear very happy and show signs of excitable behavior, or seem very tearful, low, and irritable.

All children experience mood changes, but bipolar disorder causes distinct and noticeable mood symptoms. Mood changes are also usually more extreme than a child’s typical change in mood.

Manic symptoms in children

Symptoms of mania in children can include:

• acting very silly and feeling overly happy
• talking fast and rapidly changing subjects
• having trouble focusing or concentrating
• doing risky things or experimenting with risky behaviors
• having a very short temper that leads quickly to outbursts of anger
• having trouble sleeping and not feeling tired after sleep loss

Depressive symptoms in children

With bipolar disorder, symptoms of depressive episodes in children can include:

• moping around, acting very sad, or crying frequently
• sleeping too much or too little
• having little energy for usual activities or showing no signs of interest in anything
• complaining about not feeling well, including having frequent headaches or stomachaches
• feelings of worthlessness or guilt
• eating too little or too much
• thoughts of death or suicide

Other possible diagnoses

Some of the behavior issues you notice in your child could suggest other mental health conditions, such as ADHD or depression. It’s also possible for children to have bipolar disorder with another condition.

Your child’s doctor can offer more guidance and support with noting and tracking your child’s behaviors, which can help them find the right diagnosis.

The correct diagnosis can play a major role in finding the most effective treatment for your child. Treatment, of course, can make a big difference for your child’s symptoms, not to mention their quality of life.

Read more about bipolar disorder in children.

Symptoms in teens

Shifting hormones, plus the life changes that naturally happen with puberty, can make teens seem extremely emotional from time to time.

Yet drastic or rapidly fluctuating changes in mood may suggest a more serious condition, such as bipolar disorder, rather than typical teenage development.

A bipolar disorder diagnosis is most common during the late teen and early adult years.

Common symptoms of mania in teenagers include:

• being very happy
• “acting out” or misbehaving
• taking part in risky behaviors, like substance use
• thinking about sex more than usual
• becoming overly sexual or sexually active
• having trouble sleeping, without signs of fatigue or being tired
• having a very short temper
• having trouble staying focused, or getting distracted easily

Common symptoms of a depressive episode include:

• sleeping too much or too little
• eating too much or too little
• feeling very sad and showing little excitability
• withdrawing from activities and friends
• thinking or talking about death and suicide

Keep in mind that many of these signs, like experimenting with substances and thinking about sex, aren’t uncommon teenage behaviors. But if they seem to be part of a larger pattern of shifting moods or start to affect their day-to-day life, they could be a sign of bipolar disorder or another condition.

Bipolar disorder treatment

Several treatments can help you manage bipolar disorder symptoms. These include medications, counseling, and lifestyle changes. Some natural remedies can also have benefits.

Medications

Recommended medications may include:

• mood stabilizers, such as lithium (Lithobid)
• antipsychotics, such as olanzapine (Zyprexa)
• antidepressant-antipsychotics, such as fluoxetine-olanzapine (Symbyax)
• benzodiazepines, a type of anti-anxiety medication used for short-term treatment

Psychotherapy

Recommended therapy approaches may include:

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of talk therapy that helps you identify and address unhelpful thoughts and change unwanted patterns of behavior.

Therapy offers a safe space to discuss ways to manage your symptoms. Your therapist can also offer support with:

• understanding thought patterns
• reframing distressing emotions
• learning and practicing more helpful coping strategies

Get tips on finding the right therapist.

Psychoeducation

Psychoeducation is a therapeutic approach centered around helping you learn about a condition and its treatment. This knowledge can go a long way toward helping you and the supportive people in your life recognize early mood symptoms and manage them more effectively.

Interpersonal and social rhythm therapy

Interpersonal and social rhythm therapy focuses on regulating daily habits, such as sleeping, eating, and exercising. Balancing these everyday basics could lead to fewer mood episodes and less severe symptoms.

Other options

Other approaches that can help ease symptoms include:

• electroconvulsive therapy
• sleep medications
• supplements
• acupuncture

Natural remedies for bipolar disorder

Some natural remedies might also help with bipolar disorder symptoms.

You’ll always want to check with your doctor or psychiatrist before trying these remedies, though. In some cases, they could interfere with any medications you’re taking.

The following herbs and supplements may help stabilize your mood and reduce symptoms of bipolar disorder when combined with medication and therapy:

• Omega-3. Some 2016 research suggests that taking an omega-3 supplement may help with symptoms of bipolar I. A 2012 study found this was particularly helpful with depressive symptoms.
• Rhodiola rosea. A 2013 review suggests this plant may help with moderate depression, so it could help treat depression associated with bipolar disorder.
• S-adenosylmethionine (SAMe). SAMe is an amino acid supplement that can help ease symptoms of major depression and other mood disorders.