Bipolar Disorder Guides & Articles

Leigh Morgan
Last updated:
Brindusa Vanta, MD, DHMHS
Medical Editor

What Is Bipolar Disorder?

Bipolar disorder causes changes in a person's mood, behavior, and energy levels. 1 The term covers three distinct conditions: bipolar 1, bipolar 2, and cyclothymic disorder. Bipolar 1 disorder causes an individual to experience chronic mood swings, alternating between severe manic states and severe episodes of depression 2.

People with bipolar 2 disorder have mood swings, but they don't have severe mania. Instead, they have hypomania, or periods of high energy and excessive activity. 3 Cyclothymic disorder is a chronic condition that causes episodes of mood swings that aren't as severe and don't last as long as the ones caused by bipolar 1 and bipolar 2.

Like other mental health conditions, bipolar disorder has a significant impact on personal relationships. For example, individuals with bipolar disorder tend to have higher levels of family dysfunction than people without this condition. 4 Friends and family members may also become frustrated by sudden changes in a person's behavior and mood. Bipolar disorder can even have negative effects on a family's financial circumstances, as people with this condition often have higher healthcare costs than individuals without any chronic mental or physical health conditions. 5 The financial impact of bipolar disorder may cause high levels of stress, leading to frequent arguments or other forms of family dysfunction.

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Is Bipolar Disorder Genetic?

Bipolar disorder has a "strong genetic component," but it can also develop in people with no family history of the condition. 6 Scientists have identified several genes that may play a role in its development.

  • Disrupted in Schizophrenia 1 (DISC1): The DISC1 gene plays an important role in neural plasticity, or the ability of the brain to modify itself based on experience. 7 DISC1 is also involved in brain development, so any variation in the gene may increase the risk for bipolar disorder and other mental health conditions. Scientists believe that DISC1 mutations prevent certain nerve cells from maturing correctly, impairing their function later in life. 8
  • Dopamine transporter gene (DAT1): The DAT1 gene prevents the reabsorption of dopamine at the synapse, or the space between two cells. 9 Dopamine is a chemical that helps the nerve cells communicate with each other. Scientists don't know exactly how DAT1 variations affect the development of bipolar disorder, but it may be due to disruption of normal communication in the nervous system.
  • Neuregulin 1 (NRG1): NRG1 is involved in the growth and survival of the specialized cells in the nervous system. 10 In one study, researchers found that the gene influences susceptibility to bipolar disorder and other mental health conditions. 11

How Common Is Bipolar Disorder?

Bipolar disorder affects approximately 2.8% of the U.S. population. 12 About 83% of Americans with this condition have severe symptoms. Globally, bipolar disorder affected 40 million individuals in 2019. 13 Many people begin to experience symptoms in their teens or early 20s, but it's possible to receive a bipolar diagnosis later in life. Unlike many mental health conditions, bipolar disorder affects men and women equally.

What Are the Signs of Bipolar Disorder?

The signs of bipolar disorder depend on whether the individual is experiencing a manic episode, a depressive episode, or a period of hypomania. Mania typically causes the following:

  • Abnormally high levels of energy
  • Getting very little sleep
  • Feeling overly excited
  • Inflated self-esteem
  • Racing thoughts
  • Frequent talking
  • Pacing, fidgeting, and other unusual levels of movement 14
  • Impulsive behavior

Depressive episodes have the opposite effect on mood and energy levels. These are the most common symptoms caused by a bipolar-related depressive episode:

  • Extreme sadness
  • Slower movements
  • Sleep disturbances
  • Talking slowly
  • Difficulty concentration
  • Lack of interest in most activities
  • Feelings of worthlessness or hopelessness 15

Hypomania symptoms are similar to mania symptoms, but they're not as severe. Manic episodes also last longer than periods of hypomania.

What Triggers Bipolar Disorder?

Although bipolar disorder has genetic components, there are some environmental factors that have also been associated with the development of bipolar disorders. These factors include health problems, childhood trauma, and stressful life events. People who lack support from their family members and friends are also at higher risk to develop bipolar disorder, as social support is what helps an individual feel loved, valued, and appreciated. 16 Without an adequate amount of support, life is more stressful, making it more difficult to cope. Researchers believe intrauterine infections and smoking while pregnant can also affect a developing baby's risk level when they get older.

How to Test for Bipolar Disorder

There's no single test for bipolar disorder, so the diagnostic process usually begins with a physical exam and blood tests. This helps determine if the individual has any underlying health conditions that could be causing their symptoms. 17 The next step is a full psychiatric assessment, which entails discussing behavioral patterns, thoughts, and feelings with a mental health professional. Some doctors also recommend mood charting, or keeping a daily record of sleep patterns and mood changes. After completing a full assessment, a psychiatrist evaluates the individual's symptoms according to the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Certain criteria must be met to establish the diagnosis of bipolar. Learn more about diagnosing bipolar disorder.

How to Deal With a Bipolar Diagnosis

While the disorder is manageable, it takes time to find the right treatment for bipolar disorder. In the meantime, it's helpful to keep a journal of symptoms and potential triggers. Sometimes reading past journal entries can help an individual with this condition identify factors that make their symptoms better or worse. Self-care is also important. Since poor sleep habits can trigger manic or depressive episodes, people with bipolar disorder should work on developing a sleep routine and adjusting habits that can affect how much sleep they get, such as drinking caffeinated beverages or eating just before bedtime. If you’ve been diagnosed with bipolar disorder, you’re not alone. Find treatment for bipolar disorder today.

How to Help Someone With Bipolar Disorder Who Refuses Help

If someone with bipolar disorder refuses to get help, they probably have a reason. Instead of forcing them into treatment, loved ones should try to validate their feelings as much as possible. 18 For example, asking the person what they want to change about their life can start a productive conversation that leads to a positive outcome. It's also important for loved ones to avoid giving advice unless the person with bipolar disorder specifically asks for it. Overall, it's wise to approach sensitive conversations from a place of compassion instead of judging the other person's behavior.