Bipolar Disorder: Symptoms, Causes, Types, and Diagnosis

Guide to Bipolar Disorder

If you or a loved one may be suffering from bipolar disorder, it is crucial to learn more about the condition. In this article, we will provide details on what bipolar disorder actually is. However, for a diagnosis, it is imperative that you seek help from a mental health professional.

What is Bipolar Disorder?

Bipolar disorder is a complex mental health condition. Also considered a mood disorder, it is characterized by significant periods of extreme mood states, including emotional highs (mania or hypomania) and lows (depression). These states can affect sleep, energy levels, behavior, judgment, and the ability to think clearly.

Episodes of depression and mania may occur rarely or multiple times a year. While most individuals will experience some emotional symptoms between episodes, some may not experience any. Understanding the nuances of bipolar disorder is crucial not only for those living with the condition but also for their families and healthcare providers, as it aids in better management and support.

It is important to note that having multiple mood swings within a short period of time, or even in a single day, is not usually a sign of bipolar disorder. However, it may indicate the presence of cyclothymic disorder, which we will describe in the next section, or another mental health condition.

Types of Bipolar Disorder

Bipolar disorder is divided into several subtypes, each characterized by the pattern of mood states:

Bipolar I Disorder:

This type is characterized primarily by manic episodes that last at least seven days or by manic symptoms that are so severe that immediate hospital care is needed. Usually, depressive episodes occur as well, typically lasting at least two weeks. The episodes of depression that occur in Bipolar I Disorder can be severe and disabling.

Bipolar II Disorder:

This subtype is defined by a pattern of depressive episodes and hypomanic episodes, but the manic episodes seen in Bipolar I Disorder do not occur. Hypomania in Bipolar II Disorder is generally perceived by the individual as a period of increased energy and even some euphoria. However, the depressive episodes can be significant and much more prolonged than the periods of hypomania.

Cyclothymic Disorder (Cyclothymia):

Cyclothymia is a milder form of bipolar disorder involving many mood swings, with hypomania and mild depression, but the changes are less intense and do not meet the diagnostic standards for bipolar disorder. Despite its milder nature, cyclothymia can still interfere significantly with daily life and requires proper management.

Understanding these types helps tailor treatment and management strategies to individual needs, improving outcomes and quality of life for those affected. Each type of bipolar disorder poses unique challenges and may manifest differently, emphasizing the need for personalized treatment plans and comprehensive support systems.

Symptoms of Bipolar Disorder

Bipolar disorder manifests through distinct episodes of mania, hypomania, and depression, each with its own set of symptoms:

Manic Episodes

During a manic episode, individuals may feel an exaggerated sense of well-being, euphoria, or irritability. Common symptoms include a decreased need for sleep, talking more than usual or feeling pressure to keep talking, distractibility, racing thoughts, increased goal-directed activities or physical agitation, and engaging in activities that hold potential for painful consequences, such as unrestrained buying sprees or foolish business investments.

Hypomanic Episodes

Hypomania is similar to mania but less severe. It doesn’t cause significant distress in social, occupational, or other important areas, and it lacks the psychotic features of a manic episode. Symptoms might include inflated self-esteem, decreased need for sleep, and more talkative than usual or feeling a pressure to continue talking. While it may feel temporarily desirable, it can lead to reckless decisions with damaging consequences.

Depressive Episodes

These episodes are marked by feelings of sadness, emptiness, or hopelessness, accompanied by a lack of interest or pleasure in almost all activities. Other symptoms might include significant weight loss when not dieting, weight gain, insomnia or excessive sleeping, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, and recurrent thoughts of death or suicide.

Mixed Episodes

In some cases, individuals might experience symptoms of mania and depression simultaneously or in rapid sequence, which are termed mixed episodes.

Causes of Bipolar Disorder

The exact cause of bipolar disorder is not fully understood, but it is believed to involve an interplay of the following factors:

Genetic Factors:

Bipolar disorder tends to run in families. Research indicates that individuals with certain genes are more likely to develop bipolar disorder. However, genes are not the only factor, as not everyone with a genetic predisposition develops the illness, indicating that other factors contribute to its onset.

Environmental Factors:

Certain environmental factors may trigger bipolar disorder in individuals who are genetically susceptible. These triggers could include stress, financial problems, relationship breakups, or other traumatic events that can provoke an initial episode in a vulnerable individual.

Biological Aspects:

Brain structure and function may also play a role in the risk of developing bipolar disorder. Brain scans have shown differences in the size or activation of certain brain areas involved in mood regulation, decision making, and behavior control in people with bipolar disorder compared to those without the disorder.

Diagnosing Bipolar Disorder

For a diagnosis of bipolar disorder, you will need to see a psychiatrist. The process will include the following steps:

Clinical Evaluation

A detailed interview with a psychiatrist or psychologist that includes a discussion about symptoms, their duration, and their impact on functioning. This assessment typically covers personal and family psychiatric history, which can provide crucial insights into potential hereditary patterns.

Use of Diagnostic Criteria

For a diagnosis of bipolar disorder, mental health professionals rely on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This includes identifying specific types of episodes (manic, hypomanic, and depressive) and their frequency, duration, and severity.

Medical Examination

To rule out other causes of symptoms, such as neurological diseases or thyroid problems, a physical examination and laboratory tests might be conducted. This helps ensure that the mood swings are not attributable to other health issues or substances like drugs or medications.

Psychological Tests

In some cases, written or computer-based tests may be used to assess mood, thoughts, and behavior patterns. These can help in painting a clearer picture of the condition.

Diagnosing bipolar disorder can be complex, particularly when other conditions such as ADHD or anxiety disorders are also present, which may mask or complicate the mood symptoms. All good mental health professionals should take all of these factors into account.


Bipolar disorder is a troubling condition that should not be treated lightly. If you have experienced the symptoms mentioned above, or have seen signs of bipolar disorder in a loved one, seek help from a mental health professional as soon as possible.