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Bipolar disorder is an illness where a person has episodes of very high energy (manic episodes) to depression. But many people with bipolar disorder show only the symptoms of depression. These moods may cause problems with your work, school, family life, friendships, and how well you function.
This disease is also called manic-depression.
There is no cure for bipolar disorder, but it can be helped with medicines. Counselling may also help. It is important to take your medicines exactly as prescribed, even when you feel well. You may need lifelong treatment.
The cause of bipolar disorder isn't completely understood. But experts believe many factors may be involved. It tends to run in families. You are at greater risk of having bipolar disorder if a close family member has it.
The symptoms depend on your mood swings, or "highs" and "lows." During an episode of mania, you may feel very happy, energetic, or on edge. During a low, you may feel sad and have trouble thinking and making decisions.
To find out if you have bipolar disorder, your doctor will ask how long your symptoms last and how often you have them. He or she will also ask about your family history and may do a mental health assessment. You may have other tests to make sure another problem isn't causing your symptoms.
Bipolar disorder is treated with medicines and counselling. Medicines include mood stabilizers and antipsychotics. You may need to try several to find what works for you. Counselling can help with some of the social issues that the illness may cause. You can do a few things on your own, such as getting enough sleep.
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If anyone in your family has been diagnosed with bipolar disorder, your risk of having it is higher. Bipolar disorder can be passed down through families.
The symptoms depend on your mood swings, or "highs" and "lows." During a manic high, you may feel:
Some people spend a lot of money or get involved in dangerous activities when they are manic. After a manic episode, you may return to normal. Or your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness.
During a depressive episode, or low, you may have:
The mood swings of bipolar disorder can be mild or extreme. They may come on slowly over several days or weeks or suddenly over a few minutes or hours. These mood swings may last for a few hours or for several months.
The different types of bipolar disorder are based on whether a person has more severe symptoms of mania or depression.
This is the classic form of the illness. It causes episodes of mania and depression that keep coming back.
With this form, you will have depression as in bipolar I. But the manic highs are less severe. People with bipolar II have more episodes of depression than mania.
The high and low mood swings aren't as severe as in bipolar I or bipolar II.
This is diagnosed when symptoms of mania and depression aren't frequent or severe enough for bipolar I, bipolar II, or cyclothymia.
You may have at least four episodes of depression, mania, or both within a 12-month period.
The symptoms of both mania and depression occur at the same time.
When you have bipolar disorder, you have highs and lows of mania, hypomania, and depression. In between, you may return completely to normal or you may still have some symptoms. The extreme mood changes may come on all of a sudden or appear more slowly.
During a manic episode, you may go from feeling abnormally happy and productive to behaving irresponsibly and sleeping very little. After this manic high, your mood may return to normal. Or you may feel useless and extremely sad. And you may lose interest in things you've enjoyed in the past.
At first, stress may trigger depression or mania. But as the illness progresses, mood swings may not be caused by any certain event. Without treatment, your bipolar disorder may get worse. This can cause you to move more often between mania and depression.
People with bipolar disorder may have problems with substance use, especially during manic episodes. This happens more often in men than in women.footnote 1 Substance use disorder may affect treatment and interfere with taking medicines as prescribed. Other disorders that may occur along with this disorder include:footnote 2
These illnesses need to be treated along with bipolar disorder.
Call 911 or other emergency services immediately if:
If you or someone you know talks about suicide, self-harm, or feeling hopeless, get help right away. Call your provincial suicide hotline or Crisis Services Canada: 1-833-456-4566, or go to www.crisisservicescanada.ca for more information.
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Seek care soon if:
Bipolar disorder can be hard to diagnose. This is because it has many phases and the symptoms overlap with other mental health conditions.
To find out if you have bipolar disorder, your doctor will ask detailed questions about your symptoms. You will be asked how long your symptoms last and how often you have them. Your doctor will ask about your family history.
Blood and urine tests, such as a test of your thyroid, may be done to make sure another problem isn't causing your symptoms. A toxicology screen looks at blood, urine, or hair for the presence of drugs.
The earlier the disease is confirmed, the sooner you can get treatment, feel better, and improve the quality of your life. This can also reduce your risk of other health problems, such as substance use disorder.
Bipolar disorder is treatable. A treatment plan can make you feel better.
You may need to try several medicines to find the best combination.
Counselling is also an important part of treatment. It can help you cope with some of the work and relationship issues that the illness may cause.
You can do a few things on your own. These include being active, getting enough sleep, and learning to recognize early signs of highs and lows.
People often stop taking their medicines during a manic phase because they feel good. But this is a mistake. You must take your medicines regularly, even if you're feeling better.
Home treatment is important in bipolar disorder. There are many things you can do to help control mood swings. You don't have to do them all at once. Try to do one thing, such as eating a healthy diet, then add another when you can.
Try to eat a healthy, balanced diet. A balanced diet includes foods from different food groups, such as whole grains, dairy, fruits, vegetables, and protein. Eat a variety of foods from each group. (For example, eat different fruits from the fruit group instead of only apples.) A varied diet helps you get all the nutrients you need. No single food provides every nutrient.
The signs include:
Medicines can help control bipolar mood swings. Your doctor will vary the amounts and combinations of your medicines based on:
Several medicines are used to treat bipolar disorder. The most common ones used are:
You'll need to check in with your doctor regularly when taking medicines for bipolar disorder. You may need regular blood tests to watch the amount of medicine in your blood.
The use of antidepressants alone has been linked to an increase in manic episodes. Antidepressant treatment needs to be monitored closely to avoid causing a manic episode.
Almost all people who have bipolar disorder need medicine. But counselling is also important. It helps you cope with work and relationship struggles related to your illness. Types of counselling include:
Try to form a long-term relationship with a counsellor you like. He or she will help you recognize personality changes that show when you are moving into a mood swing. Getting early treatment can reduce the length of the high or low.
Family members often feel helpless when a loved one is depressed or manic. But you can help.
Encourage the person to take prescribed medicines regularly, even when he or she is feeling good.
If family therapy is available, make sure that everyone in the family attends.
Allow your loved one to take enough time to feel better and get back into daily activities.
Hypomania can occur in people with bipolar disorder. Hypomanic episodes are less severe than manic episodes. You may notice that your loved one's mood is different than his or her usual non-depressed mood, but not manic. You may think that your loved one is just having a good day. But hypomania can still interfere with your loved one's ability to function. An episode can last for a week or more.
If a loved one has bipolar disorder, it may be helpful for you to get counselling. This can help you deal with the disorder's impact on your own life. Manic episodes can be particularly hard. Talk with a psychiatrist, a psychologist, a social worker, or a counsellor for your own therapy.
Counselling can also be helpful for a child who has a bipolar parent. The parent's mood swings may negatively affect the child. This can cause tearfulness, anger, depression, or rebellious behaviour.
CitationsAmerican Psychiatric Association (2002). Practice guideline for the treatment of patients with bipolar disorder (revision). American Journal of Psychiatry, 159(4, Suppl): 1–50.Keck PE, et al. (2004). Expert consensus guideline series: Treatment of bipolar disorder 2004. Postgraduate Medicine Special Report. Available online: http://www.psychguides.com/content/treatment-bipolar-disorder-2004.
Adaptation Date: 11/1/2022
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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