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Symptoms of bipolar disorder: Signs, types, and causes

Learn the symptoms of bipolar disorder, from manic highs to depressive lows, and understand when it's time to seek support from a therapist.

August 28, 2026

By Dr. Juli Fraga, Psy.D • Clinically reviewed by Caitlin Pugh, LCSW

8 min read

By Dr. Juli Fraga, Psy.D • Clinically reviewed by Caitlin Pugh, LCSW

Key insights

1

Bipolar disorder is a lifelong condition marked by recurring extreme mood episodes that cycle between mania or hypomania and depression, disrupting how you think, feel, and behave.

2

Manic episodes bring elevated energy, confidence, and impulsivity — sometimes with delusions or hallucinations. Hypomania is a milder version without psychosis.

3

Symptoms vary widely: racing thoughts, less need for sleep, and irritability during mania; fatigue, hopelessness, and loss of interest during depression.

Nearly everyone experiences emotional highs and lows every now and then. But when extreme mood swings, energy spikes, and impulsive behaviors begin to interfere with your daily functioning, a condition called bipolar disorder may be the cause.

In this guide, we’ll walk you through what bipolar disorder is, including its symptoms and causes, the main types of episodes, and how it differs from everyday mood swings. We’ll also cover what type of support can help. Learning more about bipolar disorder can help you better understand what you or a loved one may be experiencing.

What is bipolar disorder?

Bipolar disorder is a mental health condition that affects roughly 34 million adults across the globe each year, and it’s characterized by extreme mood swings. With it, you may feel euphoric, followed by an episode of depression. Almost everyone experiences mood fluctuations, but with bipolar disorder, these changes begin to interfere with the way you think, feel, and behave. In other words, unlike mood shifts that come and go, bipolar disorder is a lifelong condition that can involve one or all of the following symptoms: recurring episodes of mania, hypomania, and depression.

Mania can make you feel like you’re on top of the world, almost like a superhero. During a manic episode, you might feel like you have special powers or believe you can accomplish anything. Impulsive behaviors are also common.

Not everyone with bipolar disorder will experience mania. Some people experience a milder form called hypomania. With hypomania, you may be more talkative and productive. And while you may continue to function well, others will notice a change in the way you behave. Sometimes this shows up as being energized and activated but presents as anxiety and agitation.

Following mania and hypomania, depression is common. You may have low energy and feel hopeless and sad. Still, symptoms of bipolar disorder vary significantly between people. While your symptoms can feel confusing and overwhelming, effective management is possible, especially with the right support.

Signs and symptoms of bipolar disorder

If you’re wondering “Am I bipolar?” there are many different symptoms to look out for. These can be related to your thoughts, feelings, and behaviors. Here are some common bipolar signs.

Signs and symptoms of manic episodes

Mania can make you feel more energetic, uncharacteristically confident, and more talkative. Your thoughts may bounce around from topic to topic. You may feel like you can accomplish big projects or goals in a short amount of time, such as training for a marathon in one day or writing a book in two days. Impulsivity, such as spending a lot of money, using substances, or engaging in risky behavior, is another common sign.

It’s also possible for manic episodes to include psychotic features. This can include delusions and hallucinations, such as seeing or hearing things that are not there. These symptoms often interfere with daily functioning, making it more challenging to engage in work and social relationships.

Full manic episodes often require more than just speaking with a mental health professional. Since symptoms can be quite serious, urgent care or hospitalization may be required.

Hypomania symptoms

Hypomania can make you feel more energetic and productive, like an Energizer bunny. You may feel extremely happy and have a reduced need for sleep.

With hypomania, it’s also common to have racing thoughts, feel easily distracted, or more irritable. Unlike mania, however, hypomanic episodes don’t usually include symptoms of psychosis. Since these symptoms are less severe than mania, they may not always disrupt your ability to work and meet your social responsibilities.

Signs and symptoms of depressive episodes

Depression can cause extreme sadness, increased fatigue, and decreased motivation. All of the euphoric energy you experienced during a manic or hypomanic episode may suddenly disappear.

Feelings of hopelessness and guilt are common as well. For example, life may feel like it's lost its luster, and activities you once enjoyed may seem meaningless or dull. You may experience appetite changes and feel more restless than normal. Depressive symptoms can vary from mild to more severe. With more severe symptoms, your daily functioning is often affected.

Episodes with mixed features

It’s also possible to experience symptoms of mania, hypomania, and depression during a single episode. You may feel low while still full of energy, or euphoric and restless at the same time.

Symptom patterns vary between individuals. If you’re experiencing symptoms that significantly disrupt your daily life, reach out to a mental health professional like a psychiatrist or psychiatric nurse practitioner who can prescribe medications to help you feel better.

In some cases, symptoms can become severe, including risky behavior and thoughts of self-harm. If you’re experiencing any of these symptoms, call or text the 988 Suicide and Crisis Lifeline (call or text 988) or the Crisis Text Line (text HOME to 741741) or go to your nearest emergency room. Help is available 24/7.

Types of bipolar disorder

There are four main types of bipolar disorder. Each involves mood shifts, but the severity of symptoms can vary.

Bipolar I disorder

You have at least one full-blown manic episode that lasts at least seven days. Severe symptoms like psychosis, thoughts of self-harm, or an inability to sleep may require hospitalization. You may also experience an episode of depression or a mixed state. However, all of these symptoms are not necessary to be diagnosed with Bipolar I disorder.

Bipolar II disorder

With bipolar II disorder, you do not experience an episode of full-blown mania. Instead, you experience at least one episode of hypomania and one episode of major depression. Although symptoms of hypomania are less severe than mania, they can feel very disruptive. In addition, depressive episodes can be more frequent and last longer.

Cyclothymia

With cyclothymic disorder, you experience ongoing mood swings for at least two years. Unlike the occasional bad mood, these changes include symptoms of hypomania and mild depression. Symptoms are less severe than bipolar I and bipolar II disorder, but may still affect your daily living. For example, your mood may feel unsteady, even when things are going well. While there are periods when you feel better, they usually last less than eight weeks.

Other specified or non-specified bipolar and related disorder

As with many mental health conditions, bipolar disorder can be complicated. In some cases, your mood symptoms may not fit the typical patterns of bipolar I, bipolar II, or cyclothymia. Symptoms may be comorbid with other conditions, such as borderline personality disorder, PTSD or complex trauma, and ADHD.

What causes bipolar disorder?

Mental health professionals have not identified one single cause of bipolar disorder, or a surefire predisposition. Research indicates bipolar disorder causes are more likely due to a combination of factors.

Genetics can play a role. Numerous studies show that bipolar disorder can run in families. Having a first-degree relative with this condition is a recognized risk factor, but it doesn’t make a diagnosis inevitable.

Researchers have also identified a possible connection between epigenetics and bipolar disorder. Epigenetics refers to how your environment can affect your DNA. Examples include prolonged stress, illness, or adverse childhood experiences like abuse or neglect.

Changes or an imbalance in the neurotransmitters serotonin and dopamine are also possible bipolar disorder causes, as are neurodevelopmental factors, namely the way your brain works. In addition, sleep disruptions and dysregulation like prolonged sleep deprivation can trigger manic episodes in some people.

It’s also important to know that traumatic and stressful life events, such as the loss of a loved one, job loss, and financial stress, may trigger bipolar symptoms in people who are vulnerable to this condition. And while very rare, hormonal changes that accompany pregnancy, childbirth, or the menopause transition can also play a role.

How is bipolar disorder treated?

There are many different ways that providers can treat bipolar disorder. In most cases, medication, including mood stabilizers like lithium, valproate, lamotrigine, or atypical antipsychotics are needed to manage symptoms of mania and major depression.

Speaking with a therapist can be incredibly helpful. There are many different types of therapy for bipolar disorder. With each type, your therapist can help you understand your thoughts, feelings, and behaviors better. They can also teach you stress management techniques, such as mindfulness, sleep hygiene skills, and other healthy habits that support your well-being. In some cases, family therapy is also useful, especially when loved ones and caregivers want support, too.

Lifestyle changes like increasing exercise, getting adequate rest, managing stress, and avoiding substances like drugs and alcohol are often helpful. Coping skills, such as journaling, deep breathing, and speaking with a friend or family member, can also be useful tools.

Often, it’s a combination of treatments that work best. Everyone’s situation is unique, which is why long-term support from a mental health professional is central to managing bipolar disorder.

Can bipolar disorder be prevented?

Bipolar disorder itself cannot be prevented. However, people who have been diagnosed can take active steps toward reducing the frequency of episodes.

Learning more about bipolar disorder signs can help you notice the first warning signs of an oncoming episode. When you know what to look for, you can reach out to a care provider before your symptoms escalate. Making sure that you’re getting enough rest, speaking with a therapist, and avoiding alcohol and substances may also help reduce the severity of episodes.

It’s important to never stop or reduce psychiatric medication without consulting your prescriber. Abrupt discontinuation can trigger rebound episodes and may be medically dangerous.

Since bipolar disorder requires long-term management, finding a support group can also be helpful. Connecting with others who are going through something similar may help you feel less alone.

As with many mental health conditions, bipolar disorder is frequently misdiagnosed, especially across racial lines. For example, research shows that Black patients are often misdiagnosed with schizophrenia, rather than bipolar disorder.

Symptoms of bipolar disorder are also frequently misdiagnosed as depression, and it can take years to receive the right diagnosis. If you believe that you may have bipolar disorder, speak with a mental health provider, especially a prescribing provider. Finding support early ensures that you receive the care you need.

Getting support

If you’re living with bipolar disorder, you don’t have to manage it all on your own. Therapy is a proven, frontline treatment for bipolar disorder. At Headway, we have over 80,000 therapists in our network who take insurance. Many of our providers specialize in treating clients with bipolar disorder and can tailor a treatment plan that's right for your unique needs.

This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

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Mental health conditions