Roughly 4.4% of American adults are diagnosed with bipolar disorder at some point in their lives, most commonly as adolescents or young adults. Bipolar disorder is a mood disorder that includes phases of both mania or hypomania (a less intense form of mania) and major depressive episodes.

People with bipolar disorder may also experience stable moods called euthymic moods between episodes of mania and depression. Bipolar disorder can be misdiagnosed as other conditions, especially depression. Here’s how to tell the difference.

Types of Bipolar Disorder

Bipolar disorder is categorized into subtypes. These subtypes include bipolar 1 disorder, bipolar 2 disorder, and cyclothymic disorder. “Manic-depressive illness” is an earlier term for bipolar disorder, and it is still used at times.

Bipolar 1

In bipolar 1 disorder, a person experiences at least one manic episode. They may experience major depressive episodes and hypomanic episodes. They often shift between the different mood states.

Manic Episode vs. Hypomanic Episode

A manic episode is a phase of an enhanced mood (heightened emotions) and increased energy level. A hypomanic episode also includes an enhanced mood and increased energy level, but a hypomanic episode is milder than a manic episode.

Bipolar 2

In bipolar 2 disorder, a person experiences both major depressive episodes and hypomanic episodes. As in bipolar 1, they shift between the two states. Unlike in bipolar 1 disorder, however, people do not experience manic episodes.

Cyclothymic Disorder

Cyclothymic disorder is sometimes referred to as a milder version of bipolar disorder. This is because people with cyclothymic disorder do not have symptoms that are severe, frequent, or lasting long enough to be considered a major depressive episode or a hypomanic episode. However, they do experience phases with symptoms of hypomania and depression for at least two years.

Symptoms

The symptoms of bipolar disorder fluctuate. A person with bipolar disorder may experience a phase of one set of symptoms and then a phase of another set of symptoms. Often alternating between manic and depressive symptoms. They may also experience phases of euthymia, which is a phase that’s neither manic nor depressive but rather a stable mental state.

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This video has been medically reviewed by Michael MacIntyre, MD

Depression or Depressive Mood

To be considered a major depressive episode, a person must experience symptoms for at least two weeks, and they must have at least five symptoms of depression.

What Is Euthymia?

Euthymia is a mental state in which a person is doing well, is tranquil, and is functioning. It is often associated with the in-between phases of bipolar disorder, the stable times between manic and depressive episodes.

Mania or Hypomania

The symptoms of mania and hypomania are the same. However, mania is more severe than hypomania. Therefore, it is more likely for mania to interfere with daily life.

Symptoms of Depression

  • Sad, empty, or hopeless feelingIrritability (children and teens)Feelings of guilt, shame, or worthlessnessCryingDecreased interest in activitiesNo feeling of pleasure in activitiesFeeling sluggish or unable to move quicklyExcessive sleeping or difficulty sleepingDecreased energyFatigueFoggy mind or difficulty thinkingDifficulty concentrating or making decisionsChanges in appetite or weightThoughts of suicide

Suicide Prevention Helpline

If you or someone you know are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Bipolar Test

A bipolar test is not to determine a diagnosis. Instead, it can be used as a guide to discuss concerns with a doctor. Anyone who finds many of these statements apply to them should seek the support of a healthcare professional.

Symptoms of Mania or Hypomania

  • Overconfidence in selfSense of well-being beyond what is appropriate for a situationExcessively upbeat, jumpy, or wiredOverly active or energizedIncreased agitationRacing thoughtsDifficulty concentratingExcessive talkingDecreased sleepCompromised decision-making

Getting Diagnosed

Only a qualified healthcare professional, such as a psychiatrist or psychologist, can diagnose bipolar disorder and other mental health conditions. There is no medical test for bipolar disorder. Instead, it is diagnosed by ruling out other possibilities, evaluating symptoms, and taking into consideration past experiences and family history.

Signs of Bipolar Disorder

  • You feel depressed every day for long periods of time (two weeks or more).
  • You have periods of extreme, over-the-top happiness or joy for long periods of time.
  • Bipolar disorder runs in your family.
  • You have difficulty sleeping, have changing sleep habits, or have energy fluctuations.
  • You have another condition such as anxiety, ADHD (attention deficit hyperactivity disorder), psychosis, drug or alcohol addiction, or an eating disorder.
  • You have suicidal thoughts. Always seek the support of a qualified professional for suicidal thoughts.

Talk to Your Doctor

The first step to managing bipolar disorder is to talk to a doctor such as a psychiatrist or psychologist. If needed, a primary care practitioner such as a family doctor can help with a referral to a specialist. Support from a healthcare provider is important to treat symptoms and reduce bipolar episodes.

Summary

Bipolar disorder can involve shifts between depressive episodes and manic or hypomanic episodes. There are different types of this mental health illness, and the severity of symptoms and duration of episodes may vary. While there may also be phases without depressive or manic symptoms, the mood changes are part of a lifelong condition. However, diagnosis, treatment, and management are possible with the care of a healthcare professional such as a psychiatrist or psychologist.

Mental Health Resources

If you or a loved one is struggling with mental health contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.

A Word From Verywell

Suspecting bipolar disorder and receiving a diagnosis can be scary and upsetting. Even so, there is hope for management with treatment and coping techniques. If you or a loved one is struggling with symptoms of depression, mania, or hypomania, you are not alone. Reach out to a healthcare professional such as a primary care practitioner, a psychiatrist, or a psychologist for support.

Frequently Asked Questions

  • What causes bipolar disorder?
  • While it is not clear exactly what causes bipolar disorder, there are some factors that increase risk. These include biological differences and genetics. There are physical brain differences among people with bipolar disorder, and many have a first-degree relative with bipolar disorder. Stress and drug or alcohol use are also significant contributors.
  • Can depression turn into bipolar disorder?
  • Depression does not exactly turn into bipolar disorder. However, bipolar disorder is sometimes misdiagnosed as depression, especially since depressive episodes may surface earlier than manic or hypomanic symptoms. In this case, a person may later be reevaluated and diagnosed with bipolar disorder.

While it is not clear exactly what causes bipolar disorder, there are some factors that increase risk. These include biological differences and genetics. There are physical brain differences among people with bipolar disorder, and many have a first-degree relative with bipolar disorder. Stress and drug or alcohol use are also significant contributors.

Depression does not exactly turn into bipolar disorder. However, bipolar disorder is sometimes misdiagnosed as depression, especially since depressive episodes may surface earlier than manic or hypomanic symptoms. In this case, a person may later be reevaluated and diagnosed with bipolar disorder.