Bipolar disorder is a chronic psychiatric condition characterized by intense mood swings that go far beyond the normal variations of everyday life. People with this disorder can alternate between episodes of deep depression and phases of extreme euphoria, called mania or hypomania. These changes are not only emotional — they directly affect behavior, thoughts, energy, and the ability to perform daily tasks.
Although it is a serious condition, bipolar disorder can be controlled with appropriate treatment and continuous medical monitoring. In this text, we will explain what bipolar disorder is, what its symptoms are, possible causes, how it is diagnosed, the main types, and the available treatment options. We will also debunk some misconceptions about the disease.
What is bipolar disorder?
Bipolar disorder, formerly known as manic-depressive psychosis, is a mood disorder that leads to cyclical changes between periods of depression and mania. In some cases, the patient may stay weeks or even months in the same state, while in others, changes can happen more quickly.
The illness is classified as a mood disorder because it interferes with how a person feels, thinks, and behaves. During manic phases, it is common to experience increased energy, elevated self-esteem, impulsivity, and a sense of grandiosity. During depressive phases, deep sadness, loss of interest, slowness, and in severe cases, suicidal thoughts predominate.
Types of bipolar disorder
There are different forms of the disease, and a correct diagnosis is essential to define the best treatment. The main types are:
Bipolar disorder type I
Characterized by at least one manic episode lasting seven days or more, which may require hospitalization. Depressive episodes may or may not be associated.
Bipolar disorder type II
More common than type I, involves episodes of depression and hypomania (a milder form of mania). Often confused with unipolar depression, which can delay diagnosis.
Cyclothymic disorder
Involves milder and chronic oscillations between symptoms of hypomania and mild depression, without meeting all criteria for a full manic or depressive episode.
Symptoms of bipolar disorder
Symptoms vary according to the phase the patient is in. See the main characteristics of each state:
During mania or hypomania:
Excessive euphoria or irritability
Increased energy and physical activity
Decreased need for sleep
Rapid speech and racing thoughts
Impulsive decision-making and risky behaviors (excessive spending, drug use, unprotected sex)
Feelings of grandiosity or power
During depression:
Deep sadness, hopelessness
Loss of interest in previously enjoyable activities
Changes in sleep (insomnia or excessive sleep)
Fatigue, difficulty concentrating
Changes in appetite and weight
Thoughts of death or suicide
Causes of bipolar disorder
The exact causes are not fully understood, but several factors may contribute to the onset of bipolar disorder:
Genetics: people with a family history have a higher risk of developing the disorder.
Chemical changes in the brain: imbalances in neurotransmitters such as dopamine and serotonin are related to mood changes.
Environmental factors: intense stress, childhood trauma, or significant life events can trigger the first episodes.
Substance use: alcohol, drugs, or even medications can precipitate or worsen mood episodes.
Diagnosis
Bipolar disorder diagnosis is made by a psychiatrist, based on the patient’s clinical history, symptom reports, and when possible, family observations. There are no specific lab tests for diagnosis, but tests may be useful to exclude other causes.
Because it is a condition that manifests variably, bipolar disorder often takes time to be correctly identified. In some cases, the patient is treated only for depression, which may worsen the condition if manic episodes go undetected.
Treatment
Treatment of bipolar disorder is multidisciplinary and aims to stabilize mood and prevent relapses. The main approaches include:
Mood stabilizing medications, such as lithium or anticonvulsants
Atypical antipsychotics, in more severe or resistant cases
Antidepressants, with caution, as they can induce mania if used alone
Psychotherapy, especially cognitive-behavioral therapy, which helps identify triggers and regulate emotions
Lifestyle changes, focusing on regular sleep, balanced diet, physical activity, and stress reduction
It is important to highlight that treatment should be continuous, even during stable periods, to prevent new episodes.
Myths and truths about bipolar disorder
“People with bipolar disorder are dangerous” — Myth. Most people with bipolar disorder do not pose a risk to others, especially when under treatment.
“Bipolar disorder is just a mood variation” — Myth. The changes are intense, lasting, and affect many areas of a person’s life.
“People with bipolar disorder cannot work or have a normal life” — Myth. With proper treatment, many people have careers, relationships, and quality of life.
Living with bipolar disorder
Support from family, friends, and the healthcare team is essential. Creating a healthy routine, identifying early warning signs, and having a defined action plan with the doctor help maintain stability. Diagnosis may be difficult at first, but understanding the condition is the first step to learning to live well with it.
