What is Bipolar Disorder? Understanding Symptoms and Types

The Sagent Behavioral Health providers consulted for this article on bipolar disorder are Dr. Karin Ryan, LP and Brett Cushing, LMFT, hosts of the Everyday Therapy Podcast.        

Bipolar disorder is one of the most internet-searched for mental health conditions, yet it is often misunderstood and underdiagnosed. Many people know the term but aren’t always sure what it actually looks like, or how to recognize it in real life. 
 
In the United States, about 2.8% of adults experience bipolar disorder every year, with symptoms most often beginning around the age of 25. Even so, understanding the signs can be complicated and unique to each individual. This guide explains bipolar disorder, the difference between Bipolar I and Bipolar II, and how seeking early support can make a meaningful difference. 

What is Bipolar Disorder? 

Bipolar disorder can present differently from person to person, but it is a mood disorder characterized by cycles of emotional highs (mania or hypomania) and lows (depression) that can significantly disrupt daily life.  

During a manic or hypomanic episode, someone may feel unusually energized and engage in risky or impulsive behaviors. During depressive episodes, that same person may feel deeply fatigued or hopeless and disconnect themselves from others by self-isolating. 

These episodes last days or months, and the patterns can make it hard to accomplish daily tasks and live in a way that feels steady or predictable.

What Causes Bipolar Disorder?

It is important to note that bipolar disorder is a medical condition influenced by biological, genetic, and environmental factors. It is not a personality trait or someone simply being “moody”. 

There is no single cause of bipolar disorder, rather, it develops from a combination of factors:  

• Genetics: Bipolar disorder often runs in families, so having a close relative with the condition can increase risk.  

• Brain and biological factors: Differences in brain structure and neurotransmitter activity may play a role in how mood is regulated. These biological factors can affect how the brain responds to stress, sleep, and emotional stimuli. 

• Environmental influences: Life experiences can also contribute to the onset or progression of bipolar disorder. High stress, major life changes, trauma, sleep disruption, or substance use can act as triggers, especially for individuals who are already more vulnerable. 

In many cases, bipolar disorder develops when these factors overlap rather than from a single cause on its own.  

What’s the Difference Between Bipolar I vs. Bipolar II? 

While each bipolar disorder case is unique, it is generally categorized into two main types: 

Bipolar I Disorder 

Bipolar I is defined by at least one manic episode that lasts at least one week or is severe enough to require hospitalization. Depressive episodes are common in Bipolar I but are not required for an official diagnosis.  

Bipolar II Disorder 

Bipolar II involves a pattern of major depressive episodes along with hypomanic episodes that last at least four consecutive days. Hypomania includes similar symptoms to mania like increased energy and elevated mood but is less severe and does not cause the same level of disruption or risk of psychosis.  

In Bipolar II, hypomania is often difficult to recognize because it is milder and more subtle than the mania seen in Bipolar I. When hypomania goes unnoticed, clinicians may focus only on the depressive episodes, increasing the likelihood of a misdiagnosis of depression. 

What Do Manic and Hypomanic Episodes Feel Like? 

Manic and hypomanic episodes in bipolar disorder go far beyond simply feeling good or being happy.  They’re a noticeable shift from how someone thinks, feels, and functions.  

Mania (Bipolar I) 

Mania often feels intense and hard to slow down. Someone may feel unusually confident or energized, like their thoughts are moving faster than they can keep up with. Sleep may feel unnecessary, and decisions can become more impulsive or risky. 

Over time, this level of intensity can disrupt relationships, work, and overall stability. In some cases, it may require hospitalization for safety and stabilization.  

Common experiences during mania due to bipolar disorder include: 

• Feeling unusually elevated, wired, or easily irritated  

• Sleeping very little without feeling tired  

• Talking quickly or jumping between ideas  

• Taking on too much or making impulsive decisions  

• Feeling unusually confident or invincible  

Hypomania (Bipolar II)  

Hypomania often feels similar, but not as intense. It can be less disruptive and may even feel productive at first. Someone might feel more energized, social, or creative than usual. 

Because of this, hypomania can be easy to miss. However, these episodes often come with consequences over time like overcommitting, burnout, or strain in relationships. 

Common experiences during hypomania include: 

• Increased energy and activity  

• Feeling more productive or creative than usual  

• Needing less sleep  

• Talking more or feeling more social  

• Mild impulsivity or difficulty slowing down  

Even if hypomania feels manageable, it’s often followed by a depressive episode, which can be more difficult and longer lasting than the elevated period itself.

What Does a Depressive Episode Feel Like? 

A depressive episode can feel like a heavy emotional and physical slowdown. Symptoms include low mood, loss of interest, fatigue, and difficulty concentrating. Even simple tasks can feel overwhelming, and it may be hard to find motivation or a sense of hope. These episodes typically last at least two weeks, but they can extend for months or longer if left untreated. 

How is Bipolar Disorder Managed? 

The good news is that bipolar disorder is highly treatable with the right support. While it is often a lifelong diagnosis, with the right care plan, many people can manage symptoms effectively and live stable lives.  

Treatment options often include:

Medication: Mood stabilizers, antipsychotics, or other medications may be used to help regulate mood and prevent manic episodes.  

Therapy and lifestyle support: Evidence-based approaches like cognitive behavior therapy (CBT), family-focused therapy and psychoeducation can help offer stability. Maintaining consistent routines, prioritizing sleep, managing stress, and building a strong support system are also key components of care. 

When To Seek Professional Support 

Mood changes are a normal part of life, but persistent or extreme shifts in mood, energy or behavior may signal a mental health condition that could benefit from professional support. Early evaluation and treatment can reduce symptom severity, prevent further complications, and improve long-term outcomes.  

Make an appointment with Sagent Behavioral Health if you or someone you care about experiences any of the following: 

• Extreme mood changes 

• Risky behaviors or impaired functioning 

• Persistent depression 

• Thoughts of self-harm 

The trusted team at Sagent will help pair you with the right provider and the right treatment to help you find a stable path forward.  

If you or someone you care about may be experiencing symptoms of bipolar disorder, Sagent’s mental health professionals are here to help. Schedule an appointment today to receive a comprehensive evaluation and personalized support. 

Frequently Asked Questions 

Is Bipolar I or Bipolar II more common?  

Bipolar II is more commonly diagnosed as it includes longer depressive episodes, which are more likely to bring people in for treatment.  

What are 5 signs of bipolar disorder?  

Key signs of bipolar disorder include intense energy, reduced need for sleep, racing thoughts, risky behaviors, and irritability.  

At what age does bipolar start? 

Bipolar disorder most commonly begins between the ages of 15 and 25, though symptoms can appear in childhood or later into adulthood.