Skip to content

Bipolar disorder

Start here to learn what bipolar disorder is, how mood episodes present, and which supports help people live well.

Patients, families, and clinicians can use these sections to move from education to actionable medication planning.

Understanding bipolar disorder

Bipolar disorder is a brain-based condition marked by shifts in energy, activity, and mood that can range from elevated to depressed states.

  • About 2.8% of U.S. adults—roughly 7 million people—experience bipolar disorder in a given year, with Bipolar I, Bipolar II, and related spectrum presentations.
  • Mood episodes differ from ordinary ups and downs: they last days to weeks and can affect sleep, thinking, and safety.
  • A combination of genetics, biology, and life stressors influences risk; no single cause or personality type predicts who is affected.

Mania involves at least seven days of elevated or irritable mood; Hypomania is shorter and less disruptive but still clinically significant.

Common signs across mood episodes

Recognizing early cues helps people seek support before symptoms escalate.

  • Warning signs of an approaching manic or hypomanic episode include decreased need for sleep, racing thoughts, rapid speech, or impulsive decisions.
  • Bipolar depression can present with low energy, loss of interest, slowed thinking, and heightened suicide risk.
  • Mixed features combine elevated energy with depressive mood, often increasing anxiety and agitation.

Track patterns in a mood journal or app; sharing trends with clinicians can speed adjustments.

Evaluation and diagnosis

Diagnosis typically starts with a comprehensive medical and psychiatric assessment.

  • Expect lab work and medication reviews to rule out thyroid issues, substance effects, or other causes of mood shifts.
  • Clinicians gather timelines of mood episodes, sleep changes, trauma history, postpartum events, and family history of mood disorders.
  • Bringing a support person and episode notes can clarify how symptoms impact daily life.

Treatment options and recovery planning

Long-term recovery usually blends medication, psychotherapy, lifestyle adjustments, and community supports.

  • Mood stabilizers such as lithium and valproate help prevent relapse and require TDM or lab monitoring.
  • Second-generation antipsychotics (SGAs) like quetiapine, lurasidone, and cariprazine treat acute mania and bipolar depression.
  • Therapies—cognitive behavioral therapy, family-focused therapy, interpersonal and social rhythm therapy—reinforce routines and coping strategies.
  • Healthy habits (consistent sleep, nutrition, movement, and substance moderation) reduce relapse risk.

Living well day to day

Practical supports make it easier to manage work, school, and relationships.

  • Use shared calendars, medication reminders, and mood tracking tools to stay ahead of appointments and episode cues.
  • Build a personalized wellness plan that lists favorite coping skills, support contacts, and warning signs.
  • Discuss workplace or academic accommodations (flexible scheduling, exam adjustments) through ADA or campus disability services.

Transitions—postpartum periods, shift work, or travel—may require additional planning with the care team.

Supporting someone with bipolar disorder

Care partners can encourage recovery while protecting their own wellbeing.

  • Hold calm conversations about safety, medications, and goals when everyone is rested and regulated.
  • Set boundaries around finances, sleep, and household responsibilities; revisit agreements as symptoms evolve.
  • Explore education programs like NAMI Family-to-Family, peer support groups, or local clubhouse models.

Encourage crisis planning and advanced directives so everyone knows how to respond if symptoms escalate.

When to seek urgent help

Some mood changes require emergency support.

  • Call or text **988** in the U.S. for the Suicide & Crisis Lifeline, or reach out to local mobile crisis teams for in-person evaluation.
  • Immediate help is needed for suicidal thoughts, hallucinations encouraging harm, or severe mania that disrupts safety or judgment.
  • Work with clinicians to create a crisis plan covering preferred hospitals, medication lists, emergency contacts, and wellness tools.

Medication scenarios to discuss with your team

Acute mania & mixed features

Compare lithium, valproate, and SGAs when rapid calming and mood stabilization are priorities.

Evidence Library — valproate RCTs and lithium meta-analyses keep teams aligned with recent trials.

Medication roadmap for teams

Ready to customize regimens? Use these shortcuts to the tools clinicians rely on.

  • Launch the medication compare tool to enter custom combinations and export shareable links.
  • Visit individual drug pages for Monitoring & Labs tables, printable summaries, and DailyMed references.
  • Use the updates log to confirm when data or labels were last refreshed.

Monitoring checklists and safety pearls

Pair each medication decision with ongoing lab work and side-effect discussions.

  • Track weight, BMI, fasting lipids, and glucose for SGAs with higher metabolic burden.
  • Review hepatic labs for valproate, renal/thyroid labs for lithium, and rash assessments for lamotrigine.
  • Toggle compare-table risk badges (sedation, EPS, QTc, Prolactin) to align regimens with lifestyle goals.

Staying current with research

Keep pace with guidelines and trials tied to your chosen regimen.

Medication index

Browse all medication pages covered by this hub. Use Compare for side-by-side decisions and Evidence for curated studies.

Mood stabilizers (7)
Oral antipsychotics (SGAs) (21)
Oral antipsychotics (FGAs) (4)
Long-acting injectable antipsychotics (LAI formulations) (10)

Frequently asked questions

Can people with bipolar disorder lead stable lives?

Yes. Many people manage bipolar disorder with medication, therapy, structured routines, and support networks. Recovery does not erase mood episodes, but it helps people pursue goals and relationships that matter to them.

What should I bring to my appointments?

Bring a mood chart or journal, medication list, lab results, and questions about side effects, pregnancy planning, or lifestyle changes. Consider inviting a trusted support person for shared note-taking.

How often is this hub updated?

We refresh monitoring guidance, compare presets, and evidence links whenever labels or guidelines change. Check the Evidence and Medication roadmap sections for the latest updates tied to specific medications.