Signs & Symptoms of Bipolar Disorder

Learn more about the causes, symptoms, and effects of bipolar disorder. Understanding what you or your loved one is going through can be the first step to getting help.

Understanding Bipolar Disorder

Learn about bipolar disorder

Bipolar disorder is a severe mental illness that plagues countless individuals of all ages throughout the world. Characterized by its ability to wreak havoc on the lives of those who are afflicted by it, bipolar disorder causes individuals to experience such dramatic changes in mood that it interferes with their ability to function appropriately on a daily basis. These people tend to experience such strong emotional disturbances that it impairs their ability to fulfill obligations, perform at the expected level at work or school, interact socially, or even take care of seemingly mundane daily responsibilities.

When individuals receive a diagnosis of bipolar disorder, it is classified into one of three types, as determined by the type and severity of the symptoms present. These three types are described briefly in the following:

Bipolar I is the most severe of the three types. Individuals with bipolar I experience such drastic shifts in mood that their ability to function is significantly hindered and disruptions occur in most, if not all, aspects of their lives. The episodes of mania and depression that are distinctive of bipolar I may last for prolonged periods of time before alternating or may shift consistently, which is known as rapid cycling.

Bipolar II is a less severe form of bipolar I where individuals experience pervasive episodes of depression, but have also experienced at least one hypomanic episode. Hypomania is a milder form of mania and the presence of such is what distinguishes a diagnosis of bipolar II from a diagnosis of depression.

Cyclothymia is considered to be the mildest type of bipolar disorder. Individuals with cyclothymia experience episodes of depression and hypomania, yet these episodes are significantly less severe than those experienced by people with bipolar I or bipolar II.

Causes and Risk Factors

Causes and risk factors for bipolar disorder

Rather than there being one specific cause for the onset of bipolar disorder, researchers in the field believe that there are multiple components that contribute to its development. Consider the following:

Genetic: A highly weighted factor in the development of bipolar disorder lies in an individual’s genetic background. Studies have shown that children of parents who have bipolar disorder have a 15-25% greater chance of developing the illness than do individuals who do not have similar genetic backgrounds. Furthermore, when children have parents with bipolar disorder, they are believed to experience the onset of symptoms on an average of 10 years earlier than when their parents did.

Physical: Chemical imbalances in the brain play the most dominant role in the development of bipolar disorder. Neurotransmitters are the chemicals that are responsible for sending messages throughout the various areas of the brain and, when they become imbalanced, the risk that an individual will experience the onset of symptoms of bipolar disorder rises exponentially.

Environmental: Environmental factors can play a role in the onset of bipolar disorder when an individual has a genetic predisposition for the illness. Examples of such environmental factors can include experiencing trauma, going through major life changes, or being the victim of ongoing abuse and/or neglect. In addition, the chemical changes that occur in the brain when an individual abuses drugs and/or alcohol can lead to an earlier presentation of symptoms or a much more rapid onset of symptoms when someone has a genetic predisposition for bipolar disorder.

Risk Factors:

  • Family history of mental illness (especially when there is a history of bipolar disorder or depression)
  • Presence of preexisting mental illness (such as anxiety)
  • Personal or family history of substance abuse
  • Being the victim of various types of abuse or neglect (when there exists a genetic predisposition for the disorder)
  • Experiencing severe trauma (when there exists a genetic predisposition for the disorder)
  • Going through significant or stressful life changes (when there exists a genetic predisposition for the disorder)

Signs and Symptoms

Signs and symptoms of bipolar disorder

The signs and symptoms that are indicative of the presence of bipolar disorder will vary drastically depending upon whether someone is experiencing a manic episode or a depressive episode. Additionally, symptoms will typically be displayed differently in adolescents than they will be in adults. Examples of possible signs and symptoms that may be exhibited by an individual who is suffering from bipolar disorder can include, but are not limited to, the following:

Behavioral symptoms:

  • Frequent absences from school or work
  • Talking to oneself
  • Acting impulsively
  • Verbal and/or physical aggression
  • Hypersexuality
  • Instigative behaviors
  • Self-harming behaviors
  • Responding to external stimuli that others cannot see or hear
  • Jumping from one topic to another when in conversation with others
  • Restlessness
  • Starting multiple tasks but failing to complete any of them

Physical symptoms:

  • Vocal and/or motor tics
  • Alternating between insomnia and hypersomnia
  • Teeth grinding
  • Fluctuations in bodily temperature
  • Changes in eating patterns
  • Weight loss or gain
  • Alternating between heightened levels of energy and lacking energy
  • Exaggerated startle response
  • Heightened states of arousal

Cognitive symptoms:

  • Flight of ideas
  • Racing thoughts
  • Inability to focus
  • Night terrors
  • Poor working memory
  • Hallucinations (typically in the form of visual hallucinations)
  • Delusions

Psychosocial symptoms:

  • Dramatic mood swings
  • Exaggerated startle response
  • Exaggerated feelings of elation
  • False and problematic feelings and presentations of grandiosity
  • Excessive anxiety
  • Prolonged periods of emotional excitability, alternating with periods of emotional detachment
  • Extreme irritability
  • Extreme agitation
  • Fluctuating between inflated or drastically low self-esteem
  • Feelings of rage
  • Debilitating feelings of depression
  • Suicidal ideation


Effects of bipolar disorder

When people are suffering from bipolar disorder and do not receive appropriate treatment, there can be a number of long-term effects that arise. Such effects will vary amongst individuals, but may include, but are not limited to, the following:

  • Academic or occupational failure
  • School refusal
  • Frequent absences from work
  • Onset of self-harming behaviors
  • Onset of symptoms synonymous with other mental health conditions
  • Substance abuse
  • Social isolation
  • Disturbed or problematic social interactions
  • Relationship discord
  • Criminal involvement, including incarceration
  • Suicidal thoughts and behaviors

Co-Occurring Disorders

Bipolar disorder and co-occurring disorders

There are many instances in which individuals who have bipolar disorder are diagnosed with a co-occurring disorder. In some cases, the additional symptoms that are present will overlap or mirror those that are characteristic of bipolar disorder, yet an additional diagnosis will be provided in order to ensure that effective treatment can be received. Examples of mental illnesses that are known to exist alongside bipolar disorder include:

  • Generalized anxiety disorder
  • Social anxiety disorder
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Eating disorders
  • Substance use disorders
  • Posttraumatic stress disorder (PTSD)
  • Conduct disorder
  • Oppositional defiant disorder (ODD)

My severe depression had taken over my life. I’m so thankful for San Juan Capestrano Hospital for giving me the strength to start living my life again to the fullest.

– Luis S.