Frequently Asked Questions

Bipolar disorder is a chronic mental health condition characterized by extreme mood swings—from emotional highs (mania or hypomania) to lows (depression). It affects approximately 2.8% of U.S. adults and typically develops in late adolescence or early adulthood.

Bipolar disorder is a lifelong condition that cannot be cured, but it can be effectively managed with proper treatment. With medication, therapy, and lifestyle management, 80-90% of people achieve significant symptom relief and lead fulfilling, productive lives.

No. Everyone experiences mood fluctuations, but bipolar episodes are distinctly different:

• They're severe and prolonged (lasting days to weeks)
• They significantly impair functioning
• They involve characteristic symptoms (decreased need for sleep, racing thoughts, etc.)
• They're a marked change from the person's baseline behavior

Genetics play a significant role. If you have a first-degree relative (parent or sibling) with bipolar disorder, your risk is about 10%, compared to 2-3% in the general population. However, most people with a family history never develop the condition, and many people with bipolar have no family history. Environmental factors also play a role.

There's no blood test or brain scan for bipolar disorder. Diagnosis is based on a comprehensive evaluation by a mental health professional that includes:

• Psychiatric interview about symptoms and history
• Family mental health history
• Physical exam to rule out medical causes
• Assessment against DSM-5 criteria

On average, it takes 10 years from symptom onset to receive a correct diagnosis. This happens because:

• People often seek help during depression, not mania (missing the full picture)
• Hypomania can feel good and go unreported
• Symptoms can overlap with other conditions
• Young people may be misdiagnosed with other conditions first

Bipolar I involves full manic episodes lasting at least 7 days (or severe enough to require hospitalization). Depressive episodes are common but not required for diagnosis.

Bipolar II involves hypomanic episodes (less severe than full mania, lasting at least 4 days) AND major depressive episodes. Bipolar II is not "milder"—the depression is often more frequent and severe.

The main medication categories include:

• Mood stabilizers: Lithium, valproate, carbamazepine
• Atypical antipsychotics: Quetiapine, olanzapine, aripiprazole, lurasidone
• Anticonvulsants: Lamotrigine (especially for depression prevention)
• Antidepressants: Used cautiously, only with a mood stabilizer

No. This is one of the most important things to understand: feeling better is a sign that treatment is working, not that you no longer need it. Stopping medication—especially abruptly—significantly increases the risk of relapse. Studies show that stopping lithium increases relapse risk by 28 times in the first year. Always consult your doctor before making any changes.

Antidepressants can trigger manic episodes or "rapid cycling" in people with bipolar disorder. They should only be used alongside a mood stabilizer or antipsychotic, under careful supervision. Some people with bipolar cannot tolerate antidepressants at all.

It varies by medication and individual:

• For acute mania: Antipsychotics may help within days; lithium takes 1-2 weeks
• For depression: Typically 2-6 weeks
• For maintenance: Full benefit may take months

Finding the right medication or combination often requires patience and trials.

Episode duration varies:

• Manic episodes: At least 7 days by definition; untreated can last weeks to months
• Hypomanic episodes: At least 4 days; typically shorter than mania
• Depressive episodes: At least 2 weeks; often last longer than manic episodes

With treatment, episodes are typically shorter and less severe.

Common triggers include:

• Sleep disruption (both deprivation and oversleeping)
• High stress or major life changes
• Substance use (alcohol, drugs, caffeine)
• Seasonal changes
• Medication non-adherence
• Irregular routines

Triggers are individual—mood tracking helps identify your personal patterns.

Mixed episodes (or "mixed features") involve symptoms of both mania and depression at the same time—for example, feeling very energized while also hopeless. Mixed episodes are particularly dangerous because they combine depressive thoughts with the energy to act on them, increasing suicide risk.

Alcohol is generally discouraged. It can:

• Trigger mood episodes
• Interfere with medications (especially lithium)
• Disrupt sleep
• Impair judgment
• Increase impulsivity

If you do drink, do so in moderation and discuss limits with your doctor.

Absolutely. Many successful professionals, artists, executives, and entrepreneurs have bipolar disorder. Keys to success include consistent treatment, managing stress, maintaining routines, and knowing your limits. You're protected under the ADA and don't have to disclose your diagnosis to employers.

In serious relationships, sharing your diagnosis is generally recommended. Benefits include:

• Your partner can recognize warning signs
• It builds trust and intimacy
• They can support your treatment
• It explains past behavior

Timing is personal—wait until you feel secure in the relationship. Consider involving your partner in therapy or psychoeducation.

Yes, many people with bipolar disorder have healthy families. Important considerations:

• Plan pregnancy with your psychiatrist (some medications have risks)
• Postpartum period has higher episode risk—plan monitoring
• Your child has ~10% risk if one parent has bipolar (~25% if both parents)
• Build a strong support system

1. See a mental health professional (psychiatrist or psychologist) for evaluation
2. Bring a list of your symptoms, including any past "high" periods
3. Share your family mental health history
4. Be honest about substance use
5. Consider bringing a trusted friend/family member who can describe behavior changes

Options include:

• Community mental health centers (sliding scale fees)
• Federally Qualified Health Centers
• University training clinics
• Medicaid (if eligible)
• Manufacturer patient assistance programs for medications
• SAMHSA helpline: 1-800-662-4357 for referrals

If you're experiencing thoughts of suicide or are in crisis:

• 988 Suicide & Crisis Lifeline: Call or text 988
• Crisis Text Line: Text HOME to 741741
• Emergency: Call 911 or go to your nearest ER

You are not alone. Help is available 24/7.