• Mental Health

What Causes Bipolar Disorder​? How Do I Know If I Have it?

Published: July 16, 2025
Updated: July 16, 2025
5 mins

Bipolar disorder affects millions of people worldwide, yet it’s still widely misunderstood. Often mistaken for ordinary moodiness, this complex mental health condition can significantly impact relationships, work, and everyday decision-making.

Recognizing the signs and understanding the causes of bipolar disorder is crucial – not just for those who live with it, but also for friends, partners, and family members trying to offer support. With the right diagnosis and treatment, people with bipolar disorder can manage symptoms and lead meaningful, balanced lives.

What is Bipolar Disorder?

Bipolar disorder is a mental health condition characterized by drastic shifts in mood, energy, and activity levels. These changes go beyond typical ups and downs – they can interfere with daily responsibilities and relationships when left untreated.

There are three main types of bipolar disorder:

• Bipolar I disorder: Involves manic episodes that last at least seven days or are severe enough to require hospitalization. Depressive episodes often follow and typically last at least two weeks.

• Bipolar II disorder: Involves a pattern of depressive episodes and hypomanic episodes, which are less severe than full-blown mania. People with Bipolar II often spend more time in depression.

• Cyclothymic disorder (cyclothymia): Includes periods of hypomanic and depressive symptoms that are less intense but more chronic, lasting two years or more.

Whether someone is dealing with short bursts of energy or prolonged sadness, bipolar disorder doesn’t look the same for everyone. That’s why early recognition and personalized treatment are key to managing the condition effectively.

Signs and Symptoms of Bipolar Disorder

The symptoms of bipolar disorder can vary widely from person to person, but they almost always involve noticeable shifts in mood, energy, and behavior. Understanding the different phases of the illness can help you recognize the signs of bipolar disorder early and seek support before symptoms worsen.

Mania and hypomania

One of the most distinct bipolar symptoms is mania – or in milder cases, hypomania. During these phases, a person may feel unusually energetic, euphoric, or invincible. Common symptoms of bipolar mania include:

• Racing thoughts of rapid speech

• Inflated self-esteem or grandiosity

• Decreases need for sleep

• Impulsive or high-risk behaviors (such as reckless spending or unsafe sex)

Depressive episodes

On the opposite end of the spectrum are depressive episodes – periods marked by deep sadness, low motivation, and emotional exhaustion. These episodes often resemble clinical depression and may include:

• Persistent low mood or hopelessness

• Fatigue or sluggishness

• Changes in appetite or weight

• Difficulty concentrating or making decisions

• Loss of interest in activities once enjoyed

• Sleep disturbances (either insomnia or oversleeping)

• Thoughts of death or suicide

For many, the depressive phase of bipolar disorder is more frequent and longer-lasting than the manic phase.

Mixed episodes

Some individuals experience mixed episodes, where symptoms of both mania and depression occur at the same time. This can feel especially distressing – for example, having racing thoughts and agitation while also feeling hopeless or emotionally numb. Mixed episodes often lead to greater emotional instability and a higher risk of self-harm.

Early warning signs

Recognizing the early signs of bipolar can help prevent a full-blown episode. These may appear subtly at first, such as:

• Increased irritability or agitation

• Unusual mood swings not tied to external events

• Risk-taking or impulsive decision-making

• Trouble sleeping

• Feeling overly confident or restless for no clear reason

Identifying these bipolar disorder signs early – either in yourself or a loved one – can be the first step toward getting a proper diagnosis and building an effective treatment plan.

Bipolar Symptoms in Women: Are They Different?

While bipolar disorder symptoms can affect anyone, research suggests that the condition may show up differently in women. These differences aren’t just biological – they’re also shaped by hormones, life events, and how symptoms are perceived or diagnosed.

Women with bipolar disorder are more likely to:

• Experience more frequent depressive episodes than manic ones

• Have a later age of onset, often during hormonal shifts (like pregnancy or postpartum)

• Be misdiagnosed with depression before a proper bipolar disorder diagnosis is made

• Experience more rapid cycling, with four or more mood episodes in a year

Hormonal changes can intensify bipolar symptoms in women, especially during menstruation, pregnancy, or menopause. For some, mood episodes align closely with these hormonal fluctuations, which can make the condition harder to manage without specialized care.

It’s also worth noting that women are more likely to seek help during depressive phases than manic ones – meaning the full pattern of bipolar disorder signs may not be immediately obvious. That’s why it’s important to track patterns over time and work with a provider familiar with gender-specific presentations of bipolar disorder.

What Can Cause Bipolar Disorder?

Understanding what causes bipolar disorder can be complicated. While there’s no single reason someone develops the condition, research points to a combination of genetics, brain chemistry, and life experiences.

Is bipolar disorder genetic?

Yes, bipolar disorder is genetic – to some degree. If a close relative, such as a parent or sibling, has bipolar disorder, your risk of developing it increases. In fact, studies show that individuals with a family history are up to 10 times more likely to be diagnosed themselves.

But it’s not strictly hereditary. You might carry a genetic predisposition without ever developing symptoms. Likewise, someone with no family history can still be diagnosed.

Brain structure and chemistry

Differences in brain function may also play a role. People with bipolar disorder often show imbalances in neurotransmitters like dopamine and serotonin, which regulate mood, energy, and decision-making. Imaging studies also suggest that certain areas of the brain involved in emotion and impulse control may function differently in people with the condition.

Environmental triggers

Even if someone is genetically predisposed, certain life events can act as triggers. These may include:

• Traumatic or highly stressful experiences

• Substance use or withdrawal

• Major life changes (e.g., loss of a loved one, relationship breakdown, job changes)

• Sleep disturbances

These external factors don’t cause bipolar disorder on their own, but they can spark the first episode or worsen existing symptoms in someone already at risk.

How Bipolar Disorder Shapes Thoughts and Emotions

Bipolar disorder doesn’t just affect mood – it also changes how a person thinks, perceives situations, and responds emotionally. These shifts can be subtle or intense, depending on the type and phase of the illness.

During manic or hypomanic episodes, thoughts often feel sped up or scattered. A person may jump quickly from one idea to another, speak rapidly, or have difficulty focusing. This can lead to overconfidence, grand ideas, and impulsive decisions that seem logical in the moment but risky in hindsight.

On the other end, depressive episodes can cloud judgment. Thoughts may become negative, self-critical, or hopeless. It’s common to feel overwhelmed by simple tasks or convinced that nothing will ever improve. Even positive feedback may feel hard to believe.

So, how does a person with bipolar think? The answer depends on where they are in their mood cycle. During mania, thoughts might feel powerful and creative; during depression, they may feel stuck, heavy, or distorted by pessimism. And in a mixed episode, those racing thoughts can coexist with deep emotional pain – making it especially difficult to cope or seek help.

Understanding these shifts is critical – not just for those living with bipolar disorder, but for loved ones who may misinterpret the emotional extremes. Recognizing that these thought patterns are part of the illness can reduce stigma and open the door to more compassionate support.

How is Bipolar Disorder Diagnosed?

Diagnosing bipolar disorder isn't as simple as checking off a list of symptoms. Because bipolar disorder symptoms often overlap with other mental health conditions – like depression, ADHD, or anxiety – getting an accurate diagnosis requires a careful and thorough process.

Clinical interviews

A mental health professional typically starts with a clinical interview. This includes detailed questions about your current symptoms, mood patterns, sleep, energy levels, and behavior over time. You may be asked about any recent mood swings, how long they lasted, and how they affected your ability to function.

Psychiatric and medical history

Your personal and family psychiatric history plays a major role in diagnosis. Since bipolar disorder can run in families, it’s important to share whether any close relatives have experienced mood disorders, especially if they've been diagnosed with bipolar disorder, depression, or schizophrenia.

Clinicians also consider your medical history and may run tests to rule out physical causes that could mimic mood symptoms – such as thyroid issues or side effects from medications.

Ruling out other conditions

Many people are initially misdiagnosed with unipolar depression or ADHD. That’s because the first symptoms someone experiences with bipolar disorder are often depressive, not manic. And symptoms like impulsivity or restlessness can also show up in other conditions.

What sets bipolar disorder apart is the presence of manic or hypomanic episodes – periods of unusually high energy, decreased need for sleep, or impulsive behavior that are not caused by substances or another medical condition.

Why diagnosis can take time

It’s not uncommon for someone to go years without a correct diagnosis. Many people seek help during depressive episodes, when signs of mania are either not present or not recognized as part of a larger pattern. This is why mental health professionals may want to observe symptoms over time before confirming a diagnosis.

In some cases, family input or mood tracking tools can help clarify the full picture, especially if symptoms fluctuate or appear subtly.

Can Online Bipolar Tests Help?

If you’ve ever searched for a bipolar test or taken a quick bipolar quiz online, you’re not alone. These self-assessments are often the first step people take when trying to understand mood swings, energy shifts, or emotional ups and downs. 

Online tools like a bipolar disorder test or a test for bipolar depression can sometimes raise awareness of common symptoms – such as impulsivity, sleep changes, or periods of intense sadness or euphoria. These quizzes may ask whether you’ve experienced dramatic mood shifts or had trouble maintaining stability in your daily life.

While they can help you reflect on your experiences, these tests are not diagnostic. Scoring “high” on a quiz doesn’t mean you have bipolar disorder, and a low score doesn’t rule it out. That’s because only a licensed mental health professional can assess whether your symptoms meet the clinical criteria for diagnosis.

Can Bipolar Disorder Be Cured?

There’s currently no cure for bipolar disorder, but that doesn’t mean there’s no hope. With the right treatment plan, many people living with bipolar can manage their symptoms, stabilize their moods, and lead fulfilling, productive lives.

Because bipolar disorder symptoms tend to be lifelong and cyclical, the goal of treatment isn’t to erase the condition – it’s to reduce the intensity and frequency of mood episodes. This often involves a combination of:

• Medication (like mood stabilizers or antidepressants)

• Ongoing therapy (such as CBT or interpersonal therapy)

• Lifestyle strategies (including regular sleep, routine, and stress management)

Treatment is highly individual. What works well for one person may need to be adjusted for another, especially as symptoms shift over time.

Even when symptoms improve, long-term support is key. Many people experience periods of stability punctuated by relapses, especially during times of stress or sleep disruption. That’s why maintenance treatment, strong social support, and early intervention when symptoms return are so important.

While bipolar disorder isn’t curable in the traditional sense, many people thrive with it – especially once they receive an accurate diagnosis, understand their patterns, and commit to a care plan.

How Can LifeMD Help?

Bipolar disorder is too often an isolating experience for those with the condition. At LifeMD, a licensed healthcare provider can work with you to help manage bipolar disorder in your daily life.

LifeMD works with insurance plans that cover mental health services for at least 95% of our patients. Still, there are tips and alternative options for care for people without health insurance. You don’t have to figure out how to live with bipolar disorder or any other mental health challenges alone.

Get started today by exploring diverse options for bipolar disorder treatment.

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