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Things You May Not Know About Bipolar Disorder

Updated on March 6, 2017
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Lori Colbo is a certified mental health peer counselor. She shares information found in research and personal experience.

The information in this hub is not meant to assist you in diagnosing yourself, or a loved one. Please see your physician if you have symptoms you believe might be bipolar disorder.

Madness is to think too many things in succession too fast, or of one thing too exclusively."

— Voltaire

Some symptoms of Bipolar


The basic facts of Bipolar disorder

The basic information about mental disorders, specifically Bipolar disorder, given on medical websites and literature, are very generalized. There are so many variables that people may not be aware of - even people who have a Bipolar diagnosis. Bringing to the table in this article is information about Bipolar disorder that go outside the generalized information and rigid rules of diagnosis from the American Psychiatric Association (2013) text. 1

Bipolar is a mood disorder, formerly known as Manic Depressive illness. As you might guess, the word bipolar indicates two opposite poles - the high moods (mania) on one pole, and the low mood (depression) on the other pole. Approximately 5.5 million adults (2.6%) have Bipolar disorder in the United States. 2

Bipolar disorder is characterized by intense mood swings. It is cyclical in nature, although not necessarily in a regular pattern. Bipolar is no respecter of persons - it can occur in anyone, at any age, and at any stage of life. Bipolar tends to run in families. Some research has suggested that people with certain genes are more likely to develop Bipolar disorder than others. Children with a parent or sibling who has bipolar disorder are much more likely to develop the illness, compared with children who do not have a family history of Bipolar disorder.3 Doctors and scientist are still trying to determine the exact cause of this disorder. It is believed that environmental factors are also at play. Following are the basic symptoms of bipolar disorder. You can note that a few of the symptoms are evident in both mania and depression.


  • Feelings of euphoria, invincibility, and grandiosity.
  • Continuous high energy.
  • An abnormally increased level of irritability.
  • A flight of ideas.
  • Rapid speech and jumping from one topic to another.
  • Decreased amount of sleep.
  • Pleasure-seeking and increased risk taking behavior (spending sprees, risky sex etc.).
  • Racing thoughts or jumping from one idea to another.
  • Easily distractible.
  • Feeling agitated or jumpy.


  • Extended period of sadness, hopelessness, helplessness, and low self-esteem.
  • Decreased energy and fatigue.
  • Lack of interest in things that once brought pleasure.
  • Inability to make decisions.
  • Inability to concentrate.
  • Being agitated.
  • Slow movement, speech and thought.
  • Thoughts of suicide and/or attempts at suicide.

Bipolar depression.
Bipolar depression. | Source

Types of Bipolar

Some doctors and scientists believe there are only three types of Bipolar - Bipolar l, Bipolar ll, and Cyclothymia. Following are the traditional forms of thought on bipolar types. 4

Bipolar l is the most severe form. The mania is the most intense out of all the other types. With Bipolar l, the symptoms can be more extreme than all other types and is said to lead to hospitalization more often; however, I believe this to be far from reality. People with Bipolar ll have to deal with more serious depression at times.

Many people are under the impression that mania is only a positive experience (euphoria, high energy). The fact is, mania can be a very negative experience. Irritability, agitation, psychosis can all be symptoms of mania. In an agitated, irritable state, one may become angry and enraged; thus behavior can be threatening sometimes. However, many people with bipolar do not display aggression at all.

Bipolar l is characterized with the risky behaviors. Hypersexuality is one symptom that might lead to careless, impulsive sexual encounters. Or mania might cause one to go on spending sprees or make poor business decisions.

Bipolar ll is a milder form. The mania's are called hypomania - hypo meaning a lower (or under) mania. Literature often tells you that hypomania is less likely to cause marked impairment. With hypomania one is less likely to have difficulty functioning in their work, social situations, and day to day living. I think it's a case by case situation. Without the right treatment, people with type two can progress to full blown mania. Bipolar ll tends to be more on the depressive side, the depression is much more severe, and there is a higher rate of suicide with this type.

Cyclothymia is the mildest form of Bipolar. They experience milder hypomania and milder depressions. This diagnosis is seldom used because the symptoms are so mild many doctors don't want to characterize it as a bipolar illness.

These are the most commonly known types of Bipolar in the DSM IV and DSM V and other medical texts and publications. The research in recent years, though, has brought a lot more to the table. Bipolar lll, soft Bipolar, Bipolar NOS (not otherwise specified) and the Bipolar spectrum theory, to name a few. 5

Patty Duke on her Bipolar diagnosis

A cycling we will go - rapid cycling

Rapid cycling is something many are not aware of; however it is discussed frequently in medical and mental health educational literature now, and most all psychiatrists are very well informed on it and recognize it in their patients. Rapid cycling is pattern of frequent, severe mood swings. It is most often seen in bipolar ll and in women, but it can happen anywhere on the bipolar spectrum. Statistics show that rapid cycling occurs in ten to twenty percent of people with bipolar disorder. 6

Gloria Hochman describes rapid cycling this way,

"...rapid cyclers," with mood changes colliding with each other, from month to month, day to day, or sometimes even within the same day. These men and women zigzag between highs and lows so rapidly they often feel as though they are about to die. They bounce from euphoria to despair and back again within hours. They are in exquisite pain, out of control, like a race car gone berserk, and sometimes say that they are afraid of being alone with their episodes because they don't know what they will be doing next." 7

It is scary living with moods so powerful, wild, and unpredictable. Suicidal thoughts can arise and become very intense. One anonymous person said, "The person who created the phrase 'Stop the world I want to get off' was experiencing rapid cycling."

In the last century, we didn't hear about rapid cycling. But in recent years doctors, mental health professionals, and researchers have taken due note of this phenomenon in people who struggle with Bipolar (of any type); perhaps because overall, scientists and doctors are more observant as they research bipolar disorder. They believe that the use of antidepressants and stimulants (for people with ADD and ADHD) could be one of the major reasons. Certainly though, other factors could be at play - lack of sleep, more stress, trauma, etc. 8

Mixed mood state? What are you talking about?

A mixed mood, also known as a mixed state, can take someone by storm. It can be one of the most frightening experiences for someone with Bipolar disorder ever. Often it is combined with rapid cycling. One clinician told me a mixed state was mania and depression simultaniously. Huh? That seems impossible. Gloria Hochman describes it as "...a smorgasboard of symptoms that are at odds with each other."

Mixed state is not euphoria and depression simultaneously, but severe depression, severe irritability and agitation, and racing (frenzied) thoughts. Dr. Phelps doesn't beat around the bush when he states "This combination is one of the most dangerous mood states known." The combination of self-loathing, agitation, terror, and despair is indescribable. The risk for suicide is at it's highest in this state.

The mixed state can be one of the most terrifying and dangerous mood states to occur in mental illness.

Extreme moods swings can be terrifying.
Extreme moods swings can be terrifying. | Source

On psychosis

Many professionals will say that psychosis can be one of many symptoms of Bipolar l. The fact is, it is possible with any form of Bipolar, as well as schizophrenia, and severe depression, (including postpartum depression). Brain diseases or conditions, medications, illegal substances like cocaine, meth, and crack, can also cause psychosis. Many of these causes can actually be a result of sleep deprivation. When one is up for days with only a few hours of sleep here and there, or none at all, psychosis can set in.

Psychosis is when a person loses touch with reality. One can have visual or auditory hallucinations, or have irrational, false beliefs or ideas that can't be corrected by reason or confrontation, including paranoia (known clinically as delusions).

I figured I must have this for a reason and I'm supposed to tell people about it."

— Patty Duke
Sleeplessness - symptom of bipolar disorder.
Sleeplessness - symptom of bipolar disorder. | Source

Do you believe a person with bipolar can live a relatively stable, rich and meaningful life?

See results

The issue of sleeplessness

Quality sleep is of the utmost importance for most mental disorders. With bipolar it is probably the most important necessity for stability. Exercise is a close second. For years it was thought that the decreased need for sleep, or decreased sleep, is a symptom of mania. Not necessarily. Experts once grappled with "Is sleeplessness a symptom of mania, leading to depression, or is lack of sleep during depression causing mania?" They have discovered it can be both - either/or. It could be that someone is in a normal state but not sleeping well due to stress or some other non-bipolar related issue, and after a prolonged period, end up in a manic or depressed state. Inability to sleep can both be a symptom of depression. Not sleeping can be a symptom of mania or depression.

A rich and meaningful life is possible - it's true

People with Bipolar and other mental disorders can live wonderful, meaningful, and quality lives. This is not something new. How many people do you know with a serious medical condition that is managed successfully, either by medication, other regular treatments, or just practicing good self-care daily? Think diabetes, for example. It's a very serious disease. For most people, if they practice good self-care with eating, exercise, and whatever else the doctor orders, along with medication, they still can live happy fulfilled lives.

This might be simplifying things a bit, and there are some who have severe cases, but most can live quality lives even as they manage symptoms and all that involves.

It is possible for live a quality, meaningful life.
It is possible for live a quality, meaningful life. | Source

For so many years, decades even, people with mental health challenges have been told they will never get better, that treatment is maintenance and they will have to make do the best they can. Not so. People can do much more than make due. They can do more than survive - they can thrive. Being proactive in other forms of self-care, and having an attitude that living a life as meaningful as everyone else is possible, and establishing and utilizing a healthy support system, one can and will succeed and do so. It takes work, willingness, and healthy support people. This is a fairly new concept for people.

If you struggle with bipolar or some other disorder, or perhaps more than one, don't think that without hard work you can't do anything to make your life better. You CAN! It may not be easy (whose life is), but it will be good quality. It takes willingness to do whatever is necessary.


1 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

2Treatment Advocacy Center. Bipolar Fact Sheet (2011), from

3 National Institute of Mental Health (n.d.). Bipolar Disorder in Adults (NIMH publication No. 12-3679) Revised 2012. Retrieved July 25, 2014 from

4 Phelps, J. (2006). Why Am I Still Depressed?: recognizing and managing the ups and downs of bipolar ll and soft bipolar disorder. New York, NY: McGraw Hill Publishers.

5 Ibid.

6 Web M.D. Medical Reference. Reviewed by Joseph Goldberg MD (2014, May 11). Rapid Cycling in Bipolar Disorder

7 Duke, P. and Hochman, G.(1992). A Brilliant Madness: Living with manic depressive illness. New York, NY: Bantam Books.

8 Phelps, J. (2006). Why Am I Still Depressed?: Recognizing and managing the ups and downs of bipolar ll and soft bipolar disorder. New York, NY: McGraw Hill Publishers. p. 170-171

© 2014 Lori Colbo


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    • Faith Reaper profile image

      Faith Reaper 2 years ago from southern USA

      Thank you for this comprehensive hub on Bipolar disorder. I learned a lot here and I believe it is possible for someone who has such to live a happy and meaningful life, by taking take of oneself as you have indicated here.

      God bless you

    • RachaelOhalloran profile image

      Rachael O'Halloran 2 years ago from United States

      I agree that medication is key, as well as regulating it for each person. But I also believe attitude, education and a good support system are needed. You did a fine job with this hub with up to date information and good examples. Voted up and shared.

    • billybuc profile image

      Bill Holland 2 years ago from Olympia, WA

      Important information for sure my friend. Keep raising awareness and continue to help others by doing so.

    • nanderson500 profile image

      nanderson500 2 years ago from Seattle, WA

      Lots of great information here, and definitely a hopeful message about people with bipolar disorder still being able to live satisfying lives.

    • MsDora profile image

      Dora Isaac Weithers 2 years ago from The Caribbean

      Great information that is new to me. Thank you for these insights and especially for Patty Duke's account. It's good to know that there are effective treatments.

    • Suzanne Day profile image

      Suzanne Day 2 years ago from Melbourne, Victoria, Australia

      I used to think I was bipolar. I was told by others and professionals I was. I also took medication for it. Today, I am not on any of that horrible medication and have decided to call it "moodiness due to life experience and trauma" and just live with it. To be honest, the more I decided to get on with life, the easier it got with the mood swings, especially when I sought out some role models on how to live life well. I am sure a lot of other people suffer the same thing as me.

      The medication can be awful. Yes, you do have less anxiety and more stable moods. But you can get ready to send your doctor an enormous bill for all the car accidents you have due to "relaxing" your moods with pills. Not to mention the relaxed promiscuity and new and relaxed ways of putting your life and health in danger every week. It isn't worth it.

      These drugs are designed to fry your brain and bipolar people are the perfect guinea pigs. Apparently you get addicted after 2 years. Something like 80% of people who take them die from suicide before their 10 years is up. I have personally known a number of people who have died from them. If you are on them, find another way, I beg you!

    • Ericdierker profile image

      Eric Dierker 2 years ago from Spring Valley, CA. U.S.A.

      Very well done article. One thing about the disease is you will never just be able to put it on autopilot again. It takes constant modifications and moderations to keep up with the changes. Vigilance is required.

    • teaches12345 profile image

      Dianna Mendez 2 years ago

      The story behind Duke's quest helped to understand the depth this illness can take in ones life. I found new information on this disorder. Thanks for the education. Well written!

    • lifegate profile image

      William Kovacic 2 years ago from Pleasant Gap, PA

      Hi Lori,

      Well, I think you covered just about everything - at least it seemed to. You did a very thorough and well documented job, and brought attention to this difficult problem. I know of some who suffer from bipolar, and at times he's almost like two different people. Thanks for helping me to understand the situation better.

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      billybuck, I certainly plan to keep informing people. Thanks for your comments.

      Nanderson500, thanks for stopping by.

      Ms. Dora, as always, it's a pleasure to hear from you. Thanks for your comments.

      Eric, thanks for stopping by. You are mostly right about constant modifications and moderations. Really it depends on the severity and other things. For someone with a mild case it may just be that they exercise, eat well, daily, and learn management skills for stress so that it doesn't propel them into an episode. But as you saw, it is hard work to live a quality life. This is true with many medical conditions. But it's worth all the effort.

    • denise.w.anderson profile image

      Denise W Anderson 2 years ago from Bismarck, North Dakota

      I have two children with Bipolar Disorder. One high functioning, as that is the only issue that she has. She is able to hold down a job, attend college, and have a meaningful social life. She is able to manage with one medication and good self-care. My other daughter is lower functioning intellectually, and has other issues as well. Her most recent diagnosis is Schizzo-affective disorder and she has had several delusional/psychotic episodes that landed her in the hospital. It has been interesting to see the difference between the two of them, and how each has to learn to function in their own way. It makes life very interesting!

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      Denise, prayers going up for your daughters and your family. Schizo affective disorder is a more serious condition, as from what I've heard and read it involves two disorders. I hope you are doing well and getting the support you need as a mom. There is always a way to at least improve your quality of life. Daily self-care, learning to recognize your symptoms early one or what triggers them, and how to manage them is crucial. I hope your daughters are experiencing joy and happiness through their challenges. You are a special mom.

    • Purpose Embraced profile image

      Yvette Stupart PhD 2 years ago from Jamaica

      Thanks so much lambservant for writing an easy to understand hub on bipolar disorder. As clinical counselor I understand the difficulties people who have this disorder face, but your account helps me to see it on a different level.

      I really believe that despite the difficulties, you will be an effective peer counselor.

    • midget38 profile image

      Michelle Liew 2 years ago from Singapore

      Mood management, even for anyone without the disorder, is already tough!

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      Amen to that midget.

      Purpose Embraced, Thanks you for your words of affirmation. If I clinician can find anything I write on mental illness than I am very happy. Advocacy and education are very important to me. Ad I am more stable than I have ever been I think peer work can be much easier. Thanks again.

    • Nell Rose profile image

      Nell Rose 2 years ago from England

      Hi, this is really familiar to me as my brother is bipolar, the mood swings and how he can't go out on certain days does take a toll on both of us, I am trying to get him out and about but its so difficult, great job, nell

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      Thanks for sharing Nell. It can be a very big challenge trying to be supportive and knowing boundaries. You are a wonderful sister. It is for people like you I write to help educate. Often times if we know what we're dealing with, at least to some degree, we can find ways to move forward. I pray your brother finds some quality help.

    • Jeannieinabottle profile image

      Jeannie InABottle 2 years ago from Baltimore, MD

      This is a really interesting read. I have several friends with bipolar disorder and each one is totally different from the other. The good news is, all are doing well now, have jobs, and one even has two children. Thank goodness for modern medicine!

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      Jeannie, your friends are living proof that people with Bipolar can live quality lives. Thanks for stopping by.

    • Adventuretravels profile image

      Giovanna Sanguinetti 2 years ago from London UK

      Thank you so much for writing this hub. My neighbor has Bipolar and this has helped me - it's difficult understand what is happening to her - it's a very complex thing. Thanks again.

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      Greetings Adventure, I am glad you learned something. So many people are afraid and baffled by it. I believe in educating and advocation for things that have stigma attached or for anything people don't know about, thus afraid or judgmental.

      I don't know how close you are to your neighbor, but if you are close enough, try to find out as much as you can and if she's doing poorly, just be there to talk.

    • Joel Diffendarfer profile image

      Joel Diffendarfer 2 years ago from Ft Collins, Colorado

      Thanks, caught this article at the right time...helped make a differnce in my life today.

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      You are welcome Joel. That is the purpose of these kinds of hubs - to help people. God bless you on your journey.

    • DaphneDL profile image

      Daphne D. Lewis 2 years ago from Saint Albans, West Virginia

      A great article on bipolar disorder. My younger sister was bipolar and could rapid cycle in a manner that was exhausting just to witness. This is such a struggle for so many.

    • lambservant profile image

      Lori Colbo 2 years ago from Pacific Northwest

      Thanks for stopping by daphne. Your sister is blessed to have a compassionate sister like you.

    • DaphneDL profile image

      Daphne D. Lewis 2 years ago from Saint Albans, West Virginia

      You're welcome! I was blessed to have her in my life, too!!

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