The first episode of bipolar disorder is usually depression, not mania. The initial depressive episodes are often misdiagnosed as major depressive disorder (unipolar depression) because the first hypomanic or manic episodes can be subtle, missed, or occur later.
The main symptom of bipolar disorder is extreme changes to your mood. You sometimes have either: high moods (mania or hypomania) – for example, feeling very happy, excited or energetic. low moods (depression) – for example, feeling sad, tired or hopeless.
Factors that may raise the risk of getting bipolar disorder or cause the first episode include: Having a first-degree relative, such as a parent or sibling, with bipolar disorder. Periods of high stress, such as the death of a loved one or another traumatic event. Drug or alcohol misuse.
Bipolar I disorder is diagnosed when a person experiences a manic episode. During a manic episode, people with bipolar I disorder experience an extreme increase in energy and mood changes, including feeling extremely happy or uncomfortably irritable.
Stressful life events
You may be able to link the start of your symptoms to stressful experiences or situations in your life. Some people also find that stress can trigger a mood episode. Or it may make symptoms feel more intense or difficult to manage.
Early symptoms of bipolar disorder include changes in energy level (more hyper than usual or suddenly low energy), needing less sleep, periods of high excitement or irritability, talking faster than usual, and having racing thoughts.
Stressful life events, trauma and significant life changes can trigger or worsen the symptoms of bipolar disorder. Creating a stable and supportive environment can help manage these triggers.
The first red flag of bipolar disorder often appears as significant changes in sleep patterns, mood instability (irritability/euphoria), increased energy/agitation, and rapid thoughts/speech, frequently mistaken for unipolar depression or normal moodiness, with sleep disruption (insomnia or oversleeping) and heightened irritability being very common early signs, notes Better Mental Health.
Mood-stabilizing medicines help control manic or hypomanic episodes. They also may help depressive bouts. Examples include lithium (Lithobid), valproic acid, divalproex sodium (Depakote, Depakote ER), carbamazepine (Tegretol, Tegretol XR, Equetro, others) and lamotrigine (Lamictal).
Age at onset of type-I bipolar disorder (BPD) typically averages 12-24 years, is older among patients with type-II BPD, and oldest in unipolar major depressive disorder 1,2,3. Reported onset ages probably vary by ascertainment methods, and possibly among different countries and cultures 1,2,3,4,5,6.
They can affect areas of your life such as work, study and relationships. You usually develop bipolar disorder between the ages of 15 and 19. But it can develop at any age. You could have symptoms of bipolar disorder for some time before a doctor diagnoses you.
Introduction
Stimulants like cocaine, methamphetamine, and amphetamines are most commonly associated with triggering symptoms of bipolar disorder, along with alcohol and high-THC cannabis.
At the outset, bipolar symptoms are commonly mistaken for ADHD, depression, anxiety, borderline personality disorder, and, in its more severe manifestations, as schizophrenia.
A bipolar meltdown could look different depending on the symptoms you're currently experiencing. For example, you might: Go on a “binge,” or “bender,” of continuous reckless activities, like substance use, unsafe sex, or spending money. Become verbally aggressive with someone, even someone you love.
Bipolar symptoms during a manic phase may include:
getting much less sleep or no sleep. poor appetite and weight loss. racing thoughts, racing speech, talking over people. highly irritable, impatient or aggressive.
However, many people with bipolar disorder have found the following tools to be helpful in reducing symptoms and maintaining wellness:
Five key signs of bipolar disorder involve extreme mood shifts, including manic/hypomanic symptoms like inflated self-esteem, decreased need for sleep, racing thoughts, high energy/activity, and impulsive behaviors (spending/sex), alongside depressive symptoms such as persistent sadness, loss of interest, fatigue, and sleep/appetite changes, creating significant life disruption.
Both conditions share features such as impulsivity, mood instability, and restlessness, making differential diagnosis particularly challenging. These shared characteristics can lead to situations where ADHD is misdiagnosed as bipolar disorder, potentially resulting in years of ineffective treatment.
To diagnose bipolar disorder, a doctor performs a physical exam, asks about your symptoms, and recommends blood testing to determine if another condition, such as hypothyroidism, is causing your symptoms. If the doctor does not find an underlying cause of your symptoms, he or she performs a psychological evaluation.
Avoid Arguing or Raising Your Voice
Raising your voice or engaging in heated arguments with someone who has bipolar disorder can make the situation worse. During a manic episode, emotions are already heightened, and a raised tone or confrontation can escalate conflict and make it harder to manage.
How many hours should a bipolar person sleep? People should try to sleep at least 7 hours per night, regardless of whether they have a condition such as bipolar disorder.
Bipolar disorder often runs in families, and research suggests this is mostly explained by heredity—people with certain genes are more likely to develop bipolar disorder than others.
Childhood trauma is widely recognized as a crucial risk factor for the development of various psychiatric conditions, including BD, more than 25% of adult psychiatric disorders have been linked to childhood trauma exposure (Pfaltz et al., 2022; Hughes et al., 2019; Selous et al., 2020; Sugaya et al., 2012).
In addition to lowering caffeine, it's important to avoid high-fat meals with some bipolar medications. High-fat meals may delay the time it takes for some bipolar medications to be absorbed into your system. Talk to your doctor about your medications and necessary dietary changes.