Bipolar Disorder Explained

About 6 million adults, teens and children have bipolar disorder (BD) in the U.S. It’s often diagnosed before the age of 25, and once it is, BD doesn’t go away.

Not All BD Is the Same

There are actually four types of BD.

• With bipolar I disorder, a person has had one or more episodes of mania. While they will have periods of mania, they can also experience depressive episodes.
• People with bipolar II disorder shift between depressive and mild manic (hypomanic) periods. They never have a “full” manic episode.
• When someone experiences chronic hypomania and mild depression for at least two years, they have cyclothymic disorder. They will have cycles of hypomania and milder depression that occur at least half the time of those two years.
• When someone doesn’t meet the criteria for the above, but still has significant periods of abnormal mood elevation, they are diagnosed as bipolar disorder (“other specified” and “unspecified”).

Mania and Depression Aren’t “Mood Swings”

All of us have ups and downs. Sometimes we feel happy. Other times, we’re sad. It’s normal. The highs (mania) and lows (depression) of bipolar disease are very different.  Those who live with the disease may cope with the constant shift between episodes of mania and depression.

During periods of mania, individuals become hyperactive. Their thoughts race. Their behavior can be risky. They don’t sleep and can grow irritable. Rage can rear its head, too. These periods will last for at least 3 days.

A depressive episode can make people feel helpless, hopeless and worthless. They may not sleep — or may sleep all the time. They have no energy or interest in the things they used to do. Many consider ending their life. Mixed episodes where elements of depression and mania are present can also occur.

Symptoms make it hard for the person to function. It may even put them in danger. It also makes it hard for friends, family members and coworkers to cope with the situation.

Bipolar Disorder and Type 2 Diabetes Connection

The depression that is a part of bipolar disorder can also open the door to Type 2 diabetes. Studies show that individuals with BD  have a two to three times higher risk of developing Type 2 diabetes than others.

Experts cite several reasons the risk for diabetes goes hand-in-hand with BD.

Binge eating. Bipolar depression can make people feel hungry. Food is comforting and becomes a coping mechanism — especially sugary, salty and fatty foods. Overeating is common even when BD sufferers don’t feel hungry or are uncomfortably full. Uncontrolled eating packs on pounds.

Lack of physical activity. Depression kills the desire to do many things. That includes regular exercise. Instead, BD sufferers often retreat to the comfort of their bed or sofa for long periods of time. Too little activity paired with too much food is a toxic combo that can lead to obesity.

Poor sleep. The body needs at least six to seven hours of sleep each night. Skimping on shut-eye doesn’t give your body time to repair itself. It also fuels hunger and boosts insulin resistance — the body’s inability to control blood sugar levels. All contribute to weight gain.

Medications. Side effects from some prescription medicines used to treat BD increase appetite. Others act like a sedative that makes people move less. Both can lead to weight gain. Still others often disturb the body’s hormonal balance and disrupt the gut’s microbiome.

What you can do. If you are living with BD, get screened for diabetes and prediabetes regularly. Watch your blood pressure and cholesterol levels closely. If you are on BD medications and notice weight gain, talk with your care provider to see if there are other medication options.

Without Help, Bipolar Disorder Can Lead to Suicide 

On average, the lifespan of someone diagnosed with BD is nine to 17 years shorter than average. Research shows up to 20 percent of untreated BD sufferers end their own lives. Still, many die prematurely because they are never diagnosed or receive the treatment they need to cope with daily life.

Bipolar Disorder is Treatable

Treatment can make a positive difference for people struggling with bipolar disorder. Working closely with care providers, they can manage their disease and enjoy more balanced, healthier lives.

Medicines. They make up the main treatment for BD. A combination of drugs may be used to stabilize extreme mood changes. It’s important they be taken as directed. They should not be stopped, even if the person starts to feel better.

Counseling. “Talk therapy” or “psychotherapy" can help manage some of the symptoms caused by BD. Support groups can help, too.

Self-awareness. Learning about BD and how to recognize the early onset of symptoms can help prevent or lessen the severity of an episode.

Lifestyle choices. A healthy diet, exercise, good sleep habits, and meditation can all play a role in nurturing the body. They won’t take the place of medication and counseling, though. These practices should be done along with prescribed treatments.

If you have concerns about bipolar disorder, talk with your doctor. It’s the first step in finding the right kind of help for you or your family member. 

Sources: Bipolar Disorder,  National Institute of Mental Health, 2025; Prevalence of type 2 diabetes mellitus, impaired fasting glucose, general obesity, and abdominal obesity in patients with bipolar disorder: A systematic review and meta-analysis  Science Direct, Journal of Affective Disorders, 2022; How Bipolar Disorder Increases Your Risk of Developing Type 2 Diabetes,  bpHope, 2023; Waking Up to the Importance of Sleep in Type 2 Diabetes Management,  American Diabetes Association, 2024