Bipolar Disorder: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Bipolar Disorder?
A psychiatrist (a mental health doctor) usually leads treatment for bipolar disorder, often working with a psychologist or therapist for talk therapy. A primary care doctor can spot the first signs and refer you to one of them. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is bipolar disorder?
Bipolar disorder is a mental illness. It causes strong shifts in mood, energy, activity, and focus. It used to be called manic depression. People with it go through times of feeling extremely "up," elated, irritable, or full of energy. These are called manic episodes. They also go through times of feeling very "down," sad, or hopeless. These are called depressive episodes. Some people have both kinds of symptoms at once, called a mixed episode. At some point in life, 2.4 percent of people worldwide and 4.4 percent of people in the United States are diagnosed with it. It most often starts in the late teen years or early adult years.
Symptoms
During a manic episode, a person may:
- Feel very up, high, or elated.
- Feel jumpy or wired, more active than usual.
- Have racing thoughts and talk very fast.
- Need less sleep.
- Feel unusually important, talented, or powerful.
- Do risky things that show poor judgment, like spending a lot of money.
During a depressive episode, a person may:
- Feel very sad, hopeless, or worthless.
- Have little energy and sleep too much.
- Eat too much or too little.
- Lose interest in usual activities.
- Think about death or suicide.
Some people have hypomania, a less severe form of mania. They may feel very good and get a lot done, and may not feel anything is wrong, though family and friends notice the change. Some people also have symptoms of psychosis, such as hallucinations or delusions.
Causes and who gets it
The exact cause is unknown. Genes, brain structure and function, and the environment all likely play a role. Having a close relative with bipolar disorder raises your risk. But most people with a close relative who has it never get the illness themselves. Trauma or very stressful events may raise the risk even more. Stressful events such as a death in the family can set off symptoms. It often happens along with other mental health problems, such as anxiety disorders and substance abuse.
How doctors diagnose it
There is no single test for bipolar disorder. To diagnose it, a health care provider may use a physical exam, a medical history, and medical tests to rule out other conditions. The provider may also do a mental health evaluation, or send you to a mental health specialist.
Family and friends may notice the mood swings, especially during hypomania.
Treatment
Bipolar disorder usually needs lifelong treatment. But a good plan can help people manage symptoms and live a healthy, successful life. The main treatments are medicines, psychotherapy (talk therapy), or both:
- Medicines can help control symptoms. You may need to try several before finding one that works. Some people need more than one. Take your medicine every day as directed. Never stop it without talking to your provider first.
- Psychotherapy can help you spot and change troubling thoughts and behaviors. It can also give you and your family support and coping skills.
- Electroconvulsive therapy (ECT) is a brain stimulation procedure. It is done under general anesthesia, so you are asleep. Doctors use it most often for severe bipolar disorder that is not getting better with other treatments.
- Healthy habits help too: regular exercise, a steady sleep schedule, and keeping a mood journal.
When to see a doctor
See a doctor if you or someone close to you has strong mood swings, extreme energy shifts, or feelings of hopelessness that do not go away. If someone talks about suicide, get help right away. If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away. In life-threatening situations, call 911.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either one can do an initial evaluation, refer you to a psychiatrist, and stay involved with checkups and long-term care between specialist visits.
Common questions
What is the difference between bipolar I and bipolar II?
In bipolar I disorder, manic episodes last at least 7 days. Or the manic symptoms are so bad that you need hospital care right away. In bipolar II, there are depressive episodes and hypomania, a milder form of mania. There are no full-blown manic episodes.
Can bipolar disorder be cured?
No, it is a lifelong illness. Treatment focuses on managing symptoms, not curing it. With long-term, ongoing treatment, people with bipolar disorder can live a healthy, successful life.
Why is it important to keep taking medicine?
Medicines help control the symptoms. Take your medicine every day as directed. Do not stop without first talking with your provider, even if you start to feel better.
What should I do in a crisis?
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988. In life-threatening situations, call 911.
Sources
- National Institute of Mental Health - Bipolar Disorder
- MedlinePlus - Bipolar Disorder
- MedlinePlus Genetics - Bipolar disorder
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
