The symptoms of bipolar disorder depend on which type of the condition a person has, though all forms of bipolar disorder consist of periods of a level mood between episodes.

Bipolar 1 is characterized by at least one manic episode. Someone with this condition is also likely to experience symptoms of depression at times. Many people who have bipolar 1 also have depressive episodes.

With bipolar 2, you must have experienced a major depressive episode, as well as an episode of hypomania (which is less severe than full mania), with periods of a level mood between episodes.

Finally, in cyclothymia, a milder form of bipolar disorder, people experience less severe manic and depressive episodes that alternate for at least two years; these episodes don’t meet the full criteria for either hypomania or major depression.

So, what constitutes a manic, hypomanic, or depressive episode?

Manic and Hypomanic Episodes: What Is the Difference?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, commonly known as the DSM-5 and which doctors use to guide diagnosis, describes a manic episode as a period of abnormally and persistently elevated mood characterized by increased goal-directed activity or energy that lasts for at least a week. A manic episode can also consist of a period of irritable mood. Both elevated and irritable manic episodes are accompanied by some of the following symptoms:

You’re easily distracted.
You feel as though your thoughts are racing.
You experience an exaggerated level of self-confidence and self-importance.
Your need for sleep is reduced.
You’re unusually or excessively talkative.
You engage in impulsive, reckless behavior with no consideration of the consequences (such as shopping sprees or unprotected, risky, or excessive sexual activity).

In manic episodes with both elevated and irritable moods, symptoms are present most of the day, every day.

A hypomanic episode has similar daily symptoms, but they are less intense and severe. The episode is also shorter in duration, lasting at least four days.

For a behavior change to be considered a manic episode, it must meet the following criteria:

Be a distinct and noticeable change in mood and functioning
Include noticeable problems in your day-to-day activities or require hospitalization to prevent harm to yourself or others
Not be the result of alcohol or drug use, a medication you’re taking, or another medical condition

A manic episode may also trigger a break from reality (psychosis) and may cause hallucinations or false but strongly held beliefs (delusions). These psychotic symptoms can sometimes wrongly lead to a diagnosis of schizophrenia.

For a behavior change to be considered a hypomanic episode, it must meet these standards:

Involve a distinct and noticeable change in mood and functioning
Not be significant enough to disrupt daily activities or require hospitalization
Not be the result of alcohol or drug use, a medication you’re taking, or another medical condition
Not have any associated psychotic symptoms (these would indicate a full-blown manic episode)

The Symptoms of Depressive Episodes

A major depressive episode includes the following signs and symptoms:

Depressed mood
Lack of interest in, or pleasure from, normal daily activities
Significant weight loss or gain, or changes in appetite
Insomnia or excessive need for sleep
Restlessness or slowed behavior
Fatigue or loss of energy
Feelings of guilt or worthlessness
Inability to think or concentrate
Thoughts of death or suicide

To be considered a major depressive episode, you must experience five or more of these symptoms daily or nearly every day — for most of the day — over a two-week period. At least one of the symptoms must be a depressed mood or loss of interest or pleasure in activities.

Your symptoms must also cause disruption in your day-to-day activities, as well as social activities or relationships.

As with manic episodes, depressive episodes must not be the result of alcohol or drug use, a medication you’re taking, or another medical condition.

Other Symptoms and Patterns of Bipolar Disorder

Other potential signs and symptoms of bipolar 1 and 2:

Anxiety
A manic episode with some symptoms of a depressive episode, or a depressive episode with some symptoms of a manic or hypomanic episode
Feeling empty or hopeless yet also highly energized
Loss of pleasure in all or most activities
Catatonia (a state of limited or abnormal movement)
Psychosis (detachment from reality, often with hallucinations or delusions)

People with catatonia don’t react to their environment normally, and they may hold their body in an unusual position. Often, they don’t speak.

People with psychosis experience a severe episode of either mania or depression that causes them to become detached from reality.

Both bipolar 1 and bipolar 2 may occur after a woman becomes pregnant or within a month of giving birth (also known as peripartum onset).

The disorders may also follow a so-called seasonal pattern, in which episodes change with the seasons.

Finally, there is a form of the disorder called rapid cycling, in which you may experience four or more mood episodes within a single year, with full or partial disappearance of symptoms between episodes.

Diagnosis: Is There a Bipolar Disorder Test?

Because of the unresolved questions surrounding the causes of bipolar disorder, the condition remains a challenge to diagnose. Unlike some medical disorders, there is no definitive test your doctor can order to diagnose bipolar disorder. If you or your doctor suspect that you may have a form of bipolar disorder, you will most likely undergo these tests:

A physical exam, including blood tests, to rule out other potential causes of your symptoms.
A psychological exam in which your doctor will ask you about your thoughts, feelings, and behaviors (family and friends may also be consulted, with your permission). A conversation about your medical history, including any current medications, prior treatments (including medications) tried for mood problems, drug or alcohol use, and family history may also be appropriate.
Daily tracking of your moods and behaviors to confirm diagnosis.

There are no brain imaging tests to diagnose bipolar disorder. If there is something unusual about your symptoms (for example, late-life onset or neurologic symptoms), your doctor may order a magnetic resonance imaging (MRI) scan or a computed tomography (CT) scan to rule out another problem, such as a brain injury, stroke, tumor, or multiple sclerosis.

There are also multiple questionnaires that health professionals use to help make a diagnosis. These formal, researched, and clinically tested questionnaires are designed to identify and clarify your symptoms and assist in diagnosis. Your doctor may or may not use such a questionnaire.

Because bipolar symptoms can be similar to those of other disorders, the condition can be a challenge to distinguish and properly diagnose. Additionally, many people with bipolar disorder also have another concurrent condition, such as an anxiety disorder, attention deficit hyperactivity disorder, substance abuse, or an eating disorder.

Bipolar Disorder in Children and Teenagers

Although bipolar disorder has the same symptoms in children and teenagers as it does in adults, these symptoms may be more challenging to identify in younger people. This is because they are often difficult to distinguish from normal mood changes that can occur as a result of stress or trauma. As a result, children with bipolar disorder are frequently misdiagnosed with other mental health conditions.

If your child shows signs of severe mood swings that appear different from previous or normal mood swings, talk to your doctor or pediatrician.

Additional reporting by Deborah Shapiro and Leona Vaughn.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

Bipolar Disorder: Signs and Symptoms. National Institute of Mental Health.
What Are Bipolar Disorders? American Psychiatric Association.
Bipolar Disorder. National Alliance on Mental Illness.
Catatonia: Our Current Understanding of Its Diagnosis, Treatment and Pathophysiology. World Journal of Psychiatry.
Rapid Cycling. Depression and Bipolar Support Alliance.
Bipolar Disorder in Children and Teens. National Institute of Mental Health.

Resources

Bipolar Disorder: Signs and Symptoms. National Institute of Mental Health. February 2023.
What Are Bipolar Disorders? American Psychiatric Association. January 2021.
Bipolar Disorder. National Alliance on Mental Illness. August 2017.
Rasmussen SA, Mazurek MF, Rosebush PI. Catatonia: Our Current Understanding of Its Diagnosis, Treatment and Pathophysiology. World Journal of Psychiatry. December 22, 2016.
Rapid Cycling. Depression and Bipolar Support Alliance.
Bipolar Disorder in Children and Teens. National Institute of Mental Health. 2023.

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