Bipolar I Disorder.

Bipolar disorder is a serious mental illness characterized by significant and unpredictable mood shifts. These shifts range from extreme highs, or manic episodes, to profound lows, known as depressive episodes.

What is Bipolar 1 Disorder?

Bipolar 1 Disorder is a subtype of bipolar disorder. It is defined by the presence of at least one manic episode in a person’s life. While individuals with this disorder often experience depressive episodes, a manic episode is essential for the diagnosis.


The first symptoms of bipolar I disorder typically manifest during adolescence or early adulthood, before age 20, and can develop at any point before age 50.

Manic Episodes

Characterized by abnormally elevated energy levels, irritability, rapid speech, impulsivity, and sometimes delusions or hallucinations. Symptoms include intense euphoria, excessive energy, insomnia, and engaging in risky behaviors.

Depressive Episodes

These can last up to two weeks and manifest as intense sadness, fatigue, changes in sleep patterns, and frequent thoughts of death or suicide.


A milder form of mania, hypomanic episodes are shorter and less severe. They don’t significantly disrupt daily functioning and don’t require hospitalization. Highly stimulating situations, major life changes, or substance abuse can trigger hypomanic episodes.

Mixed Episodes

Here, individuals experience symptoms of both mania and depression simultaneously or in rapid succession.


Bipolar 1 Disorder is diagnosed when a manic episode lasts at least seven days or is so severe that hospitalization is required. Depressive episodes can also occur and typically last for about two weeks.

For Bipolar I Disorder, the DSM-5 sets out specific criteria:

  • Manic Episode: The individual must experience at least one manic episode.
  • Significant Distress or Impairment: The manic episode must be severe enough to cause marked impairment in social or occupational functioning, necessitate hospitalization to prevent harm to self or others, or have psychotic features.
  • Not Attributable to a Substance or Medical Condition: The episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorders. It’s also not attributable to the effects of a substance or another medical condition.
  • Depressive Episode: While the presence of a depressive episode is not required for the diagnosis of Bipolar I Disorder, many individuals do experience them.

It’s important to note that the above is a summary, and the DSM-5 provides more detailed criteria and descriptions. If someone believes they or someone they know may have Bipolar I Disorder, it’s crucial to consult a mental health professional for a comprehensive assessment and diagnosis.

Causes and Risk Factors

While the causes of bipolar disorder are still unclear, there are some potential causes and risk factors to consider:

  • Family History: While no gene has been identified as the “cause” of Bipolar 1 Disorder, research indicates that individuals with a family history of the disorder are at a higher risk.
  • Brain Chemical Imbalance: Brain scans of individuals with Bipolar 1 Disorder often show structural and functional differences compared to those without the disorder. Mood shifts in bipolar disorder are believed to be linked to imbalances in neurotransmitters like norepinephrine and serotonin.
  • Life Stressors: Certain life events or circumstances can trigger the onset or recurrence of manic and depressive episodes. This includes traumatic events, significant life changes, or high levels of prolonged stress.
  • Substance Abuse: While not a direct cause, the use of drugs or alcohol can exacerbate the symptoms of Bipolar 1 Disorder and might trigger manic or depressive episodes.
  • Anxiety Disorders: It’s not uncommon for individuals with Bipolar 1 Disorder to also suffer from anxiety disorders, including generalized anxiety disorder, panic disorder, or social anxiety disorder.
  • Physical Health Issues: Individuals with Bipolar 1 Disorder often have co-existing health issues such as cardiovascular disease, thyroid problems, or obesity. These can result from the disorder, medication side effects, or lifestyle factors.

Bipolar 1 Management and Treatment

Medication is the cornerstone of the disorder’s treatment, but psychotherapy can help patients learn about their triggers and stick to their medication regime. Bipolar 1 treatment includes medication, talk therapy, therapeutic procedures, and healthy daily habits.



Mood Stabilizers

These medications help correct imbalanced brain signaling. Each patient is prescribed a specific drug with a tailored dose based on their case. Examples include lithium, valproic acid, divalproex sodium, and lamotrigine.

Neuroleptics (Antipsychotics)

For those with severe manic episodes or those who don’t respond to mood stabilizers alone. Examples include cariprazine, lurasidone, and quetiapine.


Combining antidepressants with mood stabilizers can help prevent triggering a manic episode. They are never used as the only medication to treat bipolar disorder. Examples include fluoxetine, citalopram, and paroxetine.


Cognitive Behavioral Therapy (CBT)

Helps patients identify negative thought patterns and behaviors and replace them with healthier ones.

Family-Focused Therapy

Educates families about the disorder and equips them with strategies to support their loved ones and cope.

Interpersonal and Social Rhythm Therapy

Focuses on stabilizing daily rhythms, such as sleeping, waking, and mealtimes, to prevent manic and depressive episodes.

Other Treatments

Electroconvulsive Therapy (ECT)

ECT is a procedure in which small electric currents are passed through the brain, intentionally triggering a brief seizure. This seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.

Transcranial Magnetic Stimulation (TMS)

TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. TMS is primarily approved for the treatment of depression, but research is ongoing regarding its effectiveness in treating manic episodes in Bipolar 1 Disorder.

Both ECT and TMS are typically considered when other treatments (like medications and psychotherapy) haven’t been effective or can’t be used. They are administered under the guidance of trained professionals and often in specialized settings. It’s essential for patients to discuss potential risks and benefits with their healthcare provider.

Living With Bipolar 1 Disorder

With the proper support and management, individuals can lead fulfilling lives while managing their symptoms. Here are some recommendations for living with bipolar 1 disorder:

  • Awareness and Acceptance: Recognizing the symptoms and accepting the diagnosis are the first steps toward effective management.
  • Routine Management: Maintaining a routine, especially concerning sleep and meals, can help stabilize mood.
  • Avoiding Triggers: Being aware of personal triggers, whether they’re stress, substances, or lack of sleep, and taking steps to avoid or manage them is crucial.
  • Support Systems: Building and maintaining a strong support system, whether it’s family, friends, or support groups, can make a significant difference in managing the disorder.


The outlook and prognosis for Bipolar 1 Disorder can vary widely based on several factors, including the individual’s adherence to treatment, the presence of co-occurring disorders, and the level of support they receive. Bipolar 1 Disorder is a lifelong condition. While individuals may experience periods of wellness, the risk of recurrence is always present.

With consistent treatment, many individuals with Bipolar 1 Disorder can manage their symptoms effectively. Medication, therapy, and lifestyle changes can significantly reduce the frequency and severity of episodes. Also, individuals with strong support systems, including family, friends, and support groups, tend to have a better prognosis. Support can help with treatment adherence, coping strategies, and overall quality of life.

Keep in mind there’s an increased risk of certain physical health issues in individuals with Bipolar 1 Disorder, including cardiovascular disease, diabetes, and obesity. Regular medical check-ups and a healthy lifestyle can mitigate some of these risks.

While challenges exist, many individuals with Bipolar 1 Disorder lead fulfilling, successful lives. Early diagnosis, comprehensive treatment, and a strong support system are critical to improving the long-term outlook.


Frequently Asked Questions (FAQs)

What is a person with bipolar 1 like?

A person with Bipolar 1 Disorder experiences distinct mood episodes characterized by manic highs and, often, depressive lows. During manic episodes, they may exhibit elevated energy, reduced need for sleep, increased talkativeness, impulsivity, and grandiose thinking. In contrast, depressive episodes can lead to feelings of sadness, fatigue, loss of interest in activities, and potential thoughts of suicide.

Is bipolar type 1 serious?

Yes, Bipolar Type 1 is a serious mental health condition. Individuals with Bipolar 1 Disorder experience intense manic episodes that can lead to risky behaviors, impaired judgment, and even psychotic features like hallucinations. Additionally, depressive episodes, which are also common in Bipolar 1, can be debilitating and carry a risk of suicide.

What is the difference between bipolar 1 and 2?
Bipolar 1 and Bipolar 2 are both subtypes of bipolar disorder, but they have distinct characteristics. Bipolar 1 includes severe manic episodes, while Bipolar 2 involves milder hypomanic episodes but also includes significant depressive episodes.

Related Conditions

  • Bipolar Disorder
  • Bipolar II
  • Cyclothymia

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