Bipolar Disorder

​Bipolar disorder is a medical condition characterized by extreme mood swings that affect how people think, behave and function. (CAMH)

Remember, bipolar disorder is a medical condition, not a person’s fault or their whole identity. It is something that can be controlled through a combination of medical treatments doing their work internally, friends and family fostering acceptance and understanding on the outside, and people with bipolar disorder empowering themselves to find balance in their lives.

Helen M. Farrell

This classic form of bipolar disorder used to be called “manic depression.” In bipolar I, manic phases are clear. The person’s behavior and shifts in mood are extreme, and their behavior quickly escalates until they’re out of control. The person may end up in the emergency room if left untreated.

To have bipolar I, a person must have manic episodes. In order for an event to be considered a manic episode, it must:

  • include shifts in mood or behaviors that are unlike the person’s usual behavior
  • be present most of the day, nearly every day during the episode
  • last at least one week, or be so extreme that the person needs immediate hospital care

People with bipolar I typically have depressive episodes as well, but a depressive episode isn’t required to make the bipolar I diagnosis.

Signs & Symptoms

Manic phase

Sometimes, a person may seem continuously high, happy, and euphoric, or irritable, angry, and aggressive, for at least one week. If this change in mood is accompanied by at least three of the following symptoms, the person may be in the manic phase of bipolar disorder:

  • exaggerated self-esteem or feeling of grandeur
  • decreased need for sleep
  • more talkative than usual
  • racing thoughts
  • easily distracted
  • excessive energy for activities
  • engaging in risky behaviour or exhibiting poor judgement.

 Depressive phase

A person may be experiencing the depressive phase of bipolar disorder if at least five of the following symptoms are present for at least two weeks and experienced on most days:

  • depressed mood
  • loss of interest or pleasure in activities that used to be enjoyable
  • weight loss or gain
  • difficulty sleeping or sleeping too much
  • apathy or agitation
  • loss of energy
  • feelings of worthlessness and guilt
  • inability to concentrate
  • thoughts of suicide (which should always be taken seriously)

Mixed episodes

Some people with bipolar disorder experience manic and depressive symptoms at the same time. This is called a mixed episode. For example, someone experiencing a mixed episode may think and speak very rapidly. At the same time, they may be very anxious and have suicidal thoughts. Mixed episodes are hard to diagnose and are very painful for the individual.

Other symptoms

Psychotic symptoms

People with bipolar disorder may also experience psychotic symptoms, such as losing touch with reality, hearing voices or having ideas that are not based in reality. Psychotic symptoms can be very frightening for the person having them and for others.

Catatonic symptoms

Up to 25 per cent of people experiencing episodes of depression or mania also have problems with movement, called catatonic symptoms. These may include extreme physical agitation, slowness, and odd movements or postures.

Causes & Risk Factors

The precise causes of bipolar disorder are unknown. However, there is strong evidence that biological factors, including genetics, play an important role. Stress or difficult family relationships do not cause the illness. However, these factors may trigger an episode in someone who already has the illness.

Diagnosis & Treatment


Bipolar disorder can be hard to diagnose because it has many symptoms. Additionally, many people will have a long period between depressive and manic phases, and people are likely to seek help only when they are experiencing depressive symptoms.

To help determine whether someone has bipolar disorder, health care professionals will ask about thoughts, feelings, behaviour, and personal and family medical history.

There are no laboratory tests for bipolar disorder, but tests can rule out illnesses that have similar symptoms, such as thyroid disease.


The main treatment options for bipolar disorder are medication and psychotherapy. Often both types of treatment are needed, but in order to bring symptoms under control, it is usually medication that is needed first.

The main types of medication used to treat bipolar disorder are:

Like chronic disorders such as hypertension or diabetes, bipolar disorder can be managed and controlled by combining treatment with a healthy lifestyle. The goal in treating bipolar disorder is to help the person get well again. This includes:

  • treating symptoms until they no longer cause distress
  • improving work and social functioning
  • reducing risk of relapse.

More Resources on Bipolar Disorder

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"What makes this story even more disturbing is that the Royal Canadian Mounted Police (RCMP) knowingly participated in this sting with the FBI. They unlawfully obtained Abdulrahman’s medical records that described his mental health vulnerabilities and provided them to the FBI to better manipulate this damaged youth.

This raises serious human rights concerns of discriminatory investigations, targeting vulnerable youths such as Abdulrahman, who had no previous history of violence or criminality, until drawn in by a U.S. government actively involved in developing the plot, persuading and pressuring the target to participate."

Dennis Edney

Canadian Defence lawyer