BIPOLAR DISORDER, and how to deal with it when someone you love has it. If you have it, this will help you.

Bipolar disorder

Bipolar disorder is a chronic mental illness that affects about 2.6 percent of Americans each year. It is characterized by episodes of energetic, manic highs and extreme, sometimes depressive lows.

These can affect a person’s energy level and ability to think reasonably. Mood swings caused by bipolar disorder are much more severe than the small ups and downs most people experience on a daily basis.

What are the symptoms?

Bipolar I disorder can cause unpredictable high and low mood swings, also known as manic and depressive episodes.

It’s impossible to predict how long mood episodes may last. You might be severely depressed for a brief or extended period of time before entering into a manic episode. Mania could last anywhere from days to months as well. You may even experience manic and depressive symptoms at the same time, which is known as a mixed episode.


Mixed episodes occur when lows and highs are experienced at the same time. 

For example, you may be having a mixed episode if you’re: Having trouble concentrating. Having too much energy while feeling very sad. Feeling very up or high. Thinking about death or suicide. Exhausted but overly anxious. Feeling jumpy or wired. Feeling like you can’t enjoy anything. Feeling like your thoughts are coming very fast. Forgetting things a lot. Being talkative while pessimistic. Becoming more active than usual. Having trouble sleeping. Behaving impulsively while feeling exhausted.

What can trigger bipolar I episodes?

Approaches to managing bipolar I

When you have bipolar I, it can seem like your mood episodes are random.

But both depressive and manic episodes are often triggered by something. Being aware of your triggers or warning signs can help you in managing your mood episodes.

Common triggers for bipolar I disorder may include:

  • Sleep deprivation
  • Medications
  • Seasonal changes
  • Substance abuse
  • Stress

Some triggers, such as stress, you can control or manage, while others you may not. Be sure to discuss your triggers with your doctor.

How is it diagnosed?

My journey to a bipolar diagnosis

Bipolar I can go unrecognized for years by not only those who suffer with it, but by family, friends, and even healthcare providers. Manic symptoms are reported less often than depressive ones for most people with bipolar I, so healthcare providers may only see, and therefore treat, symptoms of depression instead of bipolar I disorder.

The first step: If you think you may have bipolar I, talk with a doctor. They can complete a physical exam to rule out other conditions.

Why this matters: People with bipolar disorder often have other health problems including substance abuse, anxiety disorders, thyroid disease, heart disease, and obesity. These conditions can have similar symptoms to bipolar I, which can complicate the diagnosis of bipolar I disorder.

Bipolar I depression is different

Bipolar refers to the opposite ends (the poles) of the emotional spectrum—lows (depression) and the highs (mania).  On top of the deep, unshakeable sadness or emptiness felt by patients with Major Depressive Disorder (MDD), patients with bipolar I also experience manic episodes. Treatments for MDD may not be effective for patients with bipolar I disorder, so it’s important to get the right diagnosis.

How is it treated?

The most effective treatment plan for bipolar I often includes a combination of medication, talk therapy, support groups, and improving overall health and wellness.

However, the cornerstone of every treatment plan is medication and finding the right one for you could take some time. Some people may require more than one medication to experience relief.

Your healthcare provider will start the process by evaluating your symptoms and treatments. So, it’s critical to share all the symptoms you’re experiencing now or have experienced in the past, as well as the medications you’re taking now or have taken in the past.

It’s difficult to be patient when bipolar I affects your life

Maybe you’ve already tried a lot of solutions. You want to get your bipolar I under control, and so does your doctor.

If you are experiencing symptoms like extreme lows and highs of your mood, let your doctor know. Ask if VRAYLAR may help.

Additional Resources


What is the most important information I should know about VRAYLAR?

Elderly people with dementia-related psychosis (having lost touch with reality due to confusion and memory loss) taking medicines like VRAYLAR are at an increased risk of death. VRAYLAR is not approved for treating patients with dementia-related psychosis.

Antidepressants may increase suicidal thoughts or actions in some children and young adults within the first few months of treatment and when the dose is changed. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant is started or when the dose is changed. Report any change in these symptoms immediately to the doctor.

  • Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death
  • Neuroleptic malignant syndrome (NMS): Call your healthcare provider or go to the nearest hospital emergency room right away if you have high fever, stiff muscles, confusion, increased sweating, or changes in breathing, heart rate, and blood pressure. These can be symptoms of a rare but potentially fatal side effect called NMS. VRAYLAR should be stopped if you have NMS
  • Uncontrolled body movements (tardive dyskinesia or TD): VRAYLAR may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking VRAYLAR. Tardive dyskinesia may also start after you stop taking VRAYLAR
  • Late-occurring side effects: VRAYLAR stays in your body for a long time. Some side effects may not happen right away and can start a few weeks after starting VRAYLAR, or if your dose increases. Your healthcare provider should monitor you for side effects for several weeks after starting or increasing dose of VRAYLAR
  • Problems with your metabolism, such as:
    • High blood sugar and diabetes: Increases in blood sugar can happen in some people who take VRAYLAR. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before or soon after starting VRAYLAR and regularly during treatment. Tell your healthcare provider if you have symptoms such as feeling very thirsty, very hungry, or sick to your stomach, urinating more than usual, feeling weak, tired, confused, or your breath smells fruity
    • Increased fat levels (cholesterol and triglycerides) in your blood: Your healthcare provider should check fat levels in your blood before or soon after starting VRAYLAR and during treatment
    • Weight gain: Weight gain has been reported with VRAYLAR. You and your healthcare provider should check your weight before and regularly during treatment
  • Low white blood cell count: Low white blood cell counts have been reported with antipsychotic drugs, including VRAYLAR. This may increase your risk of infection. Very low white blood cell counts, which can be fatal, have been reported with other antipsychotics. Your healthcare provider may do blood tests during the first few months of treatment with VRAYLAR
  • Decreased blood pressure (orthostatic hypotension): You may feel lightheaded or faint when you rise too quickly from a sitting or lying position
  • Falls: VRAYLAR may make you sleepy or dizzy, may cause a decrease in blood pressure when changing position (orthostatic hypotension), and can slow thinking and motor skills, which may lead to falls that can cause fractures or other injuries
  • Seizures (convulsions)
  • Impaired judgment, thinking, and motor skills: Do NOT drive, operate machinery, or do other dangerous activities until you know how VRAYLAR affects you. VRAYLAR may make you drowsy
  • Increased body temperature: Do not become too hot or dehydrated during VRAYLAR treatment. Do not exercise too much. In hot weather, stay inside in a cool place if possible. Stay out of the sun. Do not wear too much clothing or heavy clothing. Drink plenty of water
  • Difficulty swallowing that can cause food or liquid to get into your lungs
  • have or have had heart problems or a stroke
  • have or have had low or high blood pressure
  • have or have had diabetes or high blood sugar in you or your family
  • have or have had high levels of total cholesterol, LDL-cholesterol, or triglycerides; or low levels of HDL-cholesterol
  • have or have had seizures (convulsions)
  • have or have had kidney or liver problems
  • have or have had low white blood cell count
  • are pregnant or plan to become pregnant. VRAYLAR may harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take VRAYLAR during pregnancy. If you become pregnant or think you are pregnant during treatment, talk to your healthcare provider about registering with the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or
  • are breastfeeding or plan to breastfeed. It is not known if VRAYLAR passes into breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with VRAYLAR
  • The most common side effects were difficulty moving or slow movements, tremors, uncontrolled body movements, restlessness and feeling like you need to move around, sleepiness, nausea, vomiting, and indigestion.

Persistent depressive disorder

Persistent depressive disorder is a chronic type of depression. It is also known as dysthymia. While dysthymic depression isn’t intense, it can interfere with daily life. People with this condition experience symptoms for at least two years. About 1.5 percent of American adults experience dysthymia each year.

Generalized anxiety disorder

Generalized anxiety disorder (GAD) goes beyond regular everyday anxiety, like being nervous before a presentation. It causes a person to become extremely worried about many things, even when there’s little or no reason to worry.

Those with GAD may feel very nervous about getting through the day. They may think things won’t ever work in their favor. Sometimes worrying can keep people with GAD from accomplishing everyday tasks and chores. GAD affects about 3 percent of Americans every year.

Major depressive disorder

Major depressive disorder (MDD) causes feelings of extreme sadness or hopelessness that lasts for at least two weeks. This condition is also called also called clinical depression.

People with MDD may become so upset about their lives that they think about or try to commit suicide. About 7 percent of Americans experience at least one major depressive episode each year.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) causes constant and repetitive thoughts, or obsessions. These thoughts happen with unnecessary and unreasonable desires to carry out certain behaviors, or compulsions.

Many people with OCD realize that their thoughts and actions are unreasonable, yet they cannot stop them. More than 2 percent of Americans are diagnosed with OCD at some point in their lifetime.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental illness that’s triggered after experiencing or witnessing a traumatic event. Experiences that can cause PTSD can range from extreme events, like war and national disasters, to verbal or physical abuse.

Symptoms of PTSD may include flashbacks or being easily startled. It’s estimated that 3.5 percent of American adults experience PTSD.


Schizophrenia impairs a person’s perception of reality and the world around them. It interferes with their connection to other people. It’s a serious condition that needs treatment.

They might experience hallucinations, have delusions, and hear voices. These can potentially put them in a dangerous situation if left untreated. It’s estimated that 1 percent of the American population experiences schizophrenia.

Social anxiety disorder

Social anxiety disorder, sometimes called social phobia, causes an extreme fear of social situations. People with social anxiety may become very nervous about being around other people. They may feel like they’re being judged.

This can make it hard to meet new people and attend social gatherings. Approximately 15 million adults in the United States experience social anxiety each year.