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Managing Bipolar Highs and Lows: 5 Ways to Cope

Clinically Reviewed by: Charee Marquez, LMFT

Managing bipolar highs and lows is a crucial aspect of living with bipolar disorder, a condition characterized by dramatic mood swings ranging from manic episodes to major depressive episodes. Unlike major depressive disorder, where individuals do not experience periods of elevated mood and increased impulsivity, those with bipolar disorder do. Effective management of bipolar disorder involves recognizing early warning signs, adhering to prescribed medications, and maintaining a healthy lifestyle. For individuals experiencing manic or depressive episodes, treatment options such as mood stabilizers, talk therapy, and support groups are essential. Understanding the complexities of bipolar disorder and developing coping skills can significantly improve the quality of life for those affected by this lifelong condition.

What Is Bipolar Disorder?

Bipolar disorder, formerly known as manic-depressive illness, is a mental health condition characterized by extreme mood swings or episodes of mania and depression. Individuals with bipolar disorder experience periods of intense emotional highs (mania or hypomania) and lows (depression), which can significantly impact their daily functioning and quality of life. Bipolar disorder is covered in the DSM-5 under the category of Mood Disorders. There are several subtypes of bipolar disorder, including Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder, and other specified and unspecified bipolar and related disorders. Here are the main criteria for Bipolar I Disorder and Bipolar II Disorder:

What Causes Bipolar Disorder?

The exact cause of bipolar disorder is not fully understood, and it likely involves a combination of genetic, biological, and environmental factors. Researchers continue to study these factors to gain a better understanding of the origins of bipolar disorder. Here are some key considerations:

  1. Genetic Factors:

  • Bipolar disorder tends to run in families, suggesting a genetic component. Individuals with a family history of bipolar disorder have a higher risk of developing the condition.

  • Specific genes associated with bipolar disorder are still being identified. Multiple genes may contribute, and their interactions with environmental factors play a role in the disorder’s development.

  1. Brain Structure and Function:

  • Brain imaging studies have revealed structural and functional differences in the brains of individuals with bipolar disorder. These differences may involve areas associated with mood regulation, emotional processing, and cognitive function.

  • Abnormalities in the neurotransmitter systems, particularly those involving serotonin, dopamine, and norepinephrine, are implicated in bipolar disorder.

  1. Neurobiological Factors:

  • Imbalances in neurotransmitters (chemical messengers in the brain) are believed to contribute to mood fluctuations in bipolar disorder. The exact nature of these imbalances and their role in the disorder’s onset and progression is an area of ongoing research. Medications are often used to treat bipolar disorder, with types and doses determined based on specific symptoms.

  1. Hormonal Factors:

  • Hormones may play a role in the development and course of bipolar disorder. Changes in hormone levels, especially during puberty and pregnancy, can influence mood regulation.

  1. Environmental Factors:

  • Stressful life events, trauma, or major life changes may trigger the onset of bipolar episodes in susceptible individuals.

  • Substance abuse, particularly stimulant drugs like cocaine or amphetamines, can trigger or exacerbate manic episodes.

  1. Biological Rhythms and Circadian Rhythms:

  • Disruptions in biological rhythms, such as sleep-wake cycles and circadian rhythms, are observed in individuals with bipolar disorder. Irregular sleep patterns or disruptions in daily routines may contribute to mood episodes.

  1. Childhood Adversity:

  • Experiencing trauma or adversity during childhood, such as physical, emotional, or sexual abuse, may increase the risk of developing bipolar disorder later in life.

It’s important to note that bipolar disorder is a complex and heterogeneous condition, and no single factor can explain its occurrence. Additionally, not everyone with genetic or environmental risk factors will develop bipolar disorder, and the interplay of various factors likely contributes to its development.

Is Bipolar Disorder Hereditary?

Yes, there is evidence to suggest that bipolar disorder has a genetic component, meaning that it can run in families. Individuals with a family history of bipolar disorder may be at a higher risk of developing the condition themselves. However, like many mental health disorders, genetics is just one factor among several that contribute to the development of bipolar disorder.

Environmental factors, such as stress, trauma, and life events, can also play a role in triggering bipolar disorder in individuals with a genetic predisposition. The interaction between genetic and environmental factors is complex, and not everyone with a family history of bipolar disorder will necessarily develop the condition.


Types of Bipolar Disorder

Bipolar disorder is a spectrum of mood disorders characterized by episodes of mania, hypomania, and depression. Each type is defined by the nature and duration of mood episodes, which can significantly impact daily functioning. The primary types of bipolar disorder include Bipolar I, Bipolar II, and Cyclothymic Disorder. Here’s an overview of these types:

  1. Bipolar I Disorder:

  • Manic Episodes: The defining feature of Bipolar I is the presence of at least one manic episode. Manic episodes are characterized by a distinct period of abnormally elevated mood, increased energy or activity, and impaired functioning.

  • Depressive Episodes: Depressive episodes may also occur, lasting for at least two weeks. The individual experiences symptoms of depression, such as low mood, loss of interest, and changes in sleep and appetite.

  • Severity: Manic episodes in Bipolar I are severe and often result in significant impairment. Hospitalization may be required in some cases.

  1. Bipolar II Disorder:

  • Hypomanic Episodes: Bipolar II involves a pattern of depressive episodes alternating with hypomanic episodes. Hypomanic episodes are less severe than full manic episodes but still involve noticeable changes in mood, energy, and activity.

  • Depressive Episodes: Similar to Bipolar I, individuals with Bipolar II experience depressive episodes that meet the criteria for major depressive episodes.

  • Severity: Hypomanic episodes in Bipolar II do not lead to marked impairment in functioning and are not typically associated with psychosis.

  1. Cyclothymic Disorder:

  • Chronic Mood Instability: Cyclothymic Disorder is characterized by numerous periods of hypomanic and depressive symptoms that do not meet the criteria for a full manic or depressive episode.

  • Duration: Symptoms persist for at least two years in adults and one year in adolescents and children.

  • Stable Periods: During this time, there are no symptom-free periods lasting more than two months.

  • Severity: The mood fluctuations are chronic but milder than those seen in Bipolar I or II.

  1. Other Specified and Unspecified Bipolar Disorders:

  • Some individuals may present with symptoms that do not fit neatly into the criteria for Bipolar I, II, or Cyclothymic Disorder. In such cases, mental health professionals may use the categories of Other Specified or Unspecified Bipolar Disorders.

It’s important to note that these diagnostic categories are not rigid and that individuals may experience variations in symptom presentation.

Warning Signs of Bipolar Disorder

Manic Episode Warning Signs:

  1. Increased Energy: A noticeable surge in energy and activity levels.
  2. Reduced Need for Sleep: Feeling rested after only a few hours of sleep.
  3. Rapid Speech: Talking quickly, often jumping from one topic to another.
  4. Racing Thoughts: Experiencing a rapid flow of ideas.
  5. Impulsive Behavior: Engaging in risky activities, such as excessive spending or unsafe sex.
  6. Euphoric Mood: Feeling unusually happy, elated, or overly optimistic.
  7. Irritability: Becoming easily agitated or annoyed.

Depressive Episode Warning Signs:

  1. Persistent Sadness: Feeling overwhelmingly sad, hopeless, or empty.
  2. Loss of Interest: Disinterest in activities once enjoyed.
  3. Fatigue: Feeling tired or lacking energy, even after adequate rest.
  4. Sleep Disturbances: Experiencing insomnia or oversleeping.
  5. Difficulty Concentrating: Trouble focusing or making decisions.
  6. Appetite Changes: Significant weight loss or gain due to changes in appetite.
  7. Thoughts of Self-Harm: Experiencing thoughts of death, suicide, or self-harm.

General Warning Signs:

  1. Mood Swings: Frequent and intense shifts in mood.
  2. Unpredictable Behavior: Sudden changes in behavior and personality.
  3. Anxiety: High levels of anxiety or restlessness.
  4. Social Withdrawal: Isolating from friends and family.
  5. Guilt: Feeling excessive guilt or worthlessness.

Recognizing these warning signs early can help individuals seek timely treatment and support, potentially preventing severe mood episodes and improving overall management of bipolar disorder. If you or someone you know exhibits these signs, it’s important to consult with a mental health professional.


What are Bipolar Disorder Manic or Depressive Episodes?

Bipolar highs and lows refer to the fluctuating mood states experienced by individuals with bipolar disorder. Bipolar disorder is a mental health condition characterized by extreme shifts in mood, energy, and activity levels, often alternating between episodes of mania or hypomania and depression. These mood episodes can vary in intensity and duration and have a significant impact on a person’s daily functioning and overall well-being. Finding a therapist, managing symptoms, and making healthy lifestyle changes are crucial for improving overall well-being.

  1. Bipolar Highs (Mania or Hypomania):

  • Mania and hypomania are periods of elevated mood, increased energy, and heightened activity levels. During a manic episode, individuals may experience:

  • Feelings of euphoria or extreme happiness

  • Increased energy and activity levels

  • Racing thoughts and rapid speech

  • Reduced need for sleep

  • Impulsivity, risk-taking behavior, or reckless decision-making

  • Grandiosity or inflated self-esteem

  • Difficulty concentrating or staying focused

  • Hypomania is a less severe form of mania, characterized by similar symptoms but with less intensity and disruption to daily functioning. Individuals experiencing hypomania may still be able to maintain some level of functionality and may not require hospitalization.

  1. Bipolar Lows (Depression):

  • Depression is characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities that were once enjoyable. During a depressive episode, individuals may experience:

  • Persistent feelings of sadness, emptiness, or despair

  • Loss of interest or pleasure in activities

  • Fatigue or decreased energy levels

  • Changes in appetite or weight

  • Sleep disturbances, such as insomnia or oversleeping

  • Feelings of worthlessness or guilt

  • Difficulty concentrating, making decisions, or remembering things

  • Thoughts of death or suicide

These alternating episodes of mania/hypomania and depression can occur in varying patterns and frequencies, ranging from rapid-cycling bipolar disorder (four or more mood episodes within a one-year period) to more infrequent episodes separated by periods of relative stability.

5 Ways to Manage Bipolar Highs and Lows

1. Medication Adherence

Medication is often a cornerstone of bipolar disorder treatment, helping to stabilize mood and prevent episodes of mania and depression. It’s essential to work closely with a psychiatrist to find the right combination of medications and dosages that work best for you. Consistently taking your prescribed medications as directed can help minimize mood fluctuations and reduce the severity of symptoms.

2. Establish Healthy Routines

Maintaining a regular schedule and engaging in healthy habits can help regulate your mood and improve overall stability. Aim to establish consistent sleep patterns by going to bed and waking up at the same time each day. Incorporate regular exercise, balanced meals, and stress-reducing activities like yoga or meditation into your daily routine. Prioritize self-care and make time for activities that bring you joy and relaxation.

3. Monitor Your Mood

Keeping track of your mood and symptoms can provide valuable insights into your condition and help you identify triggers for manic or depressive episodes. Consider using a mood tracking app or journal to record your daily mood fluctuations, energy levels, sleep patterns, and any notable changes in behavior or thoughts. This information can help you and your healthcare team make informed treatment decisions and detect early warning signs of mood episodes.

4. Develop Coping Skills

Learning effective coping skills can help you navigate the challenges of bipolar disorder and cope with stressors more effectively. Practice relaxation techniques such as deep breathing, progressive muscle relaxation, or guided imagery to reduce anxiety and promote calmness. Develop healthy coping strategies for managing stress, such as problem-solving, assertive communication, and setting boundaries in relationships. Building a toolbox of coping skills can empower you to respond to mood fluctuations with resilience and self-awareness.

5. Seek Support

Don’t hesitate to reach out for support from trusted friends, family members, or mental health professionals when you’re struggling with bipolar highs or lows. Joining a support group for individuals with bipolar disorder can provide validation, encouragement, and practical tips for managing symptoms. Therapy, such as cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), can also be beneficial for learning coping skills, improving self-awareness, and addressing underlying emotional issues.

By incorporating these strategies into your daily life, you can better manage the highs and lows of bipolar disorder and cultivate greater stability, resilience, and well-being. Remember that managing bipolar disorder is an ongoing journey, and it’s essential to be patient and compassionate with yourself as you navigate the ups and downs of living with this condition. With the right support and self-care, it’s possible to live a fulfilling and meaningful life despite the challenges of bipolar disorder. Having a strong support system, reaching out to supportive friends and family members, and joining support groups are essential strategies to effectively manage bipolar disorder and improve your well-being.

Alternative Mental Health Treatment Options for Bipolar Disorder

To effectively treat bipolar disorder, our center is committed to utilizing a variety of evidence-based medications and therapies, including the main medicine lithium, which requires careful dosage management, regular blood tests, and monitoring for potential side effects. The treatment of bipolar disorder typically involves a combination of medication, psychotherapy, and lifestyle modifications. The specific approach may vary based on the individual’s symptoms, the phase of the disorder, and their response to different interventions. Here are common treatment options for bipolar disorder:

  1. Medication:

  • Mood Stabilizers: Medications such as lithium, valproate, and lamotrigine are commonly prescribed to stabilize mood and prevent manic or depressive episodes.

  • Antipsychotics: Atypical antipsychotic medications like olanzapine, quetiapine, and risperidone may be used to address manic or mixed episodes.

  • Antidepressants: In some cases, antidepressant medications may be prescribed cautiously to manage depressive symptoms. However, they are often used in combination with a mood stabilizer to prevent manic episodes triggered by antidepressants.

  1. Psychotherapy:

  • Cognitive-Behavioral Therapy (CBT): CBT can help individuals identify and change negative thought patterns and behaviors. It is effective in managing depressive symptoms and preventing relapses.

  • Interpersonal and Social Rhythm Therapy (IPSRT): IPSRT focuses on stabilizing daily routines and improving interpersonal relationships, aiming to regulate circadian rhythms and reduce the risk of mood episodes.

  • Family-Focused Therapy (FFT): Involving family members in therapy can help improve communication, support, and understanding, creating a more stable environment for the individual.

  1. Electroconvulsive Therapy (ECT):

  • ECT may be considered for severe or treatment-resistant cases. It involves administering controlled electric currents to induce a brief seizure, which can positively affect brain chemistry.

  1. Hospitalization:

  • In cases of severe manic or depressive episodes, hospitalization may be necessary to ensure the individual’s safety and provide intensive treatment.

  1. Lifestyle Management:

  • Regular Sleep Patterns: Maintaining consistent sleep patterns is crucial, as disruptions can trigger mood episodes.

  • Healthy Diet and Exercise: A balanced diet and regular exercise contribute to overall well-being and can help manage symptoms.

  • Stress Reduction Techniques: Techniques such as mindfulness, yoga, and relaxation exercises can assist in managing stress.

  1. Self-Management Strategies:

  • Mood Tracking: Keeping a mood diary can help individuals and their healthcare providers identify patterns and triggers for mood episodes.

  • Medication Adherence: Consistently taking prescribed medications as directed is essential for preventing relapses.

  1. Support Groups:

  • Joining support groups or engaging in peer support can provide individuals with bipolar disorder an opportunity to share experiences, gain insights, and receive support from others facing similar challenges.


Inpatient and Outpatient Mental Health Treatment Options for Bipolar Disorder

  1. Inpatient Treatment:

    • Description: Inpatient treatment involves hospitalization in a psychiatric facility. It is reserved for individuals experiencing severe symptoms, acute mania or depression, or those at risk of harm to themselves or others.
    • Key Features:
      • 24-hour care and supervision.
      • Structured therapeutic activities.
      • Medication management.
      • Crisis intervention.
  2. Partial Hospitalization Program (PHP):

    • Description: PHP is an outpatient program that provides intensive treatment during the day, allowing individuals to return home in the evenings. It is suitable for individuals who do not require 24-hour supervision but need structured care.
    • Key Features:
      • Daily therapeutic activities.
      • Group therapy.
      • Individual therapy.
      • Medication management.
      • Psychiatric monitoring.
  3. Intensive Outpatient Program (IOP):

    • Description: IOP is less intensive than PHP and involves fewer hours of treatment per week. It allows individuals to live at home and maintain greater independence while receiving regular therapeutic support.
    • Key Features:
      • Group therapy sessions.
      • Individual therapy.
      • Medication management.
      • Psychoeducation.
      • Flexible scheduling.
  4. Outpatient Therapy:

    • Description: Outpatient therapy involves individual or group therapy sessions that occur on a less frequent basis than PHP or IOP. It is suitable for individuals with milder symptoms or those in the maintenance phase of treatment.
    • Key Features:
      • Individual therapy sessions.
      • Group therapy (if applicable).
      • Medication management.
      • Periodic psychiatric check-ins.
  5. Medication Management:

    • Description: Medication management can be provided on an outpatient basis by a psychiatrist or psychiatric nurse practitioner. This option is often combined with therapy to address medication effectiveness and side effects.
    • Key Features:
      • Medication evaluation and adjustments.
      • Monitoring for side effects.
      • Collaboration with therapists.
  6. Psychoeducation and Support Groups:

    • Description: Psychoeducation and support groups can be valuable components of outpatient care. These groups provide education about bipolar disorder, coping strategies, and peer support.
    • Key Features:
      • Educational sessions.
      • Peer support.
      • Coping skills training.

The choice between inpatient and outpatient options, as well as the specific level of outpatient care, is determined by the individual’s clinical needs and the recommendations of mental health professionals. Collaborative decision-making involving the individual, their family, and the treatment team is crucial for developing an effective and personalized treatment plan.


In conclusion, managing bipolar disorder requires a comprehensive approach that includes medical treatment, lifestyle adjustments, and strong support systems. Recognizing and addressing the early warning signs of mood episodes, adhering to prescribed medications, and engaging in regular talk therapy are critical steps in managing bipolar highs and lows. Support groups, maintaining a consistent daily routine, and developing effective coping skills can help individuals navigate the challenges of this condition. By working closely with mental health professionals and building a robust support network, people with bipolar disorder can better manage their symptoms and lead fulfilling lives.


Seeking Treatment for Bipolar Disorder? We Can Help!

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

FAQs on Managing Bipolar Disorder

How is bipolar disorder treated?

Bipolar disorder is treated with a combination of prescribed medications (mood stabilizers, antipsychotics, antidepressants), talk therapy (cognitive behavioral therapy, psychotherapy), and lifestyle changes (healthy diet, regular exercise, consistent sleep patterns).

What are the early warning signs of a manic episode?

Early warning signs include increased energy, decreased need for sleep, rapid speech, racing thoughts, impulsive behavior, and feeling unusually happy or irritable.

What are the early warning signs of a depressive episode?

Signs include persistent sadness, loss of interest in activities, fatigue, changes in sleep patterns, difficulty concentrating, and thoughts of self-harm or suicide.

How can I manage mood swings associated with bipolar disorder?

Managing mood swings involves adhering to a treatment plan, taking prescribed medications, maintaining a regular daily routine, keeping a mood journal, and identifying and avoiding triggers.

What role does sleep play in managing bipolar disorder?

Maintaining a consistent sleep schedule is crucial, as irregular sleep patterns can trigger mood episodes. Aim for a regular bedtime and wake-up time each day.

Can diet and exercise impact bipolar disorder?

Yes, a healthy diet and regular exercise can help manage symptoms. Limiting caffeine and avoiding recreational drugs are also important.

How can I develop effective coping skills?

Coping skills can include deep breathing exercises, relaxation techniques, spending time with supportive family members or friends, and engaging in hobbies or activities that bring joy.

What should I do if I or a loved one experiences severe mood episodes?

Seek immediate help from mental health professionals. In case of a crisis, contact emergency services or go to the nearest emergency room.

Are there support groups for people with bipolar disorder?

Yes, organizations like the Depression and Bipolar Support Alliance (DBSA) and Bipolar UK offer support groups, both in-person and online, to help individuals connect with others who understand their experiences.

Can alternative medicine help in managing bipolar disorder?

Some people find alternative treatments like acupuncture, yoga, or meditation helpful in managing symptoms, but these should complement, not replace, conventional treatment. Always consult with a healthcare provider before starting any alternative therapies.

How can family members support someone with bipolar disorder?

Family members can offer emotional support, help monitor for early warning signs of mood episodes, encourage adherence to treatment plans, and educate themselves about the condition.

What is the importance of a support network in managing bipolar disorder?

A strong support network provides emotional support, helps manage stress, and offers practical assistance during mood episodes, which can significantly improve outcomes.

How can talk therapy help in treating bipolar disorder?

Talk therapy, such as cognitive-behavioral therapy, helps individuals understand their condition, develop coping strategies, and address any underlying issues contributing to mood swings.

What should I avoid to prevent triggering mania or depression?

Avoiding excessive caffeine, recreational drugs, alcohol, and maintaining a consistent daily routine can help prevent mood episodes. Identifying personal triggers and learning to manage stress effectively are also important.

What should I do if I miss a dose of my medication?

Follow your healthcare provider’s instructions for missed doses. Do not double up on the next dose without consulting a medical professional.

Can bipolar disorder be cured?

Bipolar disorder is a lifelong condition, but with the right treatment and support, individuals can manage their symptoms and lead fulfilling lives.

How can I prevent relapse of mood episodes?

Preventing relapse involves adhering to treatment plans, maintaining a healthy lifestyle, recognizing and managing stress, and staying connected with a support network.

These FAQs provide a comprehensive overview of managing bipolar disorder, addressing common concerns and highlighting essential strategies for living with this condition. Always consult with mental health professionals for personalized advice and treatment plans.

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