Bipolar disorder makes life feel like a series of very high highs and seriously low lows. Sometimes you’re full of energy and excited about a thousand new plans and ideas. A few weeks or months later, you’re not interested in anything and can’t get out of bed.

These emotional highs are called mania, and the lows are called depression. If you go through cycles of experiencing both kinds of emotional extremes, you might have bipolar disorder. With bipolar, you can have months in a row when your mood is normal in between episodes of mania and depression, or you might have episodes closer together. 

It can be hard to tell bipolar disorder apart from other mental health challenges, so it’s important talk to a mental health professional if you think you have it. Knowing more about what makes it different from other conditions can also help you get the right diagnosis.

Early signs of bipolar disorder

Bipolar disorder is usually diagnosed when you’re a teenager, most often between the ages of 15 and 19. It can also be diagnosed in older or younger people. But the early signs can be confusing and easy to miss.

The first sign of bipolar disorder can be either depression or mania. If you’re depressed, you might feel deep sadness, exhaustion, irritability, guilt, or hopelessness. Mania feels like the opposite — you’re much happier and more excited and energetic than usual. Your thoughts are racing and you have trouble focusing. You might even feel like you’re invincible and do risky or dangerous things. It's not unusual for someone having a manic episode to end up in the ER because people around them are worried that they're not safe. You can learn more here about other common signs of depression and mania.

Some people’s first sign of bipolar is a confusing combination of symptoms that’s called a mixed episode. In a mixed episode, you feel depressed but also have some of the high energy and racing thoughts that show up in mania.

Whether you experience depression or mania first, your early symptoms might be less extreme. Some people go through a milder form of mania known as hypomania, which can just feel like having a lot of energy and being in a great mood. As you get older, your symptoms may get more intense.

Bipolar disorder vs. depression

If your first experience with bipolar is depression, you might think that you only have depression. Mania, especially hypomania, can be harder to recognize than depression, so you might not know right away when you experience it.

If you have symptoms of depression, a mental health professional can help you track your mood over time to see if the highs and lows of bipolar disorder show up.

Bipolar disorder vs. ADHD

A lot of the symptoms of attention-deficit hyperactivity disorder (ADHD) overlap with bipolar disorder, especially mania. Both bipolar disorder and ADHD might include:

• Irritability

• Trouble focusing

• Being very active and having a lot of energy

• Impulsive behavior and lack of self-control

• Trouble handling intense emotions

• 
  

The key difference is that mania comes and goes, but ADHD stays constant. That’s another reason why it’s important to keep track of your symptoms over time and spot patterns in how you feel.

Bipolar disorder vs. schizophrenia

Schizophrenia is a mental health condition that involves losing touch with reality. Like bipolar disorder, it often shows up for the first time during the teenage years. People with schizophrenia often see or hear things that aren’t there, or believe things that aren’t true. These kinds of symptoms are called psychosis.

In rare cases, depression and mania can both include psychosis. If an early experience of bipolar disorder does come with psychosis, it is often misdiagnosed as schizophrenia. But schizophrenia doesn’t involve patterns of major mood swings like bipolar does.

Getting the right diagnosis

Effective treatments for bipolar disorder do exist, and the right diagnosis is the first step toward getting the help you need. To make a diagnosis and rule out other disorders, a mental health professional will help you track your symptoms. Often, they’ll also interview your family and close friends to get more information about your mood and behavior over time.

If you have symptoms that seem like they might be bipolar disorder, an adult you trust can help you find professional support.