How A Person With Bipolar Disorder Thinks: Fact Vs. Fiction

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Psych CentralSubscribeYour Guide to Navigating Bipolar DisorderContent created by PsychCentral and sponsored by our partners. Learn moreWhat People with Bipolar Disorder Say About How They Think

Medically reviewed by Bethany Juby, PsyD — Written by Morgan Mandriota and Cathy Lovering — Updated on July 12, 2024

Types of bipolar disorder
Common thoughts
Thought management tips
Recap

Discover the common thought patterns people with bipolar disorder may have, and learn how they can manage their thoughts to lead happy, healthy lives with effective treatment.

Content warning: Self-harm, suicidal ideation

There are many misconceptions about how a person living with bipolar disorder thinks and acts.

“If more people knew how those with bipolar disorder think, it would help greatly with understanding and compassion for those with the illness,” said Claire Ishi Ayetoro, who lives with bipolar I disorder. “It could also greatly help those who care for someone with bipolar disorder.”

So, how does a person with bipolar disorder really think?

First, what is bipolar disorder?

Bipolar disorder is a mental health condition that involves shifts in mood. People with bipolar disorder experience a combination of emotional highs, called mania or hypomania, and periods of depression.

Manic episodes can last for days to weeks. Depressive episodes can last for weeks.

Although the exact number varies by source, researchers estimate about 2.4% of people have bipolar disorder.

The different types of bipolar disorder include:

bipolar I disorder
bipolar II disorder
cyclothymic disorder (cyclothymia)
substance-induced or medically induced bipolar disorder

Common thought patterns in bipolar disorder

Your thoughts may differ depending on the type of bipolar disorder you have. No matter the type, proper treatment can manage it.

Cyclical thoughts

People with bipolar disorder may experience periods of rational thoughts, high energy, and productivity followed by periods of low energy, self-deprecating thoughts, and anxiety.

Ayetoro describes her thinking as “cyclical.”

“Thinking in cycles makes consistency in anything a major difficulty,” she said.

Ayetoro adds there’s no set amount of time for these states of mind. Some last a while and others are short-lived. The way she thinks highly depends on her mood as well.

Depression and negative thinking

Depression influences more negative and hopeless thinking, according to Desreen Dudley, PsyD.

“During a depressive episode, feelings of hopelessness, helplessness, and low self-worth can lead [people with bipolar disorder] to view things negatively,” she said.

These episodes can be lengthy and make it difficult for individuals to focus or maintain motivation.

“When I’m feeling this way, my thoughts seem to move at a slower rate,” said Ikaika King, who received a bipolar II disorder diagnosis when he was 17. “My ideas feel cloudy and unfocused. It’s easy to feel overwhelmed and overworked, and I have a hard time taking things one step at a time. It feels like my brain is just stuck in the mud.

“Depression in bipolar disorder type II can feel like it’s never going to end and like you have no control of your life and [makes] me feel like I should just give up on my goals,” he said.

Mania and racing thoughts

Manic episodes involve an abnormally elevated mood, increased energy, grandiosity, and racing thoughts. Those racing thoughts can impair a person’s ability to focus or complete tasks. These periods may last for a week or longer.

“Sometimes, I’ll have multiple thoughts at the same time [or] my thoughts will go so fast in my brain I can’t capture them accurately,” said Gabe Howard, author of “Mental Illness Is an Asshole” and host of the “Inside Mental Health” podcast.

Dudley says manic episodes may inspire higher energy levels, creativity, and feelings of invincibility, too.

This is especially true for King.

“When I’m feeling the manic part of my bipolar, my thoughts come at a fast rate. Information feels like it’s easier to digest and I can find a level of flow in work and relationships with less effort. This is when my mind feels like it can process things with the most efficiency,” he said.

Self-harm and suicidal behavior

People with bipolar disorder are more vulnerable to experiencing thoughts of self-harm or suicide.

Jennifer Hicks received a bipolar II disorder diagnosis at 33 years old.

“During my late 20s and early 30s, I had an exercise addiction,” she said. “At the same time, I had anorexia and engaged in self-harm.”

Howard says his mind works differently than other minds, and some of those differences are life threatening.

“When my mind tells me that it would be OK to harm myself or even kill myself, that’s very serious. Everyone gets sad, but my emotional spectrum includes depression and suicidal depression.

“I thought about suicide as far back as I can remember, but I didn’t know it was wrong. Because I was born this way, it was ‘normal’ to me,” he said.

If you’re considering self-harm or suicide, you’re not alone

If you’re having thoughts of suicide or self-harm, you can access free support right away with these resources:

988 Suicide & Crisis Lifeline: Call the Lifeline at 988, 24 hours a day, 7 days a week.
The Crisis Text Line: Text “HOME” to the Crisis Text Line at 741741.
The Trevor Project: LGBTQIA+ and under 25 years old? Call 866-488-7386, text “START” to 678678, or chat online 24/7.
Veterans Crisis Line: Dial 988 then press 1, text 838255, or chat online 24/7.
Deaf Crisis Line: Call 321-800-DEAF (3323) or text “HAND” to 839863.
Befrienders Worldwide: This international crisis helpline network can help you find a local helpline.

Psychosis and delusional thinking

In severe cases of bipolar disorder, a person may experience psychosis. Psychosis involves delusional and paranoid thinking that’s out of touch with reality.

Howard says bipolar disorder psychosis is frightening because what he thinks is happening isn’t actually happening.

“I believed demons were under my bed and chasing me. I believed the demons were there because my brain told me they were there. Realizing my brain was giving me incorrect information was particularly devastating,” he said.

Managing your thoughts with bipolar disorder

If you relate to any of these thoughts or experiences, know that you’re not alone, and treatment is available. There are different ways to manage your thoughts and achieve stability with bipolar disorder.

Medication

Medication can be extremely effective for thought management.

“Since bipolar disorder is a neurological brain disorder, certain medications work to improve brain functioning,” said Dudley.

According to the National Alliance on Mental Illness (NAMI), common prescriptions may include:

mood stabilizers, like lithium
second-generation antipsychotics (SGAs)
antidepressants
anticonvulsants

It’s best to work with a mental health professional to determine the right medication plan for you.

Therapy

If you think you may have bipolar disorder, consider scheduling an appointment with a therapist. Seeking the help of a trained licensed professional is important for diagnosing and treating bipolar disorder.

Therapy can help you learn ways to challenge negative thinking patterns and practice more adaptive behaviors.

Support and education

Dudley recommends educating yourself about bipolar disorder. Seeking support from loved ones can also be invaluable in managing the condition. Building a strong support network and learning how to maintain emotional well-being can contribute to long-term stability.

“After sharing my experience with trusted family members, I found the help I needed and opened the doors to finding treatment that works for me,” said King.

Find personalized strategies that work for you

Different strategies work for different people. Here are some strategies to consider:

self-reflection
exercise
hobbies
creative outlets
journaling
deep breathing practices

Experimenting with various techniques and being open to trying new approaches can help you identify the most effective strategies for managing your thoughts.

You can combine these and other strategies with medication for a more holistic treatment plan. Speak with a mental health professional to figure out what might work best for you.

Let’s recap

No two people with bipolar disorder share the same thoughts or experiences, but there are some common thought patterns among many people who have it. This includes cyclical thinking, manic or depressive episodes, suicidal ideation, and psychosis.

Educating yourself can help remove the stigma and support those living with the condition. This also means being mindful of the harmful myths and stereotypes about people with bipolar disorder.

With effective treatment, Dudley says a person with bipolar disorder can experience extended periods of stable mood.

Medication, therapy, a strong support network, and other mental health resources can help you better manage your thoughts and achieve long-term stability.

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Ayetoro C. (2021). Personal interview.
Bipolar disorder. (n.d.).https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder/Treatment
Dailey MW, et al. (2023). Mania.https://www.ncbi.nlm.nih.gov/books/NBK493168/
Dudley D. (2021). Personal interview.
Hicks J. (2021). Personal interview.
Howard G. (2021). Personal interview.
King I. (2021). Personal interview.
Monson ET, et al. (2021). Assessment of suicide attempt and death in bipolar affective disorder: A combined clinical and genetic approach.https://www.nature.com/articles/s41398-021-01500-w
Rowland TA, et al. (2018). Epidemiology and risk factors for bipolar disorder.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116765/

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Medically reviewed by Bethany Juby, PsyD — Written by Morgan Mandriota and Cathy Lovering — Updated on July 12, 2024

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