What Is High-Functioning Bipolar Disorder?

Bipolar disorder is a serious mental health condition characterized by shifts in mood between mania and depression. While the disorder often impacts an individual’s ability to function in a significant way, many people are able to limit these effects, continuing to maintain successful careers, foster healthy relationships, and appear happy, even if they are struggling internally. People who experience bipolar disorder in this way are often said to be living with high-functioning bipolar disorder. Below, we’re covering high-functioning bipolar disorder—its symptoms, causes, and treatment.

What is high-functioning bipolar disorder?

Bipolar Disorder is a mood disorder characterized by manic highs and depressive lows in succession. The expression of manic and depressive symptoms can vary depending on the person who experiences them. High-functioning bipolar disorder is a term used to describe someone who may experience less severe emotional symptoms or fewer disruptions to their ability to function. 

Someone may be considered high functioning for a variety of reasons. In some cases, the designation refers to the severity of an individual’s manic and depressive episodes. They may experience less extreme lows and highs or episodes that are shorter in duration. It can also refer to someone’s ability to maintain a career, nurture relationships, and address daily challenges.

The term high-functioning bipolar disorder is not an official diagnosis, and its use may be misleading because it can suggest that an individual is experiencing a less severe form of the disorder, which isn’t always the case. An increased ability to function may come at the expense of greater challenges in other symptoms, such as risky behavior. An individual may be able to function at a high level due to intense external pressures or stress that they’ve put on themselves, which can complicate other areas of their lives. Minimizing the effects an individual with bipolar disorder experiences can worsen emotional symptoms of the disorder and, in some cases, cause them to interpret that they don’t need treatment. 

Conceptualizing bipolar disorder in this way can, however, provide insights into the methods of treatment that may work well. Many people who are thought to function at a high level with bipolar disorder have found ways of managing the condition that allow them to achieve their goals. 

Types of bipolar disorder

The existence of a high-functioning form of bipolar disorder helps illustrate the varied ways this mental health condition can manifest. There are four recognized forms of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and unspecified bipolar disorder. Each form of the condition can produce different symptoms and require different treatment methods.

• Bipolar I disorder: Bipolar I disorder is considered the most severe form of the condition and is marked by periods of mania that last at least a week or manic symptoms that are severe enough to warrant immediate medical care. During these periods of mania, people with bipolar disorder may be unable to sleep, experience a racing pulse, and exhibit risky behavior. This condition is also characterized by depressive episodes that last approximately two weeks. During periods of depression, the individual may experience low mood, fatigue, and a lack of motivation. 
• Bipolar II disorder: Bipolar II disorder is characterized by manic episodes that are usually less severe than those of bipolar I. This sometimes means that the mania is not visible to others (or even the person with the disorder), as mania may be reflected in an incrementally heightened state. Depressive episodes in bipolar II may be more severe though. Bipolar II is often misdiagnosed as depression, which can lead to further complications, as treating only the depressive episodes of bipolar disorder may lead to confusion and isolation.
• Cyclothymic disorder: Cyclothymic disorder is the least severe of the types of bipolar disorders, with mood swings that typically do not disrupt day-to-day living. A cyclothymic disorder does not necessarily progress into more intense forms of bipolar disorder, though it can in some cases. 
• Unspecified bipolar disorder: Unspecified bipolar disorder is marked by manic and depressive episodes, but with symptoms that may lack the severity or duration typical in other forms of bipolar disorder. While people who have bipolar disorder usually experience episodes that last one week or longer, people with this form of the condition might experience highs and lows that cycle back and forth in days rather than weeks.

How high-functioning bipolar disorder differs from other types?

The term high-functioning bipolar disorder is not identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is instead a categorization that some people use to identify any form of bipolar disorder that is managed by the person with the condition somewhat effectively. Someone with bipolar I or bipolar II could be considered high functioning, as can people with unspecified bipolar disorder and cyclothymic disorder. Each of these forms of bipolar disorder is marked by a series of manic and depressive episodes. What makes someone high functioning is their ability to cope with and adapt to the onset of an episode.

While the term high-functioning carries with it a connotation of being better or healthier, this is not necessarily the case. Many people with high-functioning bipolar disorder have learned how to cope by hiding their condition or putting pressure on themselves. People with high-functioning bipolar disorder might actually experience more challenging symptoms of stress and anxiety because they believe they must constantly be “on” or working to hide the severity of the effects of the disorder.

Treating high-functioning bipolar disorder

Because individuals with high-functioning bipolar disorder can often manage the condition effectively, they may be overlooked for treatment. In some cases, functioning at a high level is not a goal of treatment but is instead another facet of the disorder that may need to be addressed and modified.

A mental health care professional can determine how to develop a treatment plan for bipolar disorder based on an individual’s level of functioning. The most common form of treatment for bipolar disorder is a combination of therapy and medication. Therapeutic modalities such as cognitive behavioral therapy can help an individual process their emotions regarding bipolar disorder and learn how to function in a healthy and productive manner. 

Medication may include antidepressants, sleep aids, antipsychotic medication, and sedative aids. Because the symptoms of bipolar disorder swing from one high to another, treatment often requires adjustments throughout a person’s life. Always consult with a healthcare professional before starting or stopping any medication.

Social support can also be a vital part of managing symptoms of high-functioning bipolar disorder. Because someone experiencing the disorder in this way may not exhibit symptoms, their family and friends could be unaware of its existence. However, loved ones can be a significant source of support, guidance, and care. 

How online therapy can help

Research suggests that online therapy can help individuals navigate the symptoms of bipolar disorder. For example, researchers in one study concluded that online therapy can be effective in the treatment of bipolar disorder in a collaborative-care program. Four hundred participants with bipolar disorder received treatment via videoconferencing. Rates of participation were similar to those at a facility that treats people with bipolar disorder. Improvements in several clinical indices were found in participants who completed the program.

BetterHelp hosts licensed online therapists who have expertise in bipolar disorder and can help you manage the symptoms. With BetterHelp, you can participate in therapy remotely, which can be helpful if a depressive episode makes leaving home difficult. You’ll also have the option of reaching out to your therapist outside of sessions; so, if you have a question about bipolar disorder, you can send your therapist a message, and they’ll respond when they’re able. A licensed mental health provider can help you learn how your specific bipolar disorder symptoms manifest and work with you to manage them.