Understanding High-Functioning Bipolar: Signs, Struggles, and Support

While high-functioning bipolar disorder is not a clinical diagnosis or a medical term, the topic is well-studied and refers to individuals who are living with bipolar disorder without it causing great disruption to their daily lives. High-functioning bipolar disorder isn’t specified as a classification in the Diagnostic statistical manual of mental disorders. However, the DSM-5 does point out that the severity of bipolar disorder varies depending upon the individual, the type of bipolar disorder (bipolar I disorder vs. bipolar II disorder), and genetic predispositions. High-functioning bipolar disorder doesn’t necessarily mean that an individual’s symptoms–their manic episodes or depressive episodes–are any less impactful or severe, but rather that a person can walk through his or her daily life with less disruption. 

Understanding High Functioning Bipolar: Signs, Struggles, and Support

An individual with high-functioning bipolar disorder will still experience manic episodes, hypomanic episodes, and/or depressive episodes, but with effective treatment, they can execute upon daily tasks and manage their energy levels. If you or a loved one are currently struggling with bipolar I or bipolar II, a comprehensive treatment plan, psychotherapy with a mental health professional, and psychiatry may help you unlock a higher quality of life, and can help temper your mood swings to achieve higher functioning. 

AMFM Mental Health Treatment has over a decade of experience treating mental health disorders, mood disorders, and specifically bipolar disorder. Contact us today if you’re interested in mental healthcare and a personalized treatment plan to manage your bipolar symptoms.

More About Bipolar Disorder

Bipolar Disorder is defined by the American Psychological Association as a “serious mental illness in which common emotions become intensely and often unpredictably magnified.”1 Bipolar disorder is often characterized by mood swings from high-energy, euphoric states, to lows of sadness, exhaustion, and major depression, and the shift between these two phases can grow to be so intense that an individual may consider suicide. Studies have shown that individuals living with bipolar disorder are at increased risk to attempt suicide at least once in their life, by 25-60%.2

Bipolar I Disorder vs. Bipolar II Disorder

Bipolar I Disorder is considered the most severe form of Bipolar Disorder, and is diagnosed when an individual enters a manic state, characterized by an intense mood swing “up,” consisting of high-energy, uncomfortable irritability, racing thoughts and impulsivity. While Bipolar II Disorder is also characterized by manic episodes, they may be shorter or less severe, (hypomania). A person struggling with Bipolar II will experience depressive episodes, while an individual struggling with Bipolar I may or may not experience depression. 3

Signs and Symptoms of High-Functioning Bipolar Disorder

Though an individual may seem high-functioning, he or she will still exhibit signs of bipolar disorder. These signs and symptoms may look like mood changes, periods of mania characterized by impulsive behavior and elevated mood, and/or mixed episodes, or they may be engaging in self-harm behaviors. In the cases of severe symptoms, hospitalization may be encouraged, but in a high-functioning individual, these symptoms of bipolar disorder will not seem so drastic, but rather smaller and only slightly out of character for you or your loved one.

Manic Episodes

In order to be diagnosed with bipolar I disorder, according to the diagnostic and statistical manual of mental disorders (DSM-5) an individual must experience at least one manic episode.4 Episodes of mania are generally characterized by mood changes, increased energy levels, rapid talking, increased grandiosity, (an overinflated sense of self), distractibility (which may be misattributed or related to attention deficit hyperactivity disorder), engaging in impulsive or risky behavior, and more.

Hypomanic Episodes

Hypomania refers to a shorter duration of manic symptoms, with generally milder symptoms. In order to be diagnosed with bipolar II, an individual must experience at least one episode of hypomania, in addition to an episode of depression (manic depression). According to the DSM-5, hypomanic episodes are common in bipolar I disorder as well, but are not required for the diagnosis of bipolar I.

Depressive Episodes

In order to be diagnosed with bipolar II, an individual must experience both a hypomanic and a depressive episode. Depressive episodes are characterized by low moods, suicidal thoughts, or other common symptoms of depression like loss of interest, low self-esteem, fatigue, or changes in appetite. If you or a loved one are struggling with suicidal ideation and need immediate medical assistance, please call 911 for emergency medical attention, or 988, the National Suicide and Crisis hotline, which is available 24/7, free of cost.

Cyclothymic Disorder

Cyclothymia is characterized by episodes consisting of hypomanic and depressive symptoms that do not meet the full criteria for bipolar or major depressive disorder.5 A high-functioning individual who may seem like he or she is experiencing symptoms of bipolar disorder may actually be struggling with this related mental health condition.

Types of Therapy Offered for Bipolar Disorder

Therapy for bipolar disorder is a key piece of effective treatment for a greater quality of life and emotional regulation with this lifelong condition, and may help you or your loved one with executive functioning throughout the day. Seeking care from a mental health professional can help regulate extreme mood episodes for a long-term lifestyle change. AMFM Mental Health Treatment offers a combination of holistic mental health services‌ and evidence-based therapies to provide treatment options that meet your individual needs:

Individual Therapy

Individual therapy takes place in a one on one setting with a licensed professional, usually consisting of a combination of dialectical and cognitive behavioral therapies, in which a person can talk through his or her individual struggles. Individual therapy and mental health care is one of the most crucial steps for those facing mental health challenges.

Group Therapy

Group therapy sessions can be used to help provide structured times to help you understand that you are not alone in your struggles, that your peers are also walking through these challenges, while also providing guidance, suggestions and communications from psychologists with specialized backgrounds. These groups can span a variety of backgrounds, including but not limited to art therapy, somatic therapy, and narrative therapy.

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is a form of therapy that’s focused on restructuring and reprogramming maladaptive and negative thought processes. Psychologists are trained to help you change your cognitive and emotional processes in order to outgrow coping mechanisms that may no longer be serving you.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is most commonly referred to as “talk therapy,” and is designed to help process emotions. Qualified professionals offer psychological therapy to move forward with healthy ways of engaging in interpersonal relationships and alleviating physical and emotional distress.

Eye Movement Desensitization and Reprocessing Therapy (EMDR)

EMDR Therapy is a renowned method of reprocessing most often used in trauma therapy. By activating the prefrontal cortex through a series of bilateral stimulation, qualified professionals can lead you through traumatic experiences, helping you to alleviate the distress symptomized by trauma.

Crisis Intervention and Stabilization Services

A crisis is defined by the National Library of Medicine “as an overwhelming event, which can include divorce, violence, the passing of a loved one, or the discovery of a serious illness.” The goal of crisis intervention is to provide safety and reduce any potential harm to an individual undergoing a crisis.

TMS Therapy is a type of therapy that uses magnetic pulses to treat depression by stimulating neurotransmitters in the brain. This is a noninvasive method of treatment that some mental health programs offer for treatment of depression, bipolar disorder, and post-traumatic stress disorder.

Psychiatric Care for Bipolar Disorder

AMFM Mental Health Treatment provides comprehensive psychiatric care, along with traditional therapeutic modalities. Our on-staff clinicians are equipped to design personalized treatment plans for your continued success. In combination with psychotherapy, psychiatric care is handled safely, to help you or your loved one overcome mental health challenges. 

For over half a century, Lithium has been used as a mood stabilizer to treat bipolar disorder, treating both the manic episodes as well as the bipolar depression.6 However, Lithium treatment can have side effects and complications in long-term use on the kidney and thyroid, and it’s important that an individual keep his or her clinical team in the loop on any side effects as they come up.
Antidepressants and antipsychotics are both commonly used (alone and in tandem) in the treatment of bipolar disorder as mood stabilizers. However, rapid cycling is sometimes a side effect that is associated with antidepressant treatment in bipolar disorder. 7 Conventional antipsychotics have been proven to be effective for short-term treatment of bipolar disorder, but there has been little research on the long-term efficacy of antipsychotics and antidepressants for individuals living with bipolar disorder.

Family therapy may be used when a loved one’s mental health symptoms are affecting others. This can increase a family members’ understanding of anxiety and talk about how to support each other. Family-focused therapy sessions and support groups can improve communication patterns, focus on problem-solving, address unresolved conflicts, and increase the sense of understanding among one another.

Additional Mental Health Conditions for Treatment

AMFM Mental Health Treatment has extensive experience treating a variety of mental health disorders through evidence-based therapies, including but not limited to the following:

  • Depressive Disorders
  • Eating Disorders
  • Obsessive Compulsive Disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD)
  • ADHD
  • Bipolar Disorder
  • Mood Disorders
  • Personality Disorders
  • Psychosis 
  • Schizophrenia
  • Panic Attacks

Recovery can feel isolating; mental health programming can provide cohesive treatment plans to help you or your loved one as you move forward.

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American Psychological Association. (n.d.-a). American Psychological Association. https://www.apa.org/topics/bipolar-disorder

Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010 Feb;12(1):1-9. doi: 10.1111/j.1399-5618.2009.00786.x. PMID: 20148862; PMCID: PMC4536929.

Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Mental Health Services Administration (US); 2016 Jun. Table 12, DSM-IV to DSM-5 Bipolar I Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t8/.

Bielecki JE, Gupta V. Cyclothymic Disorder. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557877/.

Burdick KE, Millett CE, Russo M, Et. al, The association between lithium use and neurocognitive performance in patients with bipolar disorder. Neuropsychopharmacology. 2020 Sep;45(10):1743-1749. doi: 10.1038/s41386-020-0683-2. Epub 2020 Apr 29. PMID: 32349118; PMCID: PMC7419515.

Kusumakar V. Antidepressants and antipsychotics in the long-term treatment of bipolar disorder. J Clin Psychiatry. 2002;63 Suppl 10:23-8. PMID: 12392350.