What Exactly Does Someone Mean by Mania Eyes?

June 27, 2025

Authored by: Taylor Shaw, B.S.

Edited by: Eric Schlothan, LCSW

“Mania Eyes”or “Bipolar Eyes” refer to the changes of characteristics observed in the eyes of an individual who is experiencing a bipolar manic or hypomanic episode. Historically, tracking eye-movement to investigate mood regulation, emotional information processing, and psychomotor disturbances has been common in learning more about unipolar and bipolar disorders.¹ These eye-tracking studies utilize observation of pupil dilation, skipping and shifting eye contact, saccadic eye movements, and retinal tracking to understand cognitive function during the shifts from mania to or from depressive episodes.

Studies have suggested that those with a bipolar disorder may, during manic/hypomanic states, evidence sparkling eyes, have dilated pupils and, albeit rarely, evidence iris colour changes, but while during depressive episodes, they may have ‘less light in the eyes’ and report or experience perceptual dimming.² By tracking eye movements, researchers can further investigate cognitive and motor function in moments of dysphoric mania, bipolar depression, and bipolar mania. Recognizing the signs of “mania eyes” may help you provide care or resources to a loved one who is entering a manic or hypomanic episode.

If you or a loved one are struggling with bipolar mania or depression, don’t hesitate to call us today for access to mental health care professionals and world-class bipolar treatment.

More on Mania Eyes

Research has shown that eye changes during manic/hypomanic phases are most commonly observed as (1) ‘sparkling eyes’ – where the eyes are bright and there may be a shimmering quality (i.e. shining with or without wavering) and (2) dilated pupils.³ In some cases, light blue eyes may undergo eye color changes (though more rarely) to a brown color.

In contrast, when an individual is experiencing bipolar depression, he or she may seem to have less “bright” eyes; Pupil constriction tends to occur more rapidly in response to light in melancholic patients, and likely reflecting norepinephrine hypoactivation.⁴

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Mania Eyes in Bipolar I and Bipolar II

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, referred to as hypomania. A person struggling with Bipolar II will experience mood swings between depressive episodes and manic or hypomanic episodes, while an individual struggling with Bipolar I may or may not experience depression. When referring to “Mania Eyes,” one may note the shift during manic or hypomanic phases; for the clinical psychiatrist managing a patient with a bipolar disorder, observing the patient as unusually bright-eyed may be a key marker identifying a manic/hypomanic state.⁵

Additional Symptoms of Bipolar Disorder

Understanding the physical symptoms of a manic or hypomanic episode may help you or a loved one recognize when an episode is coming on, in addition to eye changes and pupil dilation.

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. 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.

Depressive Episodes / Bipolar Depression

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.

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.”⁶ Bipolar disorder is often characterized by drastic mood swings from high-energy, happiness and productivity 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%.⁷ 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.

Environmental Factors and Bipolar Disorder

In addition to the mountains of evidence that prove the importance of heredity and genetics in Bipolar disorder, there are also a variety of environmental factors that have been proven to trigger the onset of bipolar disorder. For example, bipolar patients with trauma history are more likely to show rapid cycling course, psychotic features, higher number of lifetime mood episodes, and greater risk for suicide ideation and attempts.⁸ Childhood trauma, viral infections during pregnancy and adulthood, birth complications, major developmental disruptions, and seasonal peaks, can all play a role in the onset of bipolar disorder.

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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.

Lithium

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.⁹ 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

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.¹⁰ 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 BD.

Genetic Studies of Bipolar Disorder

Bipolar Disorder is a complicated mental disorder, and as a result, the studies of the heritability of the mental health disorder are complex. However, a few family-based studies have identified a “number of chromosomal regions linked to bipolar disorder, and progress is currently being made in identifying positional candidate genes within those regions.”¹¹

Bipolar I Disorder, the most severe form of the condition, exists in all of the general population worldwide. In order to thoroughly understand the mental health conditions, researchers have tried many methods to narrow down the risk of developing bipolar disorder, from segregation analyses and adoption studies, to twin studies. Consistently though, the results have been clear that genetic factors play an important role in determining one’s risk of developing BP-I, in addition to environmental factors.¹²

Nick Craddock, a leader of molecular genetic research on bipolar disorder, discovered that while “occasional families may exist in which a single gene plays a major role in determining susceptibility, the majority of bipolar disorder involves more complex genetic mechanisms such as the interaction of multiple genes and environmental factors.”¹³ These genetic studies opened the door for many successive studies to delve further into genetic mapping and learning which genes on a molecular level might contribute to Bipolar Disorder.

Genetic Sequencing

The latest studies have used gene-mapping to identify 36 credible genes in the causes of bipolar disorder. Though neuroscience is increasingly complex, specific cell types have been identified in the psychological process of bipolar disorder, “including GABAergic interneurons and medium spiny neurons. Together, these analyses provide additional insights into the genetic architecture and biological underpinnings of bipolar disorder.” ¹⁴ Another study “performed a genome-wide association study of 41,917 bipolar disorder cases and 371,549 controls of European ancestry, which identified 64 associated genomic loci.”¹⁵ Slowly, researchers are bringing us closer to the answers we need to truly understand this complex disorder.

Family Therapy Programs for 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. If you’re living with a family member who struggles with manic episodes, and you’re looking for support or resources, call us at AMFM today for more information.

Citations

Carvalho N, Laurent E, Noiret N, Chopard G, Haffen E, Bennabi D, Vandel P. Eye Movement in Unipolar and Bipolar Depression: A Systematic Review of the Literature. Front Psychol. 2015 Dec 15;6:1809. doi: 10.3389/fpsyg.2015.01809. PMID: 26696915; PMCID: PMC4678228.

Parker G, Coroneo MT, Spoelma MJ. Bipolar eyes: Windows to the pole? Aust N Z J Psychiatry. 2023 Nov;57(11):1405-1406. doi: 10.1177/00048674231195259. Epub 2023 Aug 26. PMID: 37632441; PMCID: PMC10619177.

American Psychological Association. (n.d.-b). Bipolar Disorder. 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.

Aldinger F, Schulze TG. Environmental factors, life events, and trauma in the course of bipolar disorder. Psychiatry Clin Neurosci. 2017 Jan;71(1):6-17. doi: 10.1111/pcn.12433. Epub 2016 Sep 21. PMID: 27500795; PMCID: PMC7167807.

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.

Escamilla MA, Zavala JM. Genetics of bipolar disorder. Dialogues Clin Neurosci. 2008;10(2):141-52. doi: 10.31887/DCNS.2008.10.2/maescamilla. PMID: 18689285; PMCID: PMC3181866.

Craddock N, Jones I. Molecular genetics of bipolar disorder. British Journal of Psychiatry. 2001;178(S41):s128-s133. doi:10.1192/bjp.178.41.s128

O’Connell, K.S., Koromina, M., van der Veen, T. et al. Genomics yields biological and phenotypic insights into bipolar disorder. Nature 639, 968–975 (2025). https://doi.org/10.1038/s41586-024-08468-9

Mullins N, & et al. Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology. Nat Genet. 2021 Jun;53(6):817-829. doi: 10.1038/s41588-021-00857-4. Epub 2021 May 17. PMID: 34002096; PMCID: PMC8192451.