Is Bipolar Disorder Manipulative? Separating Myths from Mental Health Realities

Some symptoms of bipolar disorder can be mistaken for intentional manipulation or manipulative behaviors, like gaslighting, love bombing, or seeking validation. However, it is a myth that a person who struggles with bipolar disorder is truly any more or less manipulative than someone else. There are no studies to support that hypothesis. Individuals living with bipolar disorder may seem manipulative due to the manic and depressive episodes that go hand in hand with the mental health disorder, and manipulative behaviors may be a result of a manic phase, impulsivity, or more. Though a person with bipolar disorder may struggle with emotional regulation in their daily life, these mental health issues do not always manifest in emotional manipulation. They may also struggle with poor memory, which in turn may be perceived as gaslighting behaviors.1 Bipolar patients also demonstrate structural brain abnormalities in prefrontal and parietal regions, which are regions associated with working memory processes.
manipulative bipolar disorder

Additionally, if someone seems like a manipulative person due to their diagnosis of bipolar disorder, they may also be misdiagnosed, and another mental health condition could be at play. If you or a loved one are struggling with bipolar disorder, or other co-occurring disorders, mental health treatment may help you find a support network, lasting wellness, and a healthier daily routine. AMFM Mental Health Treatment has over a decade of experience providing compassionate care for bipolar disorder.

Narcissistic Personality Disorder and Bipolar Disorder

Someone with bipolar disorder may be exhibiting behaviors of Narcissistic Personality Disorder, as well, particularly when manic, and the two disorders can co-occur. While a person with bipolar disorder may exhibit some personality traits of narcissism, such as an inflated sense of self-importance or lack of empathy, they may not have narcissistic personality disorder.2 Recent studies have found that when manic, bipolar patients do appear similar to the narcissistic group, sharing 12 out of 14 of the identifying criteria for NPD, supporting the inclusion of mania in the differential diagnosis of NPD.3

Bipolar Disorder and BPD

Comorbidity is the existence of two mental health conditions that exist in the same individual simultaneously. Studies have shown that comorbid BPD and BD are associated with marked psychosocial disability, with patients being more impulsive and aggressive than those with BPD and BD alone.4

Additionally, studies have also found that:

  • Approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder.
  • Approximately 20% of bipolar II patients were diagnosed with BPD,
  • Though only 10% of bipolar I patients were diagnosed with BPD.
While comorbidity rates are substantial, each disorder is nonetheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%).5

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 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%.7

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.8

Common Symptoms of Bipolar Disorder

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.9 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.

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.

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.

Cyclothymia is characterized by episodes consisting of hypomanic and depressive symptoms that do not meet the full criteria for bipolar or major depressive disorder.10 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. 

Transcranial Magnetic Stimulation (TMS) Therapy

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 for bipolar disorder, 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.11 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.12 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 Programs

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

There many other mental health disorders beyond bipolar disorder that can benefit from 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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Cho IYK, Goghari VM. The relationship between maintenance and manipulation components of working memory and prefrontal and parietal brain regions in bipolar disorder. J Affect Disord. 2020 Mar 1;264:519-526. doi: 10.1016/j.jad.2019.11.085. Epub 2019 Nov 13. PMID: 31780133. 

Cirino, E. (2025, April 26). Bipolar and narcissism: Tendencies and symptoms. Healthline. https://www.healthline.com/health/bipolar-and-narcissism

Stormberg D, Ronningstam E, Gunderson J, Tohen M. Brief communication: pathological narcissism in bipolar disorder patients. J Pers Disord. 1998 Summer;12(2):179-85. doi: 10.1521/pedi.1998.12.2.179. PMID: 9661104.

Lopes LM, Matias M, Marques M, Lopes IM, Reis J. Bipolar Disorder and Borderline Personality Disorder: A Diagnostic Challenge. Eur Psychiatry. 2023 Jul 19;66(Suppl 1):S701. doi: 10.1192/j.eurpsy.2023.1467. PMCID: PMC10661435.

 Zimmerman M, Morgan TA. The relationship between borderline personality disorder and bipolar disorder. Dialogues Clin Neurosci. 2013 Jun;15(2):155-69. doi: 10.31887/DCNS.2013.15.2/mzimmerman. PMID: 24174890; PMCID: PMC3811087.

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 Disorder. 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.