Understanding Bipolar Disorder
What Is Bipolar Disorder?
Bipolar disorder is a mental health condition characterised by episodes of depression and unusually elevated or irritable mood, known as mania or hypomania.
During mania, a person may experience increased energy, reduced need for sleep, unusually high confidence or impulsive behaviour. Depressive episodes may involve persistent sadness, fatigue and loss of interest.
Bipolar I disorder involves at least one manic episode, while Bipolar II involves hypomania and major depressive episodes. These are distinct episodes, not ordinary day-to-day mood changes (Grande et al., 2016).
Prevalence in India
A study based on India's National Mental Health Survey (2015–2016), involving 34,802 adults across 12 states, estimated:
Current prevalence: 0.3%
Lifetime prevalence: 0.5%
Treatment gap: 70.4%
This means approximately three in every 1,000 surveyed adults experienced bipolar disorder at the time of assessment, while roughly seven in ten affected individuals were not receiving treatment (Vajawat et al., 2023).
These figures reflect the survey period and should not be interpreted as current estimates.
Stigma Surrounding Bipolar Disorder
Misconceptions about bipolar disorder can lead to discrimination, social isolation and reluctance to seek help.
A systematic review of Indian studies found that internalised stigma was associated with reduced self-esteem, lower social participation and poorer quality of life. Families and caregivers may also experience stigma (Pal et al., 2021).
Understanding bipolar disorder as a health condition, rather than a personal weakness, is essential to reducing these barriers.
Latest Evidence on Treatments
Treatment depends on whether a person is experiencing mania, depression or a period of stability.
Updated Indian clinical guidelines recommend individualised treatment using appropriate mood stabilisers, including lithium, and certain antipsychotic medications (Menon et al., 2026).
A major 2026 evidence review published in The BMJ also supports established medications for preventing relapse. Psychological approaches, particularly group psychoeducation and cognitive behavioural therapy, can provide additional benefits alongside medication (De Prisco et al., 2026).
Treatment selection and medication monitoring require professional supervision.
Conclusion
Bipolar disorder is manageable, and many people lead fulfilling lives with appropriate care.
Early recognition, continued treatment, supportive relationships and reduced stigma can improve outcomes. Making evidence-based mental healthcare accessible and affordable remains an important step towards helping people receive the support they need.
References
Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. The Lancet, 387(10027), 1561–1572.
Vajawat, B., Suhas, S., Moirangthem, S., et al. (2023). Bipolar affective disorder in India: A multi-site population-based cross-sectional study. Indian Journal of Psychiatry, 65(12), 1230–1237.
Pal, A., Saxena, V., & Avinash, P. (2021). Stigma in bipolar affective disorder: A systematic quantitative literature review of Indian studies. Indian Journal of Psychological Medicine, 43(3), 187–194.
Menon, V., Ganesh, R., Deep, R., et al. (2026). Clinical practice guidelines for the management of bipolar disorder: 2025 update. Indian Journal of Psychiatry, 68(1), 8–43.
De Prisco, M., Oliva, V., Miola, A., et al. (2026). Evidence based interventions for bipolar disorder across phases and age groups: Living umbrella review, evaluation, analysis, and communication hub (U-REACH) project. The BMJ, 394, e100216.