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Table of Contents

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Susana Spiegel

Recovery Writer and Advocate

Last Update on April 25, 2024

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Bipolar disorder, also known as manic depression, is a mental health condition that affects millions of people worldwide. While many people associate bipolar disorder with emotional symptoms like mood swings, this complex condition can also cause a range of physical symptoms.

Information on the Physical Symptoms Associated with Bipolar Disorder

Bipolar disorder is a complex mental health condition that can cause a wide range of physical symptoms. While the most well-known signs and symptoms of bipolar disorder are related to mood, such as mania and depression, there are many other physical effects that people with bipolar disorder may experience. Some of the most common physical symptoms associated with bipolar disorder include:

These physical symptoms can be just as debilitating as the emotional and mental symptoms of bipolar disorder, and they can significantly impact a person’s quality of life. It’s truly important to note that not everyone with bipolar disorder will experience all of these physical symptoms, and the severity of symptoms can vary from person to person. Additionally, some physical symptoms may be more prominent during certain phases of the disorder, such as mania or depression.

Physical Symptoms Associated with Bipolar Disorder

Bipolar disorder is marked by distinct phases—mania, hypomania, depression, and psychosis—each associated with unique physical symptoms. Manic and hypomanic episodes are characterized by heightened energy and activity levels, while depressive episodes involve reduced energy and altered sleep patterns. Psychotic symptoms, such as hallucinations and delusions, may also occur during severe episodes.

Mood Swings

Mood swings are a hallmark symptom of bipolar disorder, and they can have a significant impact on a person’s physical health and overall functioning. These mood fluctuations go beyond the normal ups and downs that everyone experiences from time to time they are intense emotional states that can last for days or weeks.1 There are three main types of mood episodes that people with bipolar disorder may experience:
  • Manic Episodes: Characterized by feelings of euphoria, boundless energy, or extreme irritability.
  • Depressive Episodes: Marked by sadness, hopelessness, or a lack of energy.
  • Hypomanic Episodes: Similar to manic episodes but less severe, although they can still disrupt daily life.
  • Sleep Disturbances: People may experience insomnia during manic phases and hypersomnia during depressive phases.
  • Changes in Energy Levels: Manic episodes often involve a high state of energy and restlessness, while depressive episodes can cause extreme fatigue.
  • Appetite Changes: Reduced appetite is common during manic states, while increased appetite and significant weight changes may occur during depressive states.
These dramatic shifts in mood can make it difficult for people with bipolar disorder to carry out daily activities and maintain their overall health. That’s why it’s so important for those affected by bipolar disorder to work with their healthcare providers to develop effective treatment plans and make lifestyle adjustments that can help mitigate the impact of these symptoms. By taking a balanced approach that addresses both mental and physical health, people with bipolar disorder can improve their quality of life and better manage their condition.


During manic episodes, individuals with bipolar disorder experience a significant increase in energy and activity levels, which can manifest in various disruptive ways. The physical symptoms of bipolar disorder during these phases are intense and can lead to practical challenges in daily life2. Physical symptoms of manic episodes can include:
  • Increased Energy and Overactivity: People with bipolar disorder experience a substantial boost in energy during manic episodes, often resulting in a frenetic pace of activities.
  • Decreased Need for Sleep: Those experiencing mania may feel rested after only a few hours or be able to go days without sleep.
  • Restlessness: Manic episodes can cause an incessant urge to move, making it difficult for individuals to stay still.
  • Irritability: During mania, people with bipolar disorder may be quick to anger and often have a very short temper.
  • Reckless Behaviors: Manic episodes can lead to participation in high-risk activities without regard for the consequences, such as impulsive financial decisions or dangerous physical feats.
The impact of these bipolar disorder symptoms can be profound, affecting not only the individual but also those around them. Effective management strategies for people with bipolar disorder include medication, therapy, and lifestyle adjustments, such as establishing a routine that includes regular sleep patterns and physical activity. These interventions are truly important for mitigating the effects of mania and improving overall quality of life for those living with bipolar disorder.
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Hypomania presents with symptoms similar to mania but in a milder form. During hypomanic episodes, individuals with bipolar disorder experience an elevated mood, increased productivity, and hyperactivity, though these symptoms do not reach the full extremes of mania.3 Physical symptoms of hypomanic episodes can include the following:

  • Elevated Mood: People with bipolar disorder experience a noticeably uplifted mood during hypomanic episodes, which is less intense than in full mania.
  • Increased Productivity: Hypomania can lead to a significant boost in productivity and efficiency for those with bipolar disorder, often accompanied by a surge in creative ideas.
  • Hyperactivity: Individuals experiencing hypomania may have more energy than usual, leading to increased activity levels, but not as overwhelming as it would be during a manic episode.

Hypomanic episodes, while less severe than manic episodes, still significantly impact daily functioning and personal well-being for those living with bipolar disorder. Recognizing these signs and symptoms of bipolar disorder early can allow for prompt intervention, which can prevent the progression to more severe manic episodes. Effective management involves a combination of medication, therapy, and lifestyle adjustments to maintain stability and improve the quality of life for people with bipolar disorder.

How can bipolar disorder impact an individual's physical health?

Bipolar disorder can take a toll on a person’s physical well-being due to its effects on mood and energy levels. Individuals with bipolar disorder may experience gastrointestinal issues such as abdominal pain, nausea, vomiting, and diarrhea. These physical symptoms can be accompanied by sweating, rapid breathing, and feelings of panic or impending doom.


Depressive episodes in bipolar disorder feature significant physical symptoms that severely impair daily functioning.4 These symptoms include changes in sleep patterns, appetite fluctuations, and reduced energy levels5. Depression episodes physical symptoms can look like this:
  • Changes in Sleep Patterns: People with bipolar disorder may experience a range of sleep disturbances during depressive episodes. This can include insomnia, difficulty falling asleep and staying asleep, or hypersomnia, where individuals sleep excessively.
  • Appetite Fluctuations: Depressive episodes can cause increased or decreased appetite, leading to weight gain or loss.
  • Reduced Energy Levels: Individuals experiencing depression as part of their bipolar disorder often face a profound loss of energy, making even small tasks feel overwhelming and exhausting.
The physical symptoms of depression in bipolar disorder can be debilitating, making it truly important to address them proactively. Managing these symptoms often involves a combination of medication, psychotherapy, and lifestyle modifications, such as regular exercise and a structured daily routine. These strategies help stabilize mood and improve overall functioning, providing a pathway to a more balanced life for those living with bipolar disorder.
Failing to seek treatment for bipolar disorder can result in severe consequences, such as increased risk of substance abuse, financial instability, strained relationships, and a higher likelihood of suicidal thoughts or behaviors.
Bipolar disorder is a mental health condition characterized by drastic mood swings, causing individuals to experience intense emotional states ranging from manic or hypomanic episodes (emotional highs) to depressive episodes (emotional lows). During these episodes, a person’s mood, energy levels, and behavior can be significantly altered.
Bipolar disorder is primarily identified by the occurrence of extreme mood swings. These mood swings can alternate between periods of mania, characterized by elevated mood, increased energy, and impulsive behavior, and periods of depression, marked by feelings of sadness, hopelessness, and loss of interest in activities. These episodes typically last for several days or longer.


Severe episodes of mania or depression in bipolar disorder can lead to psychosis, which includes symptoms such as hallucinations and delusions. These psychotic symptoms are more commonly associated with manic episodes and can significantly impair an individual’s perception and behavior6. Physical symptoms of psychosis can be characterized as:
  • Hallucinations: People with bipolar disorder experiencing psychosis may sense things that are not present, such as hearing voices or seeing objects or people that aren’t there. These hallucinations can affect any of the senses (auditory, visual, tactile, olfactory, or gustatory).
  • Delusions: Psychosis can cause strongly held false beliefs not influenced by logical reasoning or explained by a person’s usual cultural concepts. These can include paranoid delusions (believing others are monitoring or plotting against them) or grandiose delusions (irrational beliefs in one’s abilities or importance).
  • Disorganized Thinking: Individuals with bipolar disorder experiencing psychosis may have difficulty organizing thoughts, leading to incoherent speech and making it hard to communicate effectively. Severe Anxiety: Psychosis can cause intense, overwhelming feelings of fear or dread that are not tied to any actual danger.
  • Physical Agitation: People experiencing psychosis may be unable to stay still, which may include pacing, hand wringing, or other repetitive motions.
  • Impaired Social Functioning: Psychotic symptoms can cause individuals with bipolar disorder to struggle with maintaining social relationships and performing at work or school.
Psychosis can profoundly disrupt a person’s life, making it truly important to recognize and treat these symptoms promptly. Treatment typically involves antipsychotic medications, which can help reduce the severity of psychotic symptoms, and psychotherapy to provide support and coping strategies. Ensuring a supportive environment and regular medical oversight can also help manage these episodes effectively and reduce their impact on daily life.

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Anxiety is a common symptom in both the manic and depressive phases of bipolar disorder, often exacerbating other symptoms. It manifests physically in several ways that can significantly affect daily functioning and overall quality of life for people with bipolar disorder 7. Physical symptoms of anxiety might appear as follows:

  • Muscle Tension: Individuals with bipolar disorder may experience persistent tension in muscles, often leading to aches and pains that can be constant or intermittent.
  • Restlessness: Anxiety can cause an inability to relax, resulting in constant movements such as fidgeting, pacing, or an overwhelming urge to move.
  • Physical Discomfort: People with bipolar disorder may experience general unease or discomfort that does not have a clear physical cause, making it difficult to stay still or at ease.
  • Tremors: Anxiety can lead to involuntary shaking or trembling, which can be subtle or quite pronounced.
  • Sweating: Excessive sweating, often not related to physical exertion or temperature, is another physical symptom of anxiety in bipolar disorder.
  • Rapid Heartbeat: An unusually fast heart rate that can occur even when at rest is a common sign of anxiety.
  • Shortness of Breath: Individuals with bipolar disorder may feel breathless or as though they cannot get enough air, which may occur in the absence of physical exertion.
  • Dizziness: Anxiety can cause a feeling of light-headedness or vertigo that can lead to balance issues.
  • Gastrointestinal Issues: Problems such as nausea, diarrhea, or stomach cramps often accompany anxiety in those living with bipolar disorder.

The physical manifestations of anxiety in bipolar disorder can be debilitating, making it truly important to address them effectively. Treatment options include medication, cognitive-behavioral therapy, and lifestyle modifications such as stress management techniques and regular physical activity. These strategies help mitigate the physical symptoms of anxiety and improve the overall management of bipolar disorder for those affected by this mental health condition.


Irritability in bipolar disorder can manifest in various disruptive physical behaviors that significantly impact social and occupational aspects of life for those living with this mental health condition8. These physical symptoms may present themselves as:
  • Physical Aggression: People with bipolar disorder may exhibit acts of aggression such as hitting, throwing items, or other violent behaviors that arise with little provocation.
  • Restlessness: Irritability can cause an ongoing inability to stay still, often resulting in pacing, shifting positions frequently, or an inability to settle into any activity for long.
  • Impulsive Behaviors: Individuals with bipolar disorder may engage in sudden and unpredictable actions that can include rash decision-making or impulsive spending.
  • Facial Grimacing: Irritability can lead to involuntary facial expressions that reflect inner tension and discomfort.
  • Tense Muscles: People with bipolar disorder may experience continuous muscle tension leading to discomfort and pain, often manifesting in the back, neck, or shoulders.
  • Increased Volume or Speed of Speech: Irritability can cause individuals to speak louder or faster than normal, which can be jarring or disruptive to conversations.
The physical symptoms of irritability in bipolar disorder can be challenging to manage, but addressing them through therapeutic strategies and medications is truly important. Interventions such as cognitive behavioral therapy, anger management classes, and lifestyle changes like regular exercise and adequate sleep can significantly help in reducing these symptoms and improving overall life quality for those affected by bipolar disorder.

Key Takeaways

Racing thoughts

Racing thoughts during manic phases of bipolar disorder are not only distressing but also manifest through various physical symptoms that can complicate daily activities and personal interactions for individuals living with this mental health condition 9. May resemble the following physical symptoms of racing thoughts:
  • Rapid Speech: People with bipolar disorder may speak at an unusually fast pace during manic episodes, making it difficult for others to follow the conversation.
  • Inability to Focus: Racing thoughts can cause a lack of concentration, disrupting work and personal tasks, making it hard for individuals to complete even simple activities.
  • Physical Exhaustion: The mental strain of constant, rapid thoughts can lead to overall fatigue and a lack of physical energy in those with bipolar disorder.
  • Restlessness: Racing thoughts can result in an inability to remain physically still, often accompanied by tapping feet, fidgeting, or pacing.
  • Interrupted Sleep Patterns: An overactive mind can make it difficult for people with bipolar disorder to fall or stay asleep, leading to sleep deprivation.
  • Heightened Sensitivity: Manic episodes can cause increased sensitivity to sensory input like sounds or lights, which can be overwhelming and distracting for those experiencing racing thoughts.
Racing thoughts can significantly affect one’s quality of life, necessitating effective management strategies. Treatments may include medications such as mood stabilizers and antipsychotics, alongside psychotherapy techniques like cognitive behavioral therapy to help slow down thought processes and promote mental calmness. Additionally, regular physical exercise and mindfulness practices such as meditation can also help in managing these symptoms more effectively for those living with bipolar disorder.


Sudden and risky actions without foresight or consideration of the consequences characterize impulsivity in bipolar disorder. These behaviors are not only hazardous but can also have severe physical and personal repercussions for individuals living with this mental health condition 10. These physical symptoms can be characterized by:

  • Excessive Spending: People with bipolar disorder may engage in rapid financial decisions that can lead to economic hardship or debt accumulation.
  • Reckless Driving: Impulsivity can cause individuals to operate vehicles in a dangerous manner that increases the risk of accidents and injury.
  • Engagement in Dangerous Activities: Impulsive people may engage in extreme sports or other risky behaviors without proper preparation or safety measures.
  • Substance Abuse: Bipolar disorder can lead to an increased likelihood of using drugs or alcohol impulsively, which can have immediate and long-term health effects.
  • Physical Injuries: Accidental injuries may occur due to impulsive decisions in physical activities or conflicts.
  • Neglect of Personal Health: Individuals with bipolar disorder may skip necessary health appointments or neglect personal care routines, which can worsen their physical health.

Managing impulsivity in bipolar disorder is truly important for preventing these potentially damaging outcomes. Treatment often involves a combination of pharmacological solutions, such as mood stabilizers or antipsychotic medications, and psychological interventions, including cognitive behavioral therapy and skills training. Implementing structured routines and engaging in mindfulness practices can also help individuals gain better control over their impulses, leading to improved safety and well-being for those affected by this mental health condition.

Psychomotor Agitation

Psychomotor agitation is a prevalent symptom of bipolar disorder, especially notable during manic episodes. It reflects the internal emotional turmoil and increased energy levels that are characteristic of these phases. This symptom not only manifests physically but also significantly disrupts daily life due to its intensity and persistence for individuals living with bipolar disorder 11. Physical symptoms of psychomotor agitation can look like this:

  • Pacing: People with bipolar disorder may engage in constant walking back and forth without a clear purpose or destination.
  • Restlessness: Psychomotor agitation can cause an overwhelming inability to stay still, manifesting in frequent position changes or fidgeting.
  • Inability to Sit Still: Individuals may experience difficulty remaining seated, often resulting in repeatedly standing up or shifting positions.
  • Rapid Talking: Speaking faster than usual can be a sign of psychomotor agitation, making communication difficult and exhausting for both the speaker and the listener.
  • Hand-Wringing: Repeated motions such as wringing hands or rubbing objects are indicative of nervous energy in those with bipolar disorder.
  • Tapping or Shaking Legs: Involuntary leg movements are symptomatic of internal agitation in individuals experiencing psychomotor agitation.

The presence of psychomotor agitation can be extremely distressing and hinder effective communication, personal relationships, and professional responsibilities for those affected by bipolar disorder. Management of this symptom is truly important and typically involves a combination of medication, such as antipsychotics or beta-blockers, and psychotherapy. Techniques such as relaxation exercises, mindfulness meditation, and structured physical activities can also help alleviate the severity of these symptoms, promoting a calmer and more controlled demeanor for individuals living with this mental health condition.

How We Can Help

Bipolar disorder is a complex mental health condition that affects individuals in numerous ways, including through a wide range of physical symptoms. At Cornerstone Healing Center, our mental health services, we understand the challenges faced by individuals and families affected by bipolar disorder. Our experienced team of professionals is dedicated to providing comprehensive, compassionate care tailored to each person’s unique needs. Whether you or a loved one seek an accurate diagnosis, effective treatment options, or ongoing support, we are here to help.

Our services include a range of evidence-based therapies, such as cognitive-behavioral therapy, family-focused therapy, medication management, and lifestyle support. We work closely with our clients to develop personalized treatment plans that address both the mental and physical aspects of bipolar disorder, promoting recovery and improving quality of life. If you or someone you care about is experiencing the physical symptoms of bipolar disorder, know that you are not alone. Reaching out for help is a sign of strength and the first step towards a brighter future. Contact our mental health services today to learn more about how we can support you on your journey to wellness!

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Author & Reviewers

susana spiegel recovery writer and SEO expert

Susana is a recovery writer and advocate with over 8 years in addiction recovery. She is passionate about sharing accurate and helpful information about mental health, addiction, and recovery. She holds a Bachelor’s in Christian Studies from Grand Canyon University and has over 7 years of working in the addiction field. 

lionel estrada lisac clinical director

Lionel is the Clinical Director of Cornerstone’s Scottsdale treatment facilities. He has had over 4 years at Cornerstone. He is personally in recovery and passionate about helping others overcome substance abuse and mental health challenges; he is trained as an EMDR, adopting a trauma-informed approach to treat the underlying issues.

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