Understanding Bipolar Disorders as a Christian

This post is about Christian bipolar.

Written by a trauma therapist, a Licensed Master Social Worker, and current Student working toward her PHD learning how to bridge the gap between theology and psychology.

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If you’ve been searching for Christian bipolar information that is both clinically accurate and grounded in faith, you’re in the right place. Bipolar disorder is a recognized, treatable health condition, not a sign of weak faith, and understanding it helps us love and support one another well. In this Christian bipolar educational post, we’ll walk through how the DSM-5-TR describes Bipolar I, Bipolar II, and cyclothymic disorder, and how faith and professional care can work together.

This post is for education only and is not a substitute for an evaluation by a licensed professional.

Why does the church need to understand bipolar disorder?

Bipolar Disorder is often misunderstood within today’s culture, misrepresenting someone with bipolar as someone who is just “moody”. While the church on the other hand can completely misunderstand the science behind bipolar disorder and view it as simply just spiritual if not given the proper education. However. neither of these adequately represent bipolar disorder. Bipolar disorders are broken up into three specific categories, and understanding these diagnoses are crucial not only for the love, care and support of the individual but also for the church to better take care of its congregation.

How to understand bipolar disorder as a Christian?

Survey data cited by the National Institute of Mental Health (NIMH, n.d.) put the figure near 2.8% of U.S. adults in a given year. That number might not seem like a lot, but across the entire U.S. population, it shows that individuals within a congregation or even your own family might be struggling with bipolar disorder. Bipolar disorder can be broken down into three main categories: Bipolar I, Bipolar II, and cyclothymic disorder. The DSM-5-TR offers a way to better understand each diagnosis.

The following review of these diagnoses is not to be used to self-diagnose or treat. The information is for educational purposes only. If you or someone you know is in need of mental health care or support, contact a licensed mental health professional or your primary care provider. If someone is in crisis or having thoughts of suicide, call or text 988 (U.S.) or call 911. Asking for help is a courageous step.

The foundation of Bipolar related conditions:

The DSM-5-TR (American Psychiatric Association, 2022) describes bipolar-related conditions using three kinds of episodes:

• Manic episode: A manic episode requires typically 7 days or more of uncharacteristic high or irritable mood, with a radically significant increase of energy. It can include racing thoughts, less need for sleep, risky impulsive choices, and significant mood disruption.
• Hypomanic episode: A hypomanic episode is similar but has milder symptoms while also lasting for at least 4 days. Those around the individuals notice the change in behavior, but it doesn’t cause major impairment.
• Major depressive episode: A major depressive episode is understood as having at least 14-days of a low mood and or loss of interest in things previously cared about. It also includes changes in one’s sleep patterns, energy levels, and ability to concentrate.

What is Bipolar I?

Bipolar I is categorized by an individual having at least one manic episode, which is what specifically distinguishes it from the other bipolar-related diagnoses. Major depressive episodes can also occur, but the DSM-5-TR does not require them (American Psychiatric Association, 2022).

What a manic episode involves. The DSM-5-TR describes a distinct period of abnormally and persistently elevated, expansive, or irritable mood, along with a noticeable increase in energy or goal-directed activity. It lasts at least one week and is present most of the day, nearly every day (or any length of time if hospitalization is needed). During that period, several other changes appear, such as:

• Inflated self-esteem or feelings of unusual importance or ability
• A decreased need for sleep, such as feeling rested after only a few hours
• Being more talkative than usual, or feeling pressure to keep talking
• Racing thoughts, or jumping quickly from idea to idea
• Distractibility
• A rise in goal-directed activity or restless physical energy
• Risky activities with painful potential consequences, such as overspending or impulsive decisions

Individuals experiencing mania can also experience psychosis, which can include delusions (fixed false beliefs) and/or hearing or seeing things others do not. Depressive and hypomanic episodes often occur in Bipolar I too, but they aren’t required.

What is Bipolar II?

Bipolar II disorder involves at least one hypomanic episode and at least one major depressive episode, with no history of a full manic episode. Both parts are required.

What hypomania involves: According to the DSM-5-TR, a hypomanic episode presents the same kinds of mood changes as mania (elevated or irritable mood, more energy, less need for sleep, faster speech, racing thoughts, distractibility, inflated confidence, risk-taking) in a milder and shorter form (at least four consecutive days). Hypomania is a noticeable change in one’s typical function and mood that others observe, with the individual having symptoms most of the day, nearly every day, for the four-day period. It is not severe enough to cause marked impairment, require hospitalization, or involve psychosis. If any of those occur, clinicians classify the episode as mania instead, which would point to Bipolar I.

What major depression involves: A major depressive episode lasts at least two weeks. It includes low mood or a loss of interest or pleasure, plus several other changes, such as shifts in sleep or appetite, fatigue, trouble concentrating, feelings of worthlessness or guilt, or thoughts of death. Not every symptom has to be present, but the DSM-5-TR calls for five or more over the same two-week period. (American Psychiatric Association, 2022).

Debunking the misconception: Bipolar II for some time was describes as a milder form of Bipolar I. However, providers and researchers strong challenge against this idea due to the harm and misconceptions it can cause. For many individuals with Bipolar II, the depressive episodes are longer and disabling compared to the hypomanic episodes. These unpredictable shifts take a significant toll on an individual’s relationships, goals, work, and self-esteem. The risk of suicidal thoughts and behavior is also elevated, especially during depressive periods.

Why it’s often missed. Bipolar II is often missed due to the difficulty of catching and identifying hypomanic episodes. Hypomanic episodes can make someone feel more productive, confident, and a short period of increased energy, so people don’t typically mention it. Individuals often only seek help when they feel the depressive episode come on when they get really low. This can also cause Bipolar II to be misdiagnosed as depression. This is why clinicians will ask about past periods of untypically high energy, periods where one needed less sleep, and increased self-confidence out of the blue. Specifiers such as anxious distress, mixed features, and rapid cycling may also apply.

What is Cyclothymic Disorder?

Cyclothymic disorder is often less commonly known or talked about. Cyclothymic disorder can be identified as a long-term pattern of mood fluctuation that is milder than the symptoms seen in Bipolar I or II, but persistent mood fluctuation is still present.

What the DSM-5-TR looks for.

• The pattern lasts at least two years in adults, or one year in children and teens.
• There are numerous periods with hypomanic-type symptoms and numerous periods with depressive-type symptoms.
• Those symptoms never fully meet the criteria for a manic, hypomanic, or major depressive episode.
• The symptoms are present at least half the time, and the person is not symptom-free for more than two months at a time.
• The pattern causes real distress or difficulty in daily life and isn’t better explained by a substance or medical condition.

What does cyclothymic disorder look like: The highs and lows of this disorder can appear as increased periods of unusual energy, self-confidence, or reduced sleep; which is then followed by a period of low self-esteem, decreased energy, or isolation, with little periods in-between the two. These symptoms typically appear in adolescence or early adulthood it can be misunderstood as moodiness or temperament, causing someone to not be diagnosed for years.

SUMMARY AT A GLANCE

Diagnosis	Manic episode	Hypomanic episode	Major depressive episode
Bipolar I	Required (at least one)	Possible	Common, not required
Bipolar II	Never	Required (at least one)	Required (at least one)
Cyclothymic disorder	Never	Milder symptoms only	Milder symptoms only

Other Bipolar-Related Diagnoses

The DSM-5-TR also includes categories for presentations that don’t fit neatly above:

• Substance/medication-induced: mood symptoms that come from a substance or medication
• Due to another medical condition: symptoms linked to a physical health condition, such as a thyroid or neurological problem
• Other specified or unspecified: bipolar-like symptoms that cause distress but don’t meet full criteria, such as hypomania lasting only two to three days alongside depression

Additional Information

ADHD, trauma, anxiety, depression, substance use, medical conditions, or poor sleep can also present similar symptoms or even overlap. As a result, it is important that a licensed mental health or medical professional evaluates and closely analyzes an individual’s symptoms and history.

What kind of treatment is available for those with mood disorders?

These conditions are treatable. Guidelines (Yatham et al., 2018) generally point toward a combination:

• Medication guided by a licensed prescriber
• Therapy and psychoeducation, such as CBT, family-focused therapy, interpersonal and social rhythm therapy, and peer support groups
• Steady routines, especially regular sleep
• Support from family, friends, and community

Recovery isn’t a straight line, and ongoing care is normal for long-term health conditions.

A Christian Psychology Perspective to Bipolar I, II, and Cyclothymic disorder

When someone has been diagnosed with any mental health condition, including Bipolar I or II or Cyclothymia it is never a sign of lack of faith or failing the Lord. We cannot help developing a mental health condition, and scripture never pushes us away from the Lord but always pulls us closer to Him. Psalm 34:18 says the Lord is close to the brokenhearted, and Psalm 147:3 says He heals them. In Matthew 9:12, Jesus notes that the sick need a physician.

Taking care of one’s mental health is never a sign of weakness or failing the Lord. Rather it is an act of devotion to Christ as you are prioritizing taking care of one’s mind and body which is always seen as a good thing in the eyes of the Lord.

Including God into your mental health journey, alongside professional care is a beautiful opportunity to invite the Lord during our most difficult moments. So, you never have to feel that God is left out of you hardest moments.

If You’re Concerned

Contact a licensed mental health professional or your primary care provider. If someone is in crisis or having thoughts of suicide, call or text 988 (U.S.) or call 911. Asking for help is a courageous step.

Christian Mental Health Book Recommendation

The Bipolar Disorder Survival Guide, 3rd Edition: What You and Your Family Need to Know by David J. Miklowitz, PhD Description: A research-informed handbook that walks people with bipolar disorder, and the loved ones beside them, through understanding the condition and building a plan for staying well. This edition gives extra attention to Bipolar II and includes practical tools readers can put to use. It’s a solid, accessible starting point for anyone who wants clear information without the clinical jargon.

Darkness Is My Only Companion: A Christian Response to Mental Illness (Revised and Expanded Edition) by Kathryn Greene-McCreight Description: Written by a theologian and priest, this book blends her personal experience of bipolar disorder with careful theological reflection. She explores how faith and the church can respond to mental illness with honesty and compassion rather than judgment. It’s a thoughtful read for believers, pastors, and families looking for a faith-centered perspective.

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Closing Thoughts

I hope today’s blog post was not only educational but also helped you draw closer to God. If you or someone you know struggling to find peace and want guidance, please connect with a therapist today! Check out TherapyforChristians.com to get connected with a faith-based provider in your area!

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Disclaimer

Educational and Spiritual Support Only: I am not your therapist. The information provided on this blog—including book recommendations, worksheets, biblical insights, coping skills, or any other content on this blog—is for  educational, informational, and spiritual encouragement purposes only. No Professional Relationship Interacting with this content, including leaving comments or sending direct messages, does not create a therapist-client relationship. This blog is not a substitute for professional medical advice, diagnosis, or treatment.

Seek Professional Help: Always seek the advice of your physician or a licensed mental health provider regarding any medical or psychological condition. Never disregard professional advice or delay seeking it because of something you have read here. If you are in a crisis, please contact your local emergency services or a crisis hotline you all have the best and most blessed day!

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

National Institute of Mental Health. Bipolar disorder [Statistics]. https://www.nimh.nih.gov/health/statistics/bipolar-disorder

Yatham, L. N., Kennedy, S. H., Parikh, S. V., et al. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disorders, 20(2), 97-170.