What Are ‘Bipolar Eyes’?

Bipolar disorder is a complex mental health condition characterized by a potential breadth of both manic and depressive symptoms, such as a euphoric mood and decreased need for sleep, shifting to loss of interest in activities, difficulty concentrating, and feeling hopeless.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298aac7eb0-3028-41cd-a5a0-45af42a74d0c It can be challenging to detect when these changes, known as mood episodes, are happening, but for some with bipolar, differences in their eyes may be a telltale sign. This effect, known colloquially as “bipolar eyes,” doesn’t happen to everyone and isn’t considered a hallmark symptom of the condition. However, it may be noticeable during a manic episode for some, says the psychiatrist Alex Dimitriu, MD, founder of Menlo Park Psychiatry and Sleep Medicine in California, and a medical reviewer at Everyday Health. “‘Bipolar eyes’ is a nonclinical term used to describe the look of someone in a manic episode, where the eyes convey excess energy or excitement,” he says. But, changes in eye appearance are just one potential part of a bigger picture when it comes to diagnosing and managing bipolar disorder.
What Do ‘Bipolar Eyes’ Look Like? Symptoms With a manic episode in bipolar disorder, increased levels of norepinephrine and dopamine flow through the body, says Dr. Dimitriu. Levels of glutamate also increase during an episode.e60dc2a1-f33c-4a05-9b50-8e3e8e59762989c1935b-f52a-42e9-8518-f9589f663438 These substances are natural chemical messengers (neurotransmitters) that play significant roles in mood, attention, memory, and perceptions of reward. When they’re elevated, a person tends to seem much more energized and excited, which can be reflected in how their eyes appear, he says.e60dc2a1-f33c-4a05-9b50-8e3e8e597629489f7877-283e-4d00-a6fd-e588fa7d95c2 According to Dimitriu, this can result in: Dilated pupils An intense stare Eyes that may change color or look darker due to larger pupils Rapidly darting eye movements Reduced blinking Smaller eyelids since eyes are open wider Eyes that seem sparkling “With the eyes like this, people can appear agitated and more alert,” he says. “That effect can be heightened with other signs of physical hyperactivity.” For instance, someone with “bipolar eyes” may seem to have trouble sitting still and be constantly fidgeting.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296401f46b-cbdb-4649-af2c-ac77d02a5355 The term is usually used for manic episodes, but “bipolar eyes” can refer to changes during depressive episodes as well, says Dimitriu. “During depression , eyes might have the opposite effect,” he says. “Pupils can become small and eyelids may seem heavier. People might look tired and lose the ‘gleam’ in their eyes. Their gaze may involve avoiding eye contact and looking off to the side.” As mentioned, although “bipolar eyes” may appear during a mood episode, especially mania, the hallmark symptoms of manic or depressive episodes are likely occurring, too. Common symptoms of a manic episode may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629b7244005-ca77-4264-976b-2ad53293efb6 Noticeably increased euphoria, energy, or irritability Grandiosity, or an exaggerated sense of self-confidence or well-being Reduced need for sleep Unusual talkativeness or rapid speech Racing thoughts or easy distractability Increased impulsive behaviors Poor or risky decision-making, such as going on shopping sprees or having risky sex Common symptoms of a depressive episode may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629b7244005-ca77-4264-976b-2ad53293efb6 Sad or depressed mood Loss of interest or pleasure in usual activities Sleeping too little or too much Appetite changes that result in unintentional weight gain or loss Restlessness Talking or moving more slowly than normal Fatigue Worthlessness, hopelessness, or guilt Difficulty concentrating or making decisions Suicidal thoughts or behaviors
What Does Research Show About ‘Bipolar Eyes’? What Research Shows Although research on eye appearance with bipolar disorder is limited, some research shows associations between bipolar disorder and changes in eye function. For example, in one study on schizophrenia and bipolar disorder, researchers evaluated eye-tracking tasks, called vergence eye movements. These involve the eyes moving in different directions to maintain focus on an object as its distance from the subject changes. In the research, those with bipolar showed difficulty with coordinating their eye movements to follow the object effectively, in part because they tended to have more rapid, jerky eye movements rather than smooth, coordinated ones.e60dc2a1-f33c-4a05-9b50-8e3e8e597629adb38a16-f10a-456e-b04d-431288d6e9c7 More research is still needed to learn about potential eye changes that can happen in people with bipolar disorder.
Are ‘Bipolar Eyes’ a Real Thing? Are ‘Bipolar Eyes’ Real? Although “bipolar eyes” is not a clinical term, the type of brain chemical changes experienced during bipolar episodes, which can cause changes in eye appearance, are indeed a real thing. The best way to manage these chemical changes is through medical treatment . The surge and drop in norepinephrine, dopamine, and other brain chemicals are the focus of medications for the condition, since they can influence these neurotransmitters, says Hilary Blumberg, MD, director of the Mood Disorders Research Program and professor of psychiatry at Yale School of Medicine in New Haven, Connecticut. However, if the presence of “bipolar eyes” makes you or your loved one feel like their bipolar disorder isn’t being adequately managed, talk to your doctor about other treatment options you could try, she says. That’s especially true if they’re accompanied by other symptoms that seem intense or severe, says Dimitriu. “There can be a misconception that there are limited treatments available for bipolar disorder,” says Dr. Blumberg. “Sometimes staying on the same medication is possible with a change in dose or a way to minimize the side effects, but there are also now multiple different types of medications that can be effective.”e60dc2a1-f33c-4a05-9b50-8e3e8e597629680cfb02-30f9-49da-89b3-0ed6114b1bf3 Several non-medication interventions can also be helpful alongside medication, including talk therapy and therapies that provide behavioral strategies such as changing sleep patterns and helping to educate and engage support systems, Blumberg adds.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c69584cc-953a-4578-8678-b8d6abe4ed18 “With many treatment options out there, there is often hope to find improved ways to feel better,” she says.
The Takeaway Due to changes in brain chemicals during a manic episode of bipolar disorder, there may be a change in the appearance and function of the eyes. Depressive episodes may lead to some eye changes as well, such as smaller pupils and heavier eyelids. “Bipolar eyes” is not a clinical term, but it may be helpful in assessing whether there is a change in bipolar symptoms.
Resources We Trust Mayo Clinic: Bipolar Disorder: Symptoms & Causes Cleveland Clinic: Bipolar Disorder National Institute of Mental Health: Bipolar Disorder Brain & Behavior Research Foundation: FAQs About Bipolar Disorder National Alliance on Mental Illness: Bipolar Disorder