Bipolar Disorder Fatigue: How to Manage It

Medically Reviewed by Jennifer Casarella, MD on August 21, 2022

With bipolar disorder you have extreme emotional mood swings. This can include episodes of highs, called mania, and lows, called depression.

During mania, you may feel very happy and full of energy, with racing thoughts and feeling a decreased need for sleep. Then you can suddenly shift into depression, where you feel very sad and hopeless with little energy.

Fatigue can come during both mania and depression. It's more than being sleepy. It’s feeling so tired that you can't do your normal things. You might feel like you can’t function or make it through your day.

Fatigue can be very common during bouts of depression. You can feel exhausted because you have no energy and you're struggling with sleep. But fatigue can also be a problem during mania. Your racing mind can bring insomnia. It takes a long time to recover from mania, so you can feel physically and emotionally drained during the recovery, as well.

Although it can be crippling, there are things you can do to manage fatigue and feel better.

Manage Your Disease

It’s important that you work closely with your doctor to keep your moods stable. Limiting the number of manic and depressive episodes you have will help you function at your best each day.

Managing bipolar disorder often means taking medication. If you take drugs, be aware of their side effects. Some medications can make you drowsy, so it’s very important that you don’t take too much. And if you take medicine for insomnia, take it only for as long you need to.

Create Good Sleep Habits

Get into a routine that includes:

  • Going to bed and getting up at the same time every day
  • Using your bedroom only for sleeping and sex
  • Limiting screen use close to bedtime
  • Keeping your bedroom at a cool, comfortable temperature

Exercise Regularly

You might not feel like you have the energy to move. But once you start an exercise plan, you’ll feel more energetic.

Start slow. Too much exercise can make you tired, too.

Ask your doctor for tips if you haven’t exercised in a while.

Don’t work your body too hard right before bed. That can make it harder to fall asleep.

Limit Caffeine

It can be tempting to reach for a soda or coffee to give you more energy. But that can backfire when you’re trying to fall asleep at night. Try to limit caffeine -- especially in the afternoons and evenings.

Get More Sunlight

If you can, get outdoors each day to get some sunshine. Light -- especially sunlight -- helps control your body clock, or what your doctor might call your circadian rhythms. That's what tells your body when it’s time to sleep and get up each day.

Check Your B12

From fruits and veggies to lean proteins, make sure you eat a balanced, nutritious diet. A shortage of certain nutrients -- particularly B12 -- can lead to things like fatigue and weakness.

You can find B12 in foods like:

  • Red meat
  • Dairy
  • Fish, such as trout, salmon, and tuna

Stay Hydrated

Make sure you drink enough water. It helps carry nutrients throughout your body. When you don’t have enough fluid, you can feel weak and tired. Don't forget that water-based foods like fruits, vegetables, and soup can help you reach that goal, too.

Show Sources


Anxiety and Depression Association of American: “Bipolar Disorder.”

American Psychiatric Association: “What Are Bipolar Disorders?”

Cleveland Clinic: “Fatigue.”

Mayo Clinic: “Fatigue.”

Veerle Bergink, MD, PhD, director of Women's Mental Health Program, professor, Department of Psychiatry, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai.

National Sleep Foundation: “Sleep Hygiene.”

National Health Service (U.K.): “Self-help tips to fight tiredness.”

Cancer Nursing: “The relationship between light exposure and sleep, fatigue, and depression in cancer outpatients: test of the mediating effect.”

National Institutes of Health Office of Dietary Supplements: “Vitamin B12.”

Harvard Health: “Fight fatigue with fluids.”

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