Bipolar disorder may, in some cases, affect the eyes. However, this is not consistent in all people with the condition, and should not be taken as a sign in itself.
Bipolar disorder is a complex mental health condition that can show up in very different ways.
Someone who lives with bipolar disorder may experience manic episodes, a symptom associated with bipolar 1 disorder. It’s suggested that you may be able to notice mania in someone’s eyes.
While their eyes may look different, this is the body’s natural response to symptoms of mania or hypomania which could lead to increased energy levels and symptoms of psychosis.
You’ll find more than a few anecdotes suggesting that bipolar disorder can change the appearance of the eyes, generally by affecting pupil dilation, gaze, and even eye color.
So-called bipolar eyes might include:
- dilated pupils
- “sparkling” eyes, or eyes that appear more liquid than usual
- eyes that change color or become black
- widened or narrowed gaze, depending on the type of mania
Some say dysphoric mania, or a mood episode with mixed features of mania and depression, leads to a narrowed or squinting gaze.
Since these supposed eye changes happen during episodes of mania, you might also hear them described as “manic eyes.”
For many people, mania does involve increased excitability, energy, and restlessness. Eyes can certainly reflect these mood shifts. Excitement, for example, could lead to wider eyes or eyes that seem to shine and sparkle.
Bipolar disorder involves more than just excitement and high energy. Symptoms of psychosis, including delusions or hallucinations, can also happen during manic episodes. Since delusions and hallucinations can feel frightening, pupils may dilate in response.
The release of this hormone can lead to pupil dilation.
Sure, some people with bipolar disorder (or their loved ones) might notice some changes in their eyes and gaze during a mood episode.
But since this won’t necessarily hold true for everyone, this assumption can be unhelpful, if not harmful. For example:
- If you suspect you could have bipolar disorder but don’t notice anything different about your eyes, you might put off seeking professional support and treatment.
- Maybe you look for changes in a loved one’s eyes to recognize when they’re having a mood episode. If you don’t notice any sparkling or color changes, you might assume they’re just fine and fail to notice other key signs.
Mixed features mood episodes involve both mania and depression symptoms, such as:
- low mood accompanied by extreme energy and restlessness
- irritability and anger combined with racing thoughts and fast speech
- inability to stop laughing despite a sense of worthlessness or despair
These emotions may feel more overwhelming and difficult to manage. Anger and irritability may appear in facial expressions, including the eyes. Some people simply have more expressive faces.
Keep in mind that plenty of everyday experiences can prompt feelings of excitement, fear, or anger. People living with bipolar disorder can still experience these common emotions, whether they’re having a mood episode or not.
Both depression and mania can also lead to changes in sleeping habits, which might affect the eyes. For example:
- Someone who always feels tired and fatigued might have trouble focusing and keeping their eyes open.
- Someone not getting the right amount of sleep might have more bloodshot eyes and blink more often due to dryness from lack of sleep.
To date, no scientific studies have explored changes in eye color or shape as a result of bipolar disorder. In other words, no actual evidence supports these anecdotes.
There is some evidence to suggest bipolar disorder can involve changes in eye movements.
Saccadic eye movements
A
Saccadic eye movements are quick, sudden movements that change the direction of eye focus, generally toward an object of interest. These movements often happen as a reflex, but you can also make them intentionally.
For example, you make these movements when you:
- read a book
- look around a store to find the department you want
- respond to a sudden loud noise
Experts recognize irregular saccadic eye movements as a common feature of some psychiatric conditions, like
Several studies evaluated in the review included people with bipolar disorder. Some results suggest people living with the condition tend to have a harder time with anti-saccadic eye movements, or movements away from the target of focus.
Researchers noted, for example, a slower reaction time and more errors when comparing people with bipolar disorder to controls.
Most of the studies were fairly small, though, and more research is needed.
Vergence eye movements
A 2022 study explored differences in vergence eye movements by comparing 32 adults with bipolar disorder with 25 control participants.
Vergence eye movements align your eyes with an object of interest. Your eyes move in different directions, with your line of sight meeting or separating, so you can focus on something that’s either closer to you or farther away.
The findings suggest people with bipolar disorder tend to make more errors in vergence eye movements. They also seem to experience more irregular saccadic eye movements, like so-called “catchup saccades” (which help a slow-moving gaze catch up with the object of interest).
To an observer, this could seem like rapid eye movements, or fast eye movements in different directions.
Study authors also noted that people who’ve had bipolar disorder for a longer period of time may show more irregularities in these eye movements. They suggested the progression of bipolar disorder as one potential explanation for changes in eye movements.
No existing scientific evidence suggests people with bipolar disorder show any obvious or noticeable differences in eye color or shape. The idea of “bipolar eyes” falls into the realm of well-worn bipolar myths.
Here are a few other myths you may have encountered.
Myth: Bipolar disorder always involves manic episodes
Truth: Manic episodes are only required for a diagnosis of bipolar 1. Other types of bipolar disorder can involve hypomania instead, which might not be as noticeable, especially when you do not know someone well.
Myth: Mood episodes always happen rapidly
Truth: Some people might have more than one mood episode at a time, while others may have only one or two per year.
They may also notice gradual changes in their mood and energy levels for a few days before the episode rather than a sudden “swing” into mania or depression.
Myth: Mania feels good
Truth: If mania represents the “high” emotional state, you might reason it feels exciting, even fun, to be on top of the world, so to speak. But mania also represents a loss of control, so it’s not possible to simply “calm down” or stem the flood of energy.
Mania can lead to:
- risk-taking
- impulsive decisions
- increased irritability
Any of these can affect relationships and daily life. Mania can also involve symptoms of psychosis, which can be pretty distressing.
Experts have found limited support for some eye movement changes in people living with bipolar disorder. And certainly, when you know someone well, you might pick up on slight shifts in their gaze or facial expressions.
For the most part, though, these differences are not all that noticeable to the average person.
When you want to support a friend or loved one with bipolar disorder, it’s generally far more helpful to pay attention to changes in their mood rather than their eyes.