While many people with bipolar disorder can drive safely, there are several important factors that could affect your driving fitness. These include having severe episodes of psychosis or mania, being on medication that prohibits driving, or having another health condition that makes driving unsafe.

Bipolar disorder is a chronic mental health condition characterized by extreme shifts in mood. There are several types of bipolar disorder, but the most common are bipolar disorders type 1 and 2.

There’s not a lot of research on bipolar disorder and driving fitness, and existing study results are mixed.

If you have questions or concerns about your ability to drive because of your bipolar disorder, talk with a doctor. Safety always comes first, and sometimes taking a break from driving while you adjust your treatment plan may be advised.

Driving fitness refers to your physical and mental capability to drive safely. Bipolar disorder has been found to affect cognition (your thought processes) but the way it affects your driving fitness is a bit more complicated.

Research from 2015 found that common cognitive impairments in people with bipolar disorder can include delayed reaction time and poor decision making.

A 2022 study found that people with bipolar disorder had longer response times than those without bipolar disorder. Researchers measured the reaction times of 33 people with bipolar disorder (in remission) against 33 people without it using 2 computer tests.

Delays in reaction time were shown in participants’ results on both a neuropsychological test and a psychometric test designed for drivers. These types of tests measure people’s ability to process information and make timely decisions.

Participants in this study displayed deficits in verbal memory, which can affect the reading and processing of signs and external information.

Results also indicated people with bipolar disorder were more likely than the control group to “have problems with visual search, scanning of the external situation, speed of processing of external information, and mental flexibility.”

Further research on how or if this translates to actual driving performance is needed.

Research from 2019 found that there is a lack of driving evaluation services to measure fitness to drive in people with mental illness. Researchers found that mental health professionals often did not address driving concerns with their clients and pointed out the lack of standard tests to evaluate driving fitness in people with mental health conditions.

However, based on general research into bipolar disorder’s effects on cognitive function, it’s clear further study of driving fitness in relation to the condition is needed.

Let’s go over some of the ways bipolar disorder symptoms and treatments might affect your driving.

Certain symptoms of bipolar disorder may impact driving fitness by affecting your thought processes, motor skills, or energy level. Knowing what signs to look for can help you make more informed decisions about your driving and recognize when to seek help.

Manic episodes

Mania refers to a state of highly elevated mood and is a hallmark of bipolar disorder type 1. Hypomania is a lesser version of mania and appears in bipolar disorder type 2.

Mania is often associated with heightened creativity and confidence, but it can present real dangers. A manic episode can cause irritability, poor decision making, and harmful behavior.

People with mania might feel invincible and overly confident in their abilities. They may experience racing thoughts, which can lead to a distracted state of mind.

This can be especially dangerous when you’re driving by causing you to drive too fast or recklessly and put yourself and others at risk.

Psychosis

Psychosis describes a mental state in which a person has lost touch with reality. While experiencing an episode of psychosis, a person may not know what is real and what is not. This can include hallucinations, paranoia, and delusions.

Many people with bipolar disorder do not experience psychosis but some do. Psychosis in bipolar disorder can occur as a result of a severe manic or depressive episode.

The mental and physical effects of psychosis make it completely unsafe to drive while in this state.

Suicidal thoughts

Bipolar disorder depression can lead to feelings of hopelessness, worthlessness, and wanting to die. People with bipolar disorder have a 10 to 30 times higher rate of suicide than the general population.

Suicidal thoughts can occur during a depressive episode of bipolar disorder. Managing suicidal thoughts may worsen your concentration, make you feel exhausted, and slow down your motor functioning.

If a person is experiencing suicidal thoughts, they may not be thinking about their own safety or the safety of others while driving. They may even consider using the car as a tool to end their own life.

If you or a loved one are having suicidal thoughts, it’s important to seek emergency assistance immediately. It is not advisable to let a person with thoughts of suicide out of your sight or drive somewhere on their own.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

While you wait for help to arrive, stay with them and remove any weapons or substances that can cause harm.

If you are not in the same household, stay on the phone with them until help arrives.

Medication side effects

The previously mentioned 2019 research pointed to the umbrella of psychotropic drugs as potentially having side effects that could impact driving. This includes medications commonly used to treat bipolar disorder, such as antidepressants, antipsychotics, and mood stabilizers.

Some medications for bipolar disorder may cause side effects like sleepiness and sedation, according to 2019 research. These sedative effects can be a risk to driving fitness. Sedative drugs slow down your body’s systems and may make you feel sluggish and exhausted.

Even if you’re not sleepy (or do not think you are), medication can impair your thinking, focus, and reaction time, among other effects.

Talk with a doctor about your prescription medications, their side effects, and any possible effects they could have on your driving. It’s also important that your doctor knows every other medication you take to make sure there are no dangerous drug interactions.

Some medications have a label warning not to drive or to wait a certain amount of time before driving. Always take medications as directed by your doctor and read the label.

Driving under the influence

Substance use can impair driving ability in anyone, including those with bipolar disorder. At least half of all adults with bipolar disorder also deal with a substance use disorder at some point in their lives.

You could seriously harm or even kill yourself or others while driving under the influence. It’s also a crime that can be considered a misdemeanor or felony.

If you’re currently dealing with a substance use disorder, help is available. Visit SAMHSA to learn more about next steps and find a treatment center near you.

While your personal medical information is private, your state’s DMV may launch an investigation into your driving fitness if they have a good reason.

Reasons for a DMV investigation can include:

  • having incidents with law enforcement surrounding your driving or exhibiting irregular behavior during a traffic incident
  • being reported by another driver on the road
  • being reported by a family member or loved one concerned about your driving fitness

If the DMV finds cause for a complaint or tip against you, they may put you on medical probation or even suspend your license. The specifics may vary by state, but medical probation usually has different levels of severity.

Being on medical probation can mean you are still allowed to drive but must prove to the DMV you are in active treatment for your condition.

The DMV can restrict or revoke licenses if they believe someone’s mental or physical health condition makes them unfit to drive. Consult your state DMV website or branch for more information on medical probations, or how to appeal them.

Living with bipolar disorder can be challenging and affect every aspect of daily life. While there’s no cure for bipolar disorder, there are treatment options that can help you stabilize and feel like yourself again.

Effectively managing your bipolar disorder is the most important thing you can do for your overall health, well-being, and driving fitness.

According to the National Institute of Mental Health, common treatment approaches for bipolar disorder include:

  • Medication. Medications used to treat bipolar disorder include mood stabilizers, antipsychotics, and antidepressants. Sometimes, people need to try more than one medication or a combination before finding the right fit for them.
  • Therapy. Talk therapy combined with medication is considered the gold standard for treating bipolar disorder.
  • Lifestyle changes. In addition to other treatment approaches, lifestyle adjustments can encourage stability and improve general well-being. These include getting enough sleep and exercise and eating a balanced diet.

It’s also important to build and maintain a strong emotional support network when living with and seeking treatment for bipolar disorder. This can include any combination of family, friends, mental health professionals, peer support groups, and mentors.

Most people with bipolar disorder are fit to drive. However, there are several reasons related to bipolar disorder that can affect your driving fitness. Managing your bipolar disorder under the guidance of a mental health professional is the best way to maintain your health and driving independence.

Manic episodes, psychosis, and suicidal thoughts can all make someone with bipolar disorder an increased risk behind the wheel. This is because these mental states can impair your ability to think and your reaction times.

Certain medications used to treat bipolar disorder can also have sedative effects that impair driving.

Talk with a doctor about any concerns you might have about your driving fitness, including any troubling symptoms or medication side effects you may be experiencing.