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Bipolar Disorder

Most people associate Bipolar disorder with the ups-and-downs in mood.  In all actuality, the ups-and-downs are experienced within the context of several mental health related illnesses.  The key to diagnosing Bipolar is this particular symptom being among a cluster of other symptoms experienced by one diagnosed with the illness.

So – What is Bipolar Illness?

What are the signs and symptoms of bipolar disorder?

People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.”

Each mood episode represents a drastic change from a person’s usual mood and behavior.

An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode. Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood.

Symptoms of mania or a manic episode include: Symptoms of depression or a depressive episode include:
Mood Changes

  1. An overly long period of feeling “high,” or an overly happy or outgoing mood.
  2. Extreme irritability.

Behavioral Changes

  1. Talking very fast, jumping from one idea to another, having racing thoughts.
  2. Being unusually distracted.
  3. Increasing activities, such as taking on multiple new projects.
  4. Being overly restless.
  5. Sleeping little or not being tired.
  6. Having an unrealistic belief in your abilities.
  7. Behaving impulsively and engaging in pleasurable, high-risk behaviors.
 Mood Changes

  1. An overly long period of feeling sad or hopeless.
  2. Loss of interest in activities once enjoyed, including sex.

Behavioral Changes

  1. Feeling overly tired or “slowed down.”
  2. Having problems concentrating, remembering, and making decisions.
  3. Being restless or irritable.
  4. Changing eating, sleeping, or other habits.
  5. Thinking of death or suicide, or attempting suicide.

Bipolar disorder can be present even when mood swings are less extreme. For example, some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomanic episode, you may feel very good, be highly productive, and function well. You may not feel that anything is wrong, but family and friends may recognize the mood swings as possible bipolar disorder. Without proper treatment, people with hypomania may develop severe mania or depression.

Bipolar disorder may also be present in a mixed state, in which you might experience both mania and depression at the same time. During a mixed state, you might feel very agitated, have trouble sleeping, experience major changes in appetite, and have suicidal thoughts. People in a mixed state may feel very sad or hopeless while at the same time feel extremely energized.

Sometimes, a person with severe episodes of mania or depression has psychotic symptoms too, such as hallucinations or delusions. The psychotic symptoms tend to reflect the person’s extreme mood. For example, if you are having psychotic symptoms during a manic episode, you may believe you are a famous person, have a lot of money, or have special powers. If you are having psychotic symptoms during a depressive episode, you may believe you are ruined and penniless, or you have committed a crime. As a result, people with bipolar disorder who have psychotic symptoms are sometimes misdiagnosed with schizophrenia.

People with bipolar disorder may also abuse alcohol or substances, have relationship problems, or perform poorly in school or at work. It may be difficult to recognize these problems as signs of a major mental illness.

How is bipolar disorder diagnosed?

Bipolar disorder usually lasts a lifetime. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of symptoms, but some people may have lingering symptoms.

Doctors diagnose bipolar disorder using guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM). To be diagnosed with bipolar disorder, the symptoms must be a major change from your normal mood or behavior. There are four basic types of bipolar disorder:

  1. Bipolar I Disorder—defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.
  2. Bipolar II Disorder—defined by a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.
  3. Bipolar Disorder Not Otherwise Specified (BP-NOS)—diagnosed when symptoms of the illness exist but do not meet diagnostic criteria for either bipolar I or II. However, the symptoms are clearly out of the person’s normal range of behavior.
  4. Cyclothymic Disorder, or Cyclothymia—a mild form of bipolar disorder. People with cyclothymia have episodes of hypomania as well as mild depression for at least 2 years. However, the symptoms do not meet the diagnostic requirements for any other type of bipolar disorder.