Symptoms of Bipolar Disorder
Understanding and interpreting the symptoms of bipolar disorder goes beyond seeing frequent swings between very good moods (mania or hypomania) and very bad moods (depression). The frequency and severity of these mood swings is also critical to the process of determining a diagnosis and eventually a treatment plan.
The patterns of the manic and depressive behavior, including the frequency and duration of each mood episode, can be very different among bipolar sufferers. Additionally, some people are more prone to either mania or depression, while others will alternate equally between the two extremities.
These differences are key to identifying the exact type of bipolar disorder that a person will be diagnosed with. These variations, along with the fact that related mental disorders share some of the same traits, make it very difficult to translate what appear to be the symptoms of bipolar disorder into an accurate diagnosis.
Interpreting the Signs of Bipolar
Adults, adolescents, and even children can exhibit behavior that can be misconstrued as signs of bipolar disorder. Their exuberance or moodiness does not necessarily make them sufferers of this or any other mental illness. That is why we continue to emphasize the importance seeing a qualified professional who can assess the signs and symptoms and make the proper decision or diagnosis on any individual. The onset of some of the behaviors discussed below may be the early warning signs of bipolar disorder, and can be a signal for a person to seek professional help.
The signs of bipolar disorder fall on either the manic side of the illness or the depression side. When a person is in a manic or a depressed state, that period is called an episode. There are four types of mood episodes based on the severity and frequency of the symptoms being displayed:
- mixed episodes
The tendency of a person to experience any or all of these types of episodes is the key to making the proper bipolar diagnosis.
Each type of bipolar disorder mood episode has a unique set of symptoms.
While in the manic phase of bipolar disorder, people feel raised levels of energy, high creativity, and general euphoria. During a manic episode, a person will often talk a mile a minute, sleep very little, and be very hyperactive.
The manic mood also gives a person an invincible feeling, a sense of power or the expectation of greatness. These illusions of grandeur can be dangerous in several ways. Reckless behavior often emerges, such as spending that gets out of control, excessive gambling, making hasty and imprudent decisions, and engaging in inappropriate sexual behavior. The feeling of invincibility can also lead to aggressive behavior such as picking a fight or taking physical risks.
The person in a manic episode can also react angrily if criticized by friends or family, who may simply be trying to curb the person's risky or outlandish actions. The manic person may also become delusional or hallucinate, even to the point of hearing voices.
Common signs and symptoms of bipolar mania include:
- Feeling unusually "high" and optimistic, or extremely irritable to the point of being argumentative or even violent
- Having unrealistic and grandiose beliefs about one's abilities or powers
- Sleeping very little, but still feeling extremely energetic and fidgety
- Being very talkative, and talking so rapidly that others can't keep up
- Being highly distractible with racing thoughts, and unable to focus or concentrate
- Exhibiting reckless judgment and impulsiveness
- In the more severe cases, having delusions and hallucinations
- Acting overly ambitious and taking on many tasks or projects at once
- Taking risks and going to extremes financially, socially and sexually
- Over-indulging in alcohol or drugs to heighten or prolong the euphoria
- Denial that anything is wrong
Hypomania is a milder, less severe form of mania. A person in a hypomanic state feels euphoric and energetic, but is still able to carry on with the daily routine and not lose touch with reality.
People with hypomania may just be viewed as being in an unusually good mood. But the condition is not entirely harmless. Hypomania can still result in bad decisions that harm relationships, careers, and reputations. In addition, hypomania can escalate into a full-blown manic episode or be followed by a major depressive episode.
The symptoms of hypomania are similar to those of mania, but just to a lesser extent.
The more common symptoms of bipolar depression include:
|Irritability or restlessness
||Concentration and memory problems, and unable to make decisions
|Feeling inappropriately guilty
||Feeling hopeless, sad, worthless, or empty
|Inability to experience pleasure
||Experiencing physiological changes like differences in appetite or weight, energy levels, and sleep schedules
|Physical and mental sluggishness
||Chronic discomfort or pain with no physical cause being evident
|Loss of interest in things and activities previously enjoyed, including sex
||Recurring thoughts about death or suicide, in extreme cases, sometimes with suicide attempt or a specific plan for committing suicide
The medical profession has only recently recognized that bipolar depression is not the same as regular depression. The differences lie mostly in the person's response to treatment, more than in the symptoms exhibited.
The signs of depression in each case are similar, and the potential damage to the individual and their personal and professional relationships is also similar. Without proper treatment, this end of the bipolar mood swing can lead to divorce, loss of job, substance abuse including alcohol and drugs, and suicide.
Some of the symptoms of bipolar depression are believed to be more prevalent than in regular depression. Examples are irritability, feelings of guilt, and restlessness. People with bipolar depression are also less physically active, sleeping a lot, and gaining weight. In addition, they are more likely to develop psychotic depression - a condition in which they've lost contact with reality. This psychotic behavior can further hinder their ability to function in social and work settings.
Dysthymia is a close relative of bipolar depression, though less severe and without the manic half of bipolar disorder.
A mixed episode of bipolar disorder involves simultaneous symptoms of both mania (or hypomania) and depression. Those individuals who experience mixed episodes are diagnosed with a variation of bipolar disorder called, appropriately, mixed bipolar. The person experiencing a mixed episode will suffer from depression combined with irritability, agitation, anxiety, insomnia, distractibility, and racing thoughts. This combination of high energy and low mood is dangerous in that it increases the risk of suicide.
There are over two million people in the United States alone who are afflicted with Bipolar Disorder. How many of them are accurately diagnosed and under treatment? Not enough. A thorough, professional assessment of the symptoms is required to develop a correct diagnosis and implement an effective treatment plan. Much easier said than done.
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