These shifts in mood tend to range from feelings of being extremely happy and elated with a lot of energy and feelings of being down and depressed. These are known as manic episodes and depressive episodes respectively.
Hypomania is a period of feeling "up" that is less extreme than standard manic episodes.
Symptoms of bipolar disorder
Bipolar disorder is marked by mood swings from mania to depression.
- Having a lot of energy
- Difficulty sleeping
- Increase in risky behaviors, like reckless sex or spending lots of money
- Rapid speech
- Being very agitated
- Feeling jumpy
It's important to know that a person in a manic state isn't aware of their unusual behavior. They may not realize that they are acting inappropriately, or be aware of the potential consequences of their behavior. They may need help in getting help and staying safe.
A less severe manic episode is known as hypomania. Symptoms of hypomania are similar to mania, but the person may be able to function well in their daily life.
If signs of hypomania aren't addressed, it can progress into a more severe form of the condition.
Signs of a depressive episode are the same as the symptoms of depression. They may include:
- Feeling down or sad
- Having very little energy
- Trouble sleeping or sleeping a lot more than usual
- Thoughts of death or suicide
- Lack of enjoyment in daily activities
Sometimes it is possible to see signs of bipolar disorder in young children and teenagers. Toddlers or young kids may have severe temper tantrums that can last for hours and become violent over time. Parents may also notice periods of extreme happiness and silly moods.
Teenagers may show some of the more common signs of bipolar disorder, especially an increase in risky behaviors, such as:
- Reckless sexual activity, drug or alcohol use
- Poor performance in school
- Increased fascination with death or suicide
It is important that any young person showing these symptoms sees a mental health professional.
Should I see a doctor?
It's always a good idea to speak with a doctor when there is concern about severe mood swings that seem to come and go or make it difficult to work.
The primary care physician is a good starting point. However, they will likely refer someone with these symptoms to a psychiatrist, or a specialist who cares for people with mental health disorders.
Someone who notices these symptoms in a friend or loved one can also speak with their doctor about their concerns. The doctor can help find local support groups or other mental health resources.
Suicide is a real risk for people with bipolar disorder. That risk is present at each phase of the disease, not just during the depressive state. In fact, people with bipolar may become more likely to commit suicide during the manic phase because they have more energy to complete their plan.
Whenever there is a risk of suicide, it is important to address the concern quickly and directly. If there is an imminent risk, the local police or suicide crisis hotline should be contacted immediately.
In the United States, the National Suicide Prevention Lifeline is available 24 hours a day, 7 days a week, and is toll-free: 1-800-273-TALK (8255).
It is not uncommon for people with bipolar disorder to experience other mental health conditions, such as:
People with bipolar disorder often experience other mental health conditions such as anxiety.
- Posttraumatic stress disorder
- Attention deficit hyperactivity disorder
- Substance abuse problems
Severe mania or depression can also lead to psychotic episodes, where a person has hallucinations.
Mania can include delusions of grandeur. During periods of depression, hallucinations tend to be more negative. This can sometimes lead to someone being misdiagnosed with schizophrenia, a mental health disorder marked by persistent hallucinations and delusions.
Treating these conditions may make it more difficult to diagnose or treat bipolar disorder. However, once the symptoms are successfully controlled with medication, these related conditions usually improve as well.
Bipolar disorder has also been linked with some medical conditions that may need to be monitored, including:
Types of bipolar disorder
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), there are four types of bipolar disorder.
1. Bipolar I disorder
A person with bipolar I disorder has periods of mania that last at least 7 days. Someone who has manic episodes that are so severe that they require immediate hospitalization may also be diagnosed with bipolar I disorder.
2. Bipolar II disorder
A person with bipolar II disorder has both episodes of depression and hypomania. People with bipolar II disorder tend to not have full manic episodes.
3. Cyclothymic disorder
Someone with cyclothymic disorder will also have alternating periods of hypomania and depression, which last for at least 2 years.
The main difference between cyclothymic disorder and bipolar II is that the symptoms of a person with cyclothymia tend to be less severe and don't meet the criteria for hypomania and depression.
4. Other specified and unspecified bipolar disorders
A person may have bipolar disorder that doesn't fit within the above patterns. They may be diagnosed with either "other specified bipolar disorder" or "unspecified bipolar disorder," depending on their symptoms.
Diagnosis of bipolar disorder
In order to diagnose bipolar disorder, a doctor will complete a medical interview and physical exam. The doctor may also request blood testing or other tests to rule out other medical conditions that might have the same symptoms.
If there are no medical conditions or medicines that are causing the person's symptoms, the doctor will consider bipolar disorder. The best person to diagnose bipolar disorder is a psychiatrist, a specialist who cares for people with mental health disorders.
Treatment for bipolar disorder
Bipolar disorder is most often treated with a combination of medications and talk therapy, or psychotherapy. Because bipolar disorder is a lifelong disease, treatment should be lifelong as well.
Treatment for bipolar disorder often includes talk therapy or psychotherapy.
Medications used to treat bipolar disorder include:
- Mood stabilizers, like lithium and some antiseizure medicines
- Antipsychotics to help manage mania and psychotic symptoms
- Antidepressants to relieve symptoms of depression
If medication and talk therapy aren't successful in managing the symptoms of bipolar disorder, a psychiatrist may consider electroconvulsive therapy, or ECT.
ECT involves applying a controlled electric shock to certain areas of the brain to help regulate mood and symptoms. It is only usually used in cases of severe bipolar disorder, or when the person is unable to take or tolerate medication.
Living with bipolar disorder
Bipolar disorder is a lifelong disorder that can have a severe impact. The condition not only affects the person with the condition, but also the lives of their family and friends.
Getting help early and actively participating in treatment are the keys to successfully managing this condition.