People with bipolar disorder experience unusually intense emotional
states that occur in distinct periods called "mood episodes." 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. It is possible for someone with bipolar
disorder to experience a long-lasting period of unstable moods
rather than discrete episodes of depression or mania.
A person may be having an episode of bipolar disorder if he or
she has a number of manic or depressive symptoms for most of the
day, nearly every day, for at least one or two weeks. Sometimes
symptoms are so severe that the person cannot function normally at
work, school, or home.
Symptoms of bipolar disorder are described below.
|Symptoms of mania or a manic episode include:
||Symptoms of depression or a depressive episode include:
- A long period of feeling "high," or an overly happy
or outgoing mood
- Extremely irritable mood, agitation, feeling "jumpy"
- Talking very fast, jumping from one idea to another,
having racing thoughts
- Being easily distracted
- Increasing goal-directed activities, such as taking
on new projects
- Being restless
- Sleeping little
- Having an unrealistic belief in one's abilities
- Behaving impulsively and taking part in a lot of
high-risk behaviors, such as spending sprees, impulsive
sex, and impulsive business investments.
- A long period of feeling worried or empty
- Loss of interest in activities once enjoyed,
- Feeling tired or "slowed down"
- Having problems concentrating, remembering, and
- Being restless or irritable
- Changing eating, sleeping, or other habits
- Thinking of death or suicide, or attempting suicide.
In addition to mania and depression, bipolar disorder can cause a
range of moods, as shown on the scale.
One side of the scale includes severe depression, moderate depression,
and mild low mood. Moderate depression may cause less extreme
symptoms, and mild low mood is called dysthymia when it is chronic
or long-term. In the middle of the scale is normal or balanced mood.
At the other end of the scale are hypomania and severe mania.
Some people with bipolar disorder experience hypomania. During
hypomanic episodes, a person may have increased energy and activity
levels that are not as severe as typical mania, or he or she may
have episodes that last less than a week and do not require
emergency care. A person having a hypomanic episode may feel very
good, be highly productive, and function well. This person may not
feel that anything is wrong even as family and friends recognize the
mood swings as possible bipolar disorder. Without proper treatment,
however, people with hypomania may develop severe mania or
During a mixed state, symptoms often include agitation, trouble
sleeping, major changes in appetite, and suicidal thinking. People
in a mixed state may feel very sad or hopeless while feeling
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, psychotic symptoms for a person having a manic episode may
include believing he or she is famous, has a lot of money, or has
special powers. In the same way, a person having a depressive
episode may believe he or she is ruined and penniless, or has
committed a crime. As a result, people with bipolar disorder who
have psychotic symptoms are sometimes wrongly diagnosed as having
schizophrenia, another severe mental illness that is linked with
hallucinations and delusions.
People with bipolar disorder may also have behavioral problems.
They may abuse alcohol or substances, have relationship problems, or
perform poorly in school or at work. At first, it's not easy to
recognize these problems as signs of a major mental illness.