Traits of bipolar disorder
Symptoms - Bipolar disorder - NHS
Bipolar disorder is characterised by extreme mood swings. These can range from extreme highs (mania) to extreme lows (depression).
Episodes of mania and depression often last for several weeks or months.
Depression
During a period of depression, your symptoms may include:
- feeling sad, hopeless or irritable most of the time
- lacking energy
- difficulty concentrating and remembering things
- loss of interest in everyday activities
- feelings of emptiness or worthlessness
- feelings of guilt and despair
- feeling pessimistic about everything
- self-doubt
- being delusional, having hallucinations and disturbed or illogical thinking
- lack of appetite
- difficulty sleeping
- waking up early
- suicidal thoughts
Mania
The manic phase of bipolar disorder may include:
- feeling very happy, elated or overjoyed
- talking very quickly
- feeling full of energy
- feeling self-important
- feeling full of great new ideas and having important plans
- being easily distracted
- being easily irritated or agitated
- being delusional, having hallucinations and disturbed or illogical thinking
- not feeling like sleeping
- not eating
- doing things that often have disastrous consequences – such as spending large sums of money on expensive and sometimes unaffordable items
- making decisions or saying things that are out of character and that others see as being risky or harmful
Patterns of depression and mania
If you have bipolar disorder, you may have episodes of depression more regularly than episodes of mania, or vice versa.
Between episodes of depression and mania, you may sometimes have periods where you have a "normal" mood.
The patterns are not always the same and some people may experience:
- rapid cycling – where a person with bipolar disorder repeatedly swings from a high to a low phase quickly without having a "normal" period in between
- mixed state – where a person with bipolar disorder experiences symptoms of depression and mania together; for example, overactivity with a depressed mood
If your mood swings last a long time but are not severe enough to be classed as bipolar disorder, you may be diagnosed with a mild form of bipolar disorder called cyclothymia.
Living with bipolar disorder
Bipolar disorder is a condition of extremes. A person with bipolar disorder may be unaware they're in the manic phase.
After the episode is over, they may be shocked at their behaviour. But at the time, they may believe other people are being negative or unhelpful.
Some people with bipolar disorder have more frequent and severe episodes than others.
The extreme nature of the condition means staying in a job may be difficult and relationships may become strained. There's also an increased risk of suicide.
During episodes of mania and depression, someone with bipolar disorder may experience strange sensations, such as seeing, hearing or smelling things that are not there (hallucinations).
They may also believe things that seem irrational to other people (delusions). These types of symptoms are known as psychosis or a psychotic episode.
Find out more about living with bipolar disorder
Page last reviewed: 14 March 2019
Next review due: 14 March 2022
Bipolar disorder - Symptoms and causes
Overview
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.
Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.
Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
Bipolar disorder care at Mayo Clinic
Products & Services
- Book: Mayo Clinic Family Health Book, 5th Edition
- Newsletter: Mayo Clinic Health Letter — Digital Edition
Symptoms
There are several types of bipolar and related disorders.
They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.
- Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.
- Cyclothymic disorder. You've had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.
Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.
Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.
Mania and hypomania
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
- Abnormally upbeat, jumpy or wired
- Increased activity, energy or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Distractibility
- Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments
Major depressive episode
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships.
An episode includes five or more of these symptoms:
- Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Marked loss of interest or feeling no pleasure in all — or almost all — activities
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
- Either insomnia or sleeping too much
- Either restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning or attempting suicide
Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others.
The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.
Symptoms in children and teens
Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.
Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.
The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.
When to see a doctor
Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need.
And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.
If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.
When to get emergency help
Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Request an Appointment at Mayo Clinic
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.
To provide you with the most relevant and helpful information, and understand which
information is beneficial, we may combine your email and website usage information with
other information we have about you. If you are a Mayo Clinic patient, this could
include protected health information. If we combine this information with your protected
health information, we will treat all of that information as protected health
information and will only use or disclose that information as set forth in our notice of
privacy practices.
You may opt-out of email communications at any time by clicking on
the unsubscribe link in the e-mail.
Causes
The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:
- Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
- Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.
Risk factors
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:
- Having a first-degree relative, such as a parent or sibling, with bipolar disorder
- Periods of high stress, such as the death of a loved one or other traumatic event
- Drug or alcohol abuse
Complications
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
- Problems related to drug and alcohol use
- Suicide or suicide attempts
- Legal or financial problems
- Damaged relationships
- Poor work or school performance
Co-occurring conditions
If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder.
Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:
- Anxiety disorders
- Eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug problems
- Physical health problems, such as heart disease, thyroid problems, headaches or obesity
More Information
- Bipolar disorder care at Mayo Clinic
- Bipolar disorder and alcoholism: Are they related?
Prevention
There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:
- Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse.
You may have identified a pattern to your bipolar episodes and what triggers them. Call your doctor if you feel you're falling into an episode of depression or mania. Involve family members or friends in watching for warning signs. - Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
- Take your medications exactly as directed. You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.
By Mayo Clinic Staff
Related
Associated Procedures
Products & Services
Bipolar Disorder | Symptoms, complications, diagnosis and treatment
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
Episodes of mood swings may occur infrequently or several times a year.
When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When the mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, alertness, judgment, behavior, and the ability to think clearly.
Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medication and psychological counseling (psychotherapy).
Symptoms
There are several types of bipolar and related disorders. These may include mania, hypomania, and depression. The symptoms can lead to unpredictable changes in mood and behavior, leading to significant stress and difficulty in life.
- Bipolar disorder I.
You have had at least one manic episode, which may be preceded or accompanied by hypomanic or major depressive episodes. In some cases, mania can cause a break with reality (psychosis). - Bipolar disorder II. You have had at least one major depressive episode and at least one hypomanic episode, but never had a manic episode.
- Cyclothymic disorder. You have had at least two years - or one year in children and adolescents - many periods of hypomanic symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types. These include, for example, bipolar and related disorders caused by certain drugs or alcohol, or due to health conditions such as Cushing's disease, multiple sclerosis, or stroke.
Bipolar II is not a milder form of Bipolar I but is a separate diagnosis. Although bipolar I manic episodes can be severe and dangerous, people with bipolar II can be depressed for longer periods of time, which can cause significant impairment.
Although bipolar disorder can occur at any age, it is usually diagnosed in adolescence or early twenties. Symptoms can vary from person to person, and symptoms can change over time.
Mania and hypomania
Mania and hypomania are two different types of episodes, but they share the same symptoms. Mania is more pronounced than hypomania and causes more noticeable problems at work, school, and social activities, as well as relationship difficulties. Mania can also cause a break with reality (psychosis) and require hospitalization.
Both a manic episode and a hypomanic episode include three or more of these symptoms:
- Abnormally optimistic or nervous
- Increased activity, energy or excitement
- Exaggerated sense of well-being and self-confidence (euphoria)
- Reduced need for sleep
- Unusual talkativeness
- Distractibility
- Poor decision-making - for example, in speculation, in sexual encounters or in irrational investments
Major depressive episode
Major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in daily activities such as work, school, social activities, or relationships.
Episode includes five or more of these symptoms:
- Depressed mood, such as feeling sad, empty, hopeless, or tearful (in children and adolescents, depressed mood may manifest as irritability)
- Marked loss of interest or feeling of displeasure in all (or nearly all) activities
- Significant weight loss with no diet, weight gain, or decreased or increased appetite (in children, failure to gain weight as expected may be a sign of depression)
- Either insomnia or sleeping too much
- Either anxiety or slow behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking, planning or attempting suicide
Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorder may include other signs such as anxiety disorder, melancholia, psychosis, or others.
The timing of symptoms may include diagnostic markers such as mixed or fast cycling. In addition, bipolar symptoms may occur during pregnancy or with the change of seasons.
When to see a doctor
Despite extreme moods, people with bipolar disorder often do not realize how much their emotional instability disrupts their lives and the lives of their loved ones and do not receive the necessary treatment.
And if you are like people with bipolar disorder, you can enjoy feelings of euphoria and be more productive. However, this euphoria is always accompanied by an emotional disaster that can leave you depressed and possibly in financial, legal, or other bad relationships.
If you have symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder does not improve on its own. Getting mental health treatment with a history of bipolar disorder can help control your symptoms.
14 Early Symptoms of Bipolar Disorder You Shouldn't Ignore
October 19, 2020 Likbez Health
Psychosis is closer than it seems.
Check it out.
This disorder was brought to the fore a few years ago when Catherine Zeta-Jones was diagnosed with bipolar disorder.
Catherine Zeta-Jones
actress
Millions of people suffer from this, and I'm just one of them. I say this out loud so that people know that there is no shame in seeking professional help in such a situation.
Largely due to the courage of the black-haired Hollywood diva, other celebrities began to admit that they were experiencing this psychosis: Mariah Carey, Mel Gibson, Ted Turner ... Doctors suggest bipolar disorder in already deceased famous people: Kurt Cobain, Jimi Hendrix, Ernest Hemingway, Vivien Leigh, Marilyn Monroe…
Listing familiar names is only needed to show that psychosis is very close to you. And maybe even you.
What is bipolar disorder
At first glance, it's okay. Just mood swings. For example, in the morning you want to sing and dance for the joy that you live. In the middle of the day, you suddenly snap at colleagues who distract you from something important.
By evening, a severe depression rolls over you, when you can’t even raise your hand ... Familiar?
The line between mood swings and manic-depressive psychosis (this is the second name of this disease) is thin. But she is.
The attitude of those who suffer from bipolar disorder constantly jumps between the two poles. From an extreme maximum (“What a thrill it is to just live and do something!”) to an equally extreme minimum (“Everything is bad, we will all die. So, maybe there is nothing to wait, it's time to lay hands on yourself ?!”). The highs are called periods of mania. The lows are periods of depression.
A person realizes how stormy he is and how often these storms have no reason, but he cannot do anything with himself.
Manic-depressive psychosis exhausts, worsens relationships with others, sharply reduces the quality of life and, as a result, can lead to suicide.
Where does bipolar disorder come from
Mood swings are familiar to many and are not considered something out of the ordinary.
Therefore, bipolar disorder is quite difficult to diagnose. However, scientists are getting better at it. In 2005, for example, about 5 million Americans were estimated to suffer from some form of manic-depressive psychosis.
Bipolar disorder is more common in women than in men. Why is not known.
However, despite the large statistical sample, the exact causes of bipolar disorders have not yet been clarified. It is only known that:
- Manic-depressive psychosis can occur at any age. Although it appears most often in late adolescence and early adulthood.
- It can be caused by genetics. If one of your ancestors had this disease, there is a risk that it will knock on your door too.
- The disorder is associated with an imbalance of chemicals in the brain. Mainly serotonin.
- The trigger is sometimes severe stress or injury.
How to Recognize the Early Symptoms of Bipolar Disorder
In order to capture unhealthy mood swings, you first need to find out if you are experiencing emotional extremes - mania and depression.
7 Key Signs of Mania
- You experience high spirits and a sense of happiness for long (several hours or more) periods.
- You have a reduced need for sleep.
- You speak fast. And so much so that those around you do not always understand, and you do not have time to formulate your thoughts. As a result, it is easier for you to communicate in instant messengers or through emails than to talk to people live.
- You are an impulsive person: first you act, then you think.
- You are easily distracted and jump from one thing to another. As a result, productivity often suffers.
- You are confident in your abilities. It seems to you that you are faster and smarter than most of those around you.
- You often exhibit risky behavior. For example, agreeing to have sex with a stranger, buying something that you can't afford, participating in spontaneous street races at traffic lights.
7 key signs of depression
- You often experience protracted (several hours or more) periods of unmotivated sadness and hopelessness.
- You withdraw into yourself. It's hard for you to come out of your own shell. Therefore, you limit contacts even with family and friends.
- You have lost interest in those things that used to really cling to you, and have not gained anything new in return.
- Your appetite has changed: it has dropped sharply or, on the contrary, you no longer control how much and what exactly you eat.
- You regularly feel tired and lack energy. And such periods go on for quite a long time.
- You have problems with memory, concentration and decision making.
- You sometimes think about suicide. Catch yourself thinking that life has lost its taste for you.
Manic-depressive psychosis is when you recognize yourself in almost all the situations described above. At some point in your life, you clearly show signs of mania, and at other times, symptoms of depression.
However, sometimes it also happens that the symptoms of mania and depression manifest themselves at the same time and you cannot understand which phase you are in.
This condition is called mixed mood and is also one of the signs of bipolar disorder.
What is bipolar disorder like
Depending on which episodes occur more often (manic or depressive) and how pronounced they are, bipolar disorder is divided into several types.
- Disorder of the first type. It is heavy, alternating periods of mania and depression are strong and deep.
- Type II disorder. Mania does not manifest itself too brightly, but it covers with depression just as globally as in the case of the first type. By the way, Catherine Zeta-Jones was diagnosed with it. In the case of the actress, the trigger for the development of the disease was throat cancer, which her husband, Michael Douglas, fought for a long time.
Regardless of the type of manic-depressive psychosis in question, the disease in any case requires treatment. And preferably faster.
What to do if you suspect you have bipolar disorder
Don't ignore your feelings.
If you are familiar with 10 or more of the above signs, this is already a reason to consult a doctor. Especially if from time to time you catch yourself in suicidal moods.
First, go to a therapist. The doctor will suggest that you do several tests, including a urine test, as well as a blood test for the level of thyroid hormones. Often, hormonal problems (in particular, developing diabetes, hypo- and hyperthyroidism) are similar to bipolar disorder. It is important to exclude them. Or treat if found.
The next step will be a visit to a psychologist or psychiatrist. You will have to answer questions about your lifestyle, mood swings, relationships with others, childhood memories, trauma, and family history of illness and drug incidents.
Based on the information received, the specialist will prescribe treatment. It can be both behavioral therapy and medication.
Let's finish with the phrase of the same Catherine Zeta-Jones: “There is no need to endure. Bipolar disorder can be controlled.
